From source to sink: A comparative study of streamside and beach litter in the Black Sea.

The increasing amount of marine litter pollution and its impact on the marine environment raises global concern. This study aims to reveal the effect of streams on marine litter density and composition. A total of ten stations on the southeastern Black Sea and six stations on the Manahoz stream were seasonally surveyed. The litter density ranged between 0.838 ± 0.33 and 4.01 ± 0.55 items/m2 in the beach stations, and 0.93 ± 0.27 2.40 ± 2.18 items/m2 in the streamside stations. No significant difference was determined among the seasons for both beach and streamside (Kruskal-Wallis test, p > 0.05). On the other hand, the litter density was also similar in beach and streamside stations in the same season. The litter composition consisted of > 75% plastic. Principal component analysis and PERMANOVA determined no significant difference in litter composition among beach and streamside stations. The litter items mostly consisted of single-use items. Among them, plastic beverage containers were the most abundant litter subcategory during the study (ranging between 18.79% and 34.50%). The subcategory composition exhibited a significant difference among beach and streamside stations (ANOSIM, p < 0.05), which was mainly explained by plastic pieces, beverage containers, and foams according to SIMPER analysis. Personal protection equipment that was not reported before the COVID-19 pandemic emerged. The results of our study can be used for marine litter modeling studies and legislation for restriction or ban of most abundant single-use litter items.

Spatial pattern and characteristics of the benthic marine litter in the southern Black Sea shelf.

The abundance and characteristics of benthic marine litter in the southern Black Sea shelf were demonstrated. During the surveys, 671 litter items weighing 83.93 kg were collected from the stations. The average density by number and weight were 460.70 ± 99.71 n/km2 and 80.68 ± 48.06 kg/km2. The litter density was significantly higher at 10-20 m (646.09 ± 165.63 n/km2) compared to 20-30 m (165.53 ± 81.02 n/km2) and >30 m (413.87 ± 146.59 n/km2) depth classes. Plastic (69.03%) was the most abundant material by number, followed by textile (20.94%) and metal (5.68%). The litter composition differed between the no-trawl zone and trawl ground. Our results indicate that more detailed research is needed to understand the interaction of various factors influencing transportation and accumulation of marine litter in the Black Sea.

The Number of Patients Diagnosed with Brain Death and Organ Donation Rates at the Baskent University Konya Hospital: 6-Year Experience.

OBJECTIVES: Kidney transplant started at Baskent University Konya Hospital in July 2016. In this study, we compared the causes of brain death and the organ donation rates in our center between 2013 and 2016 versus between 2016 and 2019. MATERIALS AND METHODS: Patient files and records were analyzed retrospectively. Age, biologic sex, cause of brain death, and organ donation rates of patients diagnosed with brain death were examined and compared. RESULTS: The number of patients who were diagnosed with brain death and became deceased donors at our center increased 4-fold during the period from 2016 to 2019 compared with that shown from 2013 to 2016. In addition, organ donation rates increased to 71.4%, which is much higher than the average in Turkey (24%-28%). Between 2013 and 2016, trauma was the leading cause of brain death (42.8%), whereas between 2016 and 2019 cerebral hemorrhages rose to first place with a rate of 89.3%. In 2018 and 2019, there were 199 and 62 brain deaths, respectively, reported in our organ donation coordination region with an approximate organ donation rate of 25%. In our center, 12 patients were diagnosed with brain death in 2018 and 8 of these patients (66.7%) became donors; 6 brain deaths were diagnosed in 2019, and 4 patients (66.7%) became donors. Since we started kidney transplant at our center in 2016, the number of patients diagnosed with brain death has increased significantly. CONCLUSIONS: Establishing a healthy communication with relatives of patients and having a dedicated organ transplant center are important reasons for our much higher organ donation rates compared with the general rate in Turkey. A healthy communication is the most effective way to establish trust with next-of-kin and the general public.

Ultrasound-guided bilateral greater occipital nerve block on headache seen after endovascular treatment of ruptured or unruptured intracranial aneurysms: A case report.

Headache is a common symptom in subarachnoid hemorrhage (SAH). Often, pain control is difficult and opioid use can have a complicated effect on the patient's state of consciousness. In this study of 2 cases, opioid consumption was reduced while effective pain control of headache occurring after endovascular treatment of an intracranial aneurysm was achieved using an ultrasound-guided, bilateral greater occipital nerve (GON) block. Case 1 was a 59-year-old male patient with a Glasgow Coma Scale (GCS) of 13 who was diagnosed with Fisher scale grade 3 SAH. Coiling and stenting were performed for an anterior communicating artery aneurysm. Cerebrospinal fluid drainage was provided with a lumbar spinal catheter. Case 2 was a 55-yearold male patient with a GCS of 15 who underwent coiling of a fusiform aneurysm in the left basilar artery and stenting of the stenotic region due to a basilar artery aneurysm. After the procedure, the visual analog score (VAS) of the patients was 9 and 7, respectively, and a bilateral GON block was performed with ultrasound guidance. The VAS score of both patients decreased to 3 and did not exceed 3 during follow-up in the intensive care unit, eliminating the need for additional analgesics. A bilateral GON block provided effective analgesia and significantly reduced the need for other pain relief in both cases.

Determination of the healthiness of aquaculture fish by enzymes and histopathological methods.

The health of fishes from select aquacultures was investigated by conducting histopathologic and enzymatic analyses, as well as by examining pollutant accumulation rates in fish tissues ranging in age from juvenile to two years old. Histopathologic examinations demonstrated that the fishes had some abnormalities in their livers, spleens, intestines and reproduction systems, such as lipidation, ovotestis formation, lysis and enlargements of the tissues. The occurrence rate of these abnormalities was not very frequent but also not negligible. Statistical analysis demonstrated that enzyme activity (i.e. CAT, EROD, SOD) and protein concentration fluctuated predominantly by age and season. These parameters were not found to be related to the fish farm or other spatial changes, when their existing environmental conditions were not extreme (i.e. polluted or otherwise unsuitable). Metal concentrations (i.e. Ni, Cu, Zn, As, Cd, Pb and Hg) were never found to be higher than national or international regulatory limits. The quality of the fishes caught from optimal farm conditions may be evaluated as good quality for human consumption.

Higher dose intra-arterial milrinone and intra-arterial combined milrinone-nimodipine infusion as a rescue therapy for refractory cerebral vasospasm.

Background Cerebral vasospasm (CV) is a major cause of delayed morbidity and mortality in patients with subarachnoid hemorrhage (SAH). Various cerebral protectants have been tested in patients with aneurysmal SAH. We aimed to research the success rate of treatment of CV via intra-arterial milrinone injection and aggressive pharmacological therapy for refractory CV. Methods A total of 25 consecutive patients who received intra-arterial milrinone and nimodipine treatment for CV following SAH between 2014 and 2017 were included in the study. Patients who underwent surgical clipping were excluded. Refractory vasospasm was defined as patients with CV refractory to therapies requiring ≥3 endovascular interventions. Overall, six patients had refractory CV. Long-term neurological outcome was assessed 6-18 months after SAH using a modified Rankin score and Barthel index. Results The median modified Rankin scores were 1 (min: 0, max: 3) and Barthel index scores were 85 (min: 70, max: 100) From each vasospastic territory maximal 10-16 mg milrinone was given to patients; a maximum of 24 mg milrinone was given to each patient in a session and a maximum of 42 mg milrinone was given to a patient in a day. Both milrinone and nimodipine were given to three patients. There was a large vessel diameter increase after milrinone and nimodipine injections. No patient died due to CV; only one patient had motor dysfunction on the right lower extremity. Conclusion Higher doses of milrinone can be used effectively to control refractory CV. For exceptional patients with refractory CV, high dose intra-arterial nimodipine and milrinone infusion can be used as a rescue therapy.

Effects of Addition of Preoperative Intravenous Ibuprofen to Pregabalin on Postoperative Pain in Posterior Lumbar Interbody Fusion Surgery.

OBJECTIVE: Ibuprofen and pregabalin both have independent positive effects on postoperative pain. The aim of the study is researching effect of 800 mg i.v. ibuprofen in addition to preoperative single dose pregabalin on postoperative analgesia and morphine consumption in posterior lumbar interbody fusion surgery. MATERIALS AND METHODS: 42 adult ASA I-II physical status patients received 150 mg oral pregabalin 1 hour before surgery. Patients received either 250 ml saline with 800 mg i.v. ibuprofen or saline without ibuprofen 30 minutes prior to the surgery. Postoperative analgesia was obtained by morphine patient controlled analgesia (PCA) and 1 g i.v. paracetamol every six hours. PCA morphine consumption was recorded and postoperative pain was evaluated by Visual Analog Scale (VAS) in postoperative recovery room, at the 1st, 2nd, 4th, 8th, 12th, 24th, 36th, and 48th hours. RESULTS: Postoperative pain was significantly lower in ibuprofen group in recovery room, at the 1st, 2nd, 36th, and 48th hours. Total morphine consumption was lower in ibuprofen group at the 2nd, 4th, 8th, 12th, and 48th hours. CONCLUSIONS: Multimodal analgesia with preoperative ibuprofen added to preoperative pregabalin safely decreases postoperative pain and total morphine consumption in patients having posterior lumbar interbody fusion surgery, without increasing incidences of bleeding or other side effects.

Pheniramine Maleate is more effective than Lidocaine on Fentanyl Induced Cough.

OBJECTIVE: Fentanyl is frequently used during anesthesia induction. The use of fentanyl can cause cough through different mechanisms. Here, we aimed to investigate effects of pheniramine maleate (PM), an antihistaminic agent, and compare it with lidocaine on fentanyl induced cough. METHODS: This is a randomized double-blind prospective clinical study of ASA I-II, 120 patients scheduled for elective abdominal surgery. Patients were administered drugs intravenously and randomly allocated into three groups: Group C (2 ml 0.9 % normal saline), Group L (1mg/kg lidocaine), and Group F (PM 45.5 mg). 90 seconds after administration, 2µ/kg fentanyl was applied in three seconds to all patients. Severity of cough (mild: 1-2, moderate: 3-5, severe> 5), time of the cough and vital parameters were recorded 90 seconds after fentanyl injection. RESULTS: Eight patients (25%) in Group C had fentanyl induced cough whereas three patients (7.5%) in Group L and one patient (2.5%) in Group F experienced this phenomenon. There was statistically significant difference between Group F and Group C (p<0.05); however, differences between Group L and Group C or Group F and Group L were not statistically significant (p>0.05). CONCLUSIONS: Pheniramine Maleate 45.5 mg is better that placebo and as effective as lidocaine to prevent fentanyl induced cough.

Fast scanning of illegal oil discharges for forensic identification: a case study of Turkish coasts.

Increasing marine traffic, over 55,000 ships visit per year, through the Turkish Straits System and the Sea of Marmara, produces a yearly average of 12 illegal oil discharges. This paper documents the comparison of chemical fingerprints of spilled oil with suspected sources of oils for identifying the source of illegal pollution in Turkey's seas. Fingerprinting is initiated by comparison of the synchronous fluorescence spectra (Δ=20 or 15 nm) of fugitive and suspected source oils. Potential matches of the spectra/chromatogram are confirmed or rejected by subsequent comparison of Fourier transform infrared spectrometry (FTIR), high-pressure liquid chromatography (HPLC) and gas chromatography with a flame ionisation detector (GC-FID) analysis results. In this study, 39 clean sea waters, 41 polluted sea waters and 111 suspected samples were analysed. According to the comparison of the suspected source sample and polluted sea water sample spectra by using spectrofluorometric analysis, 76 suspected source samples were categorised as non-match whilst 35 suspected samples were classified as match or probable match. Then, match and probable match samples were analysed by using further selected chromatographic methods. Finally, 28 suspected source samples were confirmed as a match, enabling legal proceedings to be initiated.

Effects of pyrene on mussels in different experimental conditions.

The toxicity of the polyaromatic hydrocarbon pyrene to Mytilus edulis and Mytilus galloprovincialis was investigated in experiments conducted in the United Kingdom for M. edulis and in Turkey for M. galloprovincialis. Experimental conditions of temperature and salinity were chosen to be appropriate to the ambient conditions in which the mussels typically live. The effect of different feeding regimes on pyrene bioaccumulation and toxicity was also investigated. Feeding rate and neutral red retention biomarker techniques were used for toxicity assessment. An experiment with M. edulis demonstrated that mussels exposed to pyrene accumulated increasing amounts of this compound throughout a 15-day exposure period and that accumulation increased in relation to exposure concentration and with increasing concentration of unicellular algal food material. However, in these experiments, which were protected from UV light, there was no clear relationship between pyrene concentration in tissues and feeding rate. A clear concentration-response relationship was observed between tissue concentration and neutral red retention for days 1 and 7 of the experiment, but this relationship was lost by day 15, with evidence of the cells recovering. A similar experiment was conducted with M. galloprovincialis at a single (high) pyrene concentration in darkness. The feeding rate of the exposed mussels was always lower than the feeding rate of the control mussels, although the difference was insignificant at 7-day exposure. A decreasing trend in health status of the mussels was indicated by the neutral red retention assay results after 7 and 15 days of exposure to pyrene. In a third experiment (with M. galloprovincialis), an illuminated algal chemostat system containing pyrene was inserted in the exposure system as the food source for the mussels. Both biomarker results showed conclusively that toxic effects correlated with pyrene bioaccumulation, though there was no clear evidence for light-enhanced toxicity. These experiments showed that experimental conditions such as salinity, temperature and feeding regime and perhaps the species of mussel used may influence whether pyrene is perceived as being a toxic molecule.

Polycyclic aromatic hydrocarbons (PAHs) and polychlorinated biphenyls (PCBs) distributions in the Bay of Marmara sea: Izmit Bay.

In 1999, the concentrations of 16 polycyclic aromatic hydrocarbons (PAHs), the total PAH and polychlorinated biphenyls (PCBs) were measured in sea water, sediment and mussels collected along the coast of Izmit Bay, the most important bay of the Marmara Sea. The total-PAH concentrations, measured by Spectrofluorometry were in the range of 1.16-13.68 microg/l in sea water, in the range of 30.0 1670.0 microg/g dry weight in sediments and in the range from 5.67 to 14.81 microg/g wet weight in edible part of mussel. HPLC revealed Phenanthrene (three rings), chrysene (four rings) and benz[a]antracene (five rings) to be the dominant PAHs in sea water, while 16 different PAHs compounds were observed and measured in mussel samples. The most pollution occured at Dogu Kanali and Dil Deresi where were the main rivers containing wastes fall into the the Izmit Bay. Although the maximum mono-ortho PCB concentrations in sea water were measured in the Dil Deresi River (26.33 ng/l) and the Solventas (22.19 ng/l) stations, maximum PCB concentrations in mussels were measured in the SEKA (28.11 microg/kg) and the Dil Deresi River (25.68 microg/kg). The dominant congeners of PCBs were from tetra to hexachlorobiphenyls. The toxicity equivalent values were very low in sea water and mussels.