Cumhuriyet Dönemi ilk terzileri ve Kemal Milaslı

Ankara : İhsan Doğramacı Bilkent Üniversitesi İktisadi, İdari ve Sosyal Bilimler Fakültesi, Tarih Bölümü, 2014.This work is a student project of the The Department of History, Faculty of Economics, Administrative and Social Sciences, İhsan Doğramacı Bilkent University.by Öztürk, İbrahim Mert

Trombüs aspirasyonu yapılan akut anteriyor miyokard infaktüsünde reperfüzyon başarısının TIMI Frame sayımıyla değerlendirilmesi

Aim: Achieving reperfusion is the key target in the treatment of myocardial infarction with acute ST elevation. In our study,we aimed to compare the improvement in coronary blood flow using corrected TIMI frame score (cTFC) in patients, whopresented with acute anterior ST elevated myocardial infarction (AASTEMI), underwent primary percutaneous coronaryintervention (PPCI) with manual thrombus aspiration (MTA) and those, who underwent PPCI alone.Material and Methods: We included 30 patients with acute AASTEMI, who underwent PPCI with MTA and 60 patients,who underwent PPCI alone, between June 2009 and August 2013. Coronary angiography images were reviewed afterthe procedure to evaluate distal embolization, TIMI scores and the corrected TIMI frame scores in both groups. Allcause mortality and stent thrombosis were recorded at hospital admission. All-cause mortality, stent thrombosis, andhospitalization due to cardiac failure, occurring within a month of discharge, were investigated.Results: The mean age was 56.50 ± 16.45 among patients undergoing thrombus aspiration; there were 22 males and8 females. Among those who did not undergo MTA, the mean age was 56.57 ± 13.21; and there were 44 males and 16females. The rate of previous myocardial infarction (MI) (23.3 % vs 6.6 %; p = 0.019) and history of percutaneous coronaryintervention (PCI) (20.0 % vs 6.7 %, p = 0.040) was higher in patients, who underwent MTA. The mean TIMI frame scorewas 28.33 ± 7.24 and 26.68 ± 8.22, respectively in the patients, who underwent and did not undergo MTA; however, nostatistically significant difference was detected (p = 0.389). Overall time to ischemia was longer in the groups of patients,who underwent MTA (8.23 ± 9.68 vs 3.68 ± 8.22 hours, p = 0.003). Three patients, who underwent MTA (10 %, p = 0.007) diedbefore discharge and 1 patients (13.1 %, p = 0.003) died within a month. No cases of death were detected in the group ofpatients, who did not undergo MTA, in the hospital and within a month. There were no statistically significant differencesbetween these two groups with respect to hospitalization due to cardiac failure and occurrence of stent thrombosis.Conclusion: The use of MTA in AASTEMI did not have a favorable impact on reperfusion compared to not using MTA.Amaç: Akut ST yükselmeli miyokard enfarktüsü tedavisinde reperfüzyonun sağlanması temel hedeftir. Bizim çalışmamızda amacımız; akut anteriyor miyokard infarktüsü ile başvuran, manuel trombüs aspirasyonu ile primer perkütan koroner girişim yapılan ve yalnızca primer perkütan koroner girişim yapılan hastalarda, koroner kan akımındaki iyileşmeyi, düzeltilmiş TİMİ frame sayımı ( dTFS ) kullanarak kıyaslamaktır. Gereç ve Yöntemler: Çalışmaya retrospektif olarak akut anteriyor miyokard in-farktüsü olup manuel trombüs aspirasyonu ile birlikte primer perkütan koroner giri-şim uygulanmış 30, yalnızca primer perkütan koroner girişim uygulanmış 60 hasta alındı. Gruplar yaş ve cinsiyet açısından eşleştirdi. Koroner anjiografi filmleri tekrar izlenerek her iki grubta distal embolizasyon, TİMİ skoru ve dTFS değerlendirildi. Hastane yatışı esnasında tüm nedenli ölümler, stent trombozu kaydedildi. Taburcu-luk sonrası bir ay içinde meydana gelen tüm nedenli ölümler, stent trombozu ve kalp yetersizliği nedenli yatışları incelendi. Bulgular: Trombüs aspirasyonu yapılanların, ortalama yaşı 56.50±16.45. Tombüs aspirasyonu yapılmayanların ortalama yaşı 56.57±13.21 idi. Manuel trombüs aspi-rasyonu yapılan grupta dTFS ortalama 28.33±7.24, yapılmayan grupta ortalama 26,68±8.22, olarak tespit edildi. Ancak istastistiksel olarak fark tespit edilmedi (p=0.389). İşlem sonrası her iki grupta da EKG‘de benzer oranlarda ST segment rezolüsyonu tespit edildi. Manuel trombüs aspirasyonu yapılan 3 hasta (%10, p= 0.007) taburculuk öncesi, 1 hasta (%13.1, p=0.003) bir ay içinde ölmüştür. Trombüs aspirasyonu yapılmayan grupta hastane içinde ve bir ay içinde ölüm izlenmemiştir. Gruplar arasında bir ay içinde kalp yetersizliği nedenli hastane yatışı ve stent trom-bozu görülme oranları açısından istastistiksel fark tespit edilmedi. Sonuç: Çalışma grubumuzda akut anteriyor miyokard infarktüsünde manuel trom-büs aspirasyonun kullanılması, kullanılmamasına göre reperfüzyon üzerine olumlu etki göstermemiştir

Association between Plasma Fibrinogen Level and Saphenous Vein Graft Patency

BACKGROUND: Fibrinogen is related to the pathogenesis of atherosclerosis. The inflammatory process in atherosclerosis may cause an increase in plasma fibrinogen level. Therefore, in this study we proposed to investigate whether plasma fibrinogen is associated with the patency of saphenous vein graft in patients at least 1 year after coronary artery bypass graft (CABG) surgery. METHODS: Patients who had undergone CABG surgery at least 1 year previously with at least one saphenous vein graft were included in the study. Patients were directed to cardiac catheterization for stable anginal symptoms or positive stress test results. Before coronary angiography, all patients underwent routine blood tests including assessment of plasma fibrinogen levels. RESULTS: Saphenous vein grafts were found to be patent in 199 patients and occluded in 132 patients. Plasma fibrinogen levels were significantly different between the two groups (2.85 ± 0.49 g/L vs. 3.62 ± 0.82 g/L, p < 0.001, respectively). Although the time duration after CABG operation differs significantly between the two groups (p = 0.004), multiple logistic regression analysis showed that plasma fibrinogen levels were found to be significantly associated with the patency of vein graft (odds ratio = 0.27, 95% confidence internal: 0.16-0.48, p < 0.001). CONCLUSIONS: Our results demonstrated that plasma fibrinogen levels were higher in patients with an occluded saphenous vein graft. To conclusively prove the relationship between plasma fibrinogen values and saphenous vein graft patency, additional investigation would be necessary

Perspective of Turkish Medicine Students on Cancer, Cancer Treatments, Palliative Care, and Oncologists (ARES Study): a Study of the Palliative Care Working Committee of the Turkish Oncology Group (TOG)

Cancer is one of the most common causes of death all over the World (Rahib et al. in Cancer Res 74(11):2913-2921, 2014; Silbermann et al. in Ann Oncol 23(Suppl 3):iii15-iii28, 2012). It is crucial to diagnose this disease early by effective screening methods and also it is very important to acknowledge the community on various aspects of this disease such as the treatment methods and palliative care. Not only the oncologists but every medical doctor should be educated well in dealing with cancer patients. Previous studies suggested various opinions on the level of oncology education in medical schools (Pavlidis et al. in Ann Oncol 16(5):840-841, 2005). In this study, the perspectives of medical students on cancer, its treatment, palliative care, and the oncologists were analyzed in relation to their educational status. A multicenter survey analysis was performed on a total of 4224 medical school students that accepted to enter this study in Turkey. After the questions about the demographical characteristics of the students, their perspectives on the definition, diagnosis, screening, and treatment methods of cancer and their way of understanding metastatic disease as well as palliative care were analyzed. The questionnaire includes questions with answers and a scoring system of Likert type 5 (absolutely disagree = 1, completely agree = 5). In the last part of the questionnaire, there were some words to detect what the words "cancer" and "oncologist" meant for the students. The participant students were analyzed in two study groups; "group 1" (n = 1.255) were phases I and II students that had never attended an oncology lesson, and "group 2" (n = 2.969) were phases III to VI students that had attended oncology lessons in the medical school. SPSS v17 was used for the database and statistical analyses. A value of p < 0.05 was noted as statistically significant. Group 1 defined cancer as a contagious disease (p = 0.00025), they believed that early diagnosis was never possible (p = 0.042), all people with a diagnosis of cancer would certainly die (p = 0.044), and chemotherapy was not successful in a metastatic disease (p = 0.003) as compared to group 2. The rate of the students that believed gastric cancer screening was a part of the national screening policy was significantly more in group 1 than in group 2 (p = 0.00014). Group 2 had a higher anxiety level for themselves or their family members to become a cancer patient. Most of the students in both groups defined medical oncologists as warriors (57% in group 1 and 40% in group 2; p = 0.097), and cancer was reminding them of "death" (54% in group 1 and 48% in group 2; p = 0.102). This study suggested that oncology education was useful for the students' understanding of cancer and related issues; however, the level of oncology education should be improved in medical schools in Turkey. This would be helpful for medical doctors to cope with many aspects of cancer as a major health care problem in this country