Planimetry investigation of the corpus callosum in temporal lobe epilepsy patients

Objective: To evaluate the effects of temporal lobe epilepsy (TLE) on corpus callosum (CC) morphometry in patients with TLE. Methods: This retrospective study was conducted at the Faculty of Medicine, Tekirdag Namik Kemal University, Tekirdag, Turkey between November 2010 and December 2013. The epileptic syndrome diagnosis was based on International League Against Epilepsy criteria, and this study was conducted on the MRIs of 25 epilepsy patients and 25 control subjects. We classified the patients according to their duration of epilepsy: = 10 years. The projection area length (PAL) of the CC was also estimated. Total brain volumes (TBV) were measured on CT images. Results: The mean values of TBV for patients with TLE and the control group were not statistically different, but the CC PAL values were statistically different. The mean CC PAL values of under and over 25 years of age in patients with TLE were statistically different. The mean values of TBV of under and over 10 years duration of TLE were small statistically, but the CC PAL values were statistically different. Conclusion: The results indicate a clear influence of TLE on the structure of the CC rather than TBV

The Effect of Hemorrhage Volume on Mortality in Spontaneous Intracerebral Hemorrhages

INTRODUCTION: Spontaneous intracerebral hemorrhage is associated with severe morbidity and mortality. In this study, it was aimed to investigate the effect of hemorrhage volume and other known prognostic factors on mortality in spontaneous intracerebral hemorrhages. METHODS: The study was performed retrospectively in patients diagnosed with spontaneous intracerebral hemorrhage at a state hospital emergency department between 01/01/2014- 31/12/2019. Ethical approval was obtained from the Local Clinical Research Ethics Committee for the study. Patients' age, gender, systemic disease, antiaggregant or anticoagulant medication use, systolic blood pressure (SBP) and Glasgow Coma Scale (GCS), INR, hemorrhage volume, ventricular extension of hemorrhage and location determined by computed tomography (CT), ICH (Intracerebral Hemorrhage) Score, 30-day mortality data were retrospectively assessed for the study. RESULTS: A total of 55 patients, 26 males (47.27%), 29 females (52.73%) were included in the study. The mean age was detected as 70 +- 13. The 30-day mortality rate was 49.09%. Mortality was significantly higher in patients with ventricular extension of hemorrhage (p <0.001). When subgroup analysis was done, in the group with mortality in supratentorial hemorrhages, the volume of hemorrhage was significantly higher (p <0.001). A moderate to high degree of negative correlation was found between GCS and hemorrhage volume (p <0.001; rho = -0.599). When multivariate analysis of factors predicting mortality was performed, only GCS had an effect on mortality. DISCUSSION AND CONCLUSION: Hemorrhage volume is associated with increased mortality in spontaneous intracerebral supratentorial hemorrhages. Lower GCS on admission was associated with mortality in our retrospective cohort study

The influence of alcohol related accidents on health care cost

Introduction: Road traffic accidents are globally leading causes of mortality and morbidity. Alcohol is among the most frequently used pleasure-inducing substances in the world. Use of motor vehicle under the influence of alcohol is completely illegal in some countries. However, it is allowed up to a certain level of eth- anol in blood in other countries. Traffic accidents caused by alcohol consumption are known to cause more harmonhealthofindividuals.Thealcoholaffectsnervoussystem. Alcoholslowsreflexesandimpairsbalance. In other words, alcohol intake reduces capability of individuals while using any motor vehicle. This study aims to search the health care cost of individuals who had traffic accidents under the influence of alcohol.  Methods: This present study included 657 patients who were admitted to the E.R. resulting from traffic accidents between the dates 01.01.2017–01.06.2017. Demographic information of the patients, their time of hospital admission, medical analyses and examinations, the cost of those analyses and examinations, and their ethanol levels were recorded.  Results: 657 patients were included in the study. 460 (68.1) of those patients were males. Their age average was 35.57 ± 15.18. 61 (9.0%) of the patients were seen to have ethanol positive blood. The health care expenditures of ethanol positive patients were found to be 374,75 ± 251,3 TL whereas the expenditures of ethanol free patients were identified to be 283,17 ± 222,72 TL. The health care expenditures of ethanol positive patients were seen to have substantially increased. (p = 0,003).  Conclusions: Alcohol intake is known to be a leading cause of traffic accidents that generally results in deaths and heavy injuries. This present study displays that traffic accidents caused by alcohol consumption increases the cost of health care as well.

Determination of the Level of Emergency Medicine Resident Physicians to Recognize the Electrocardiography Findings

Abstract Objective: The aim of this study is to determine the accuracy and reliability of the interpretation of electrocardiography (ECG) findings by emergency medicine resident physicians (EMPs) and to provide training recommendations in line with emerging deficiencies. Material and Methods: This research depended on the data from a questionnaire that we conducted among EMPs in Ankara. The survey included multiple-choice questions, selected through conceived cases presented in major textbooks or congresses. EMP ECG assessment levels were compared according to the duration of residency education and the presence of ECG education. The data were evaluated by using the Statistical Package for Social Sciences 17.0 (SPSS Inc., Chicago, IL, USA). Results: A total of 112 volunteers participated. Mean age was 29.6±4.4; also, 47 were female and 65 were male. When all of the questions were taken into account, the mean number of total correct answers was higher for those who had received ECG training than who had not received it, those who underwent more training than those who underwent less training, and those whose duration of assistantship was longer than those whose duration was shorter. Conclusion: The results of our study revealed that the evaluation of ECG is improved by increasing clinical knowledge and training. Depending on these results, we suggest that effective and practical ECG courses and training programs should be organized for EMPs. (JAEM 2014; 13: 108-11

TRAVMATİK EL VE YÜZ LASERASYONLARININ SÜTÜRASYONUNDA LOKAL İNFİLTRASYON ANESTEZİSİ İLE REJYONAL SİNİR BLOĞUNUN HASTA MEMNUNİYETİ AÇISINDAN KARŞILAŞTIRILMASI

Acil servislerde travmatik laserasyonların tamirinde genellikle lokal infiltrasyon anestezisi kullanılmaktadır. Periferik sinir bloğu tekniği de daha az sıklıkla bu amaçla kullanılmaktadır. Periferik sinir bloğu tekniğinin lokal infiltrasyona göre avantajlı yönleri vardır. Bu çalışmada travmatik el ve yüz kesilerinin tamirinde kullanılan lokal infiltrasyon anestezisi ve sinir bloğu tekniklerinin, anestezi enjeksiyonu ve sütür ağrısı, hasta memnuniyeti ve anestezi etkinliği açısından karşılaştırılması amaçlanmıştır. Araştırma, prospektif, açık, randomize olarak planlandı. Araştırmaya alınmama kriterleri değerlendirilerek, elde (radial, ulnar, median veya dijital sinir dermatomu) veya yüzde (supraorbital, infraorbital veya mental sinir dermatomu) 114 tek sinir dermatomunda laserasyonları olan 18 yaşından büyük hastalar çalışmaya alındı. Standart yara bakım yöntemleri kullanıldı. Lokal infiltrasyon ve sinir bloğu yapılacak hastalar randomize seçildi. Lidokain’in %2’lik çözeltisi ve 27gauge kalınlıkta 4cm uzunlukta iğne kullanıldı. Anestezi enjeksiyonu ve sütür ağrısı ölçümü için 100mm görsel analog skala kullanıldı. Memnuniyet için 5 kademeli bir skala kullanıldı. Pin-prick testinde duyarlılığın kaybolduğu süre, tam anestezi başlangıç süresi olarak kabul edildi. İlave anestezi ihtiyacı not edildi. Kriterlere uyan 72 hasta çalışmaya alındı ve 36 hastaya lokal infiltrasyon, 36 hastaya sinir bloğu uygulandı. Ortalama yaş 34,4 bulundu. Hastaların %73,6’sı erkekti. Grupların demografik özellikleri ve vital bulguları homojendi. Ağrı skorları açısından ana veya subgrupların hiçbirinde istatistiksel anlamlı fark elde edilmedi. Aynı şekilde memnuniyet dereceleri açısından da gruplar farklılık göstermedi. Lokal infiltrasyon grubunda 1 hastada, sinir bloğu grubunda 3 hastada ilave anestezi ihtiyacı oldu. Pin-prick duyarlılığının kaybolduğu süre ortalaması lokal infiltrasyon grubunda 1,2 dakika, sinir bloğu grubunda 2,2 dakika bulundu. Bu fark istatistiksel olarak anlamlı bulundu (p=0,001). Periferik sinir bloğu, çoğu zaman tek enjeksiyon gerektirmesi, az miktar anestezik madde gerektirmesi (özellikle büyük boylu kesilerde), yara dudaklarını deforme etmemesi yönleri ile lokal infiltrasyon anestezisine göre avantajlıdır. Tecrübe gerektirmesi de dezavantajıdır. Bu bilgiler ışığında periferik sinir bloğunun en az lokal infiltrasyon kadar kullanışlı, ucuz, kolay ve acil servislere uygun bir teknik olduğu düşünülmektedir

MKE Sanayi ve Teknoloji Müzesi

Ankara : İhsan Doğramacı Bilkent Üniversitesi İktisadi, İdari ve Sosyal Bilimler Fakültesi, Tarih Bölümü, 2018.This work is a student project of the Department of History, Faculty of Economics, Administrative and Social Sciences, İhsan Doğramacı Bilkent University.The History of Turkey course (HIST200) is a requirement for all Bilkent undergraduates. It is designed to encourage students to work in groups on projects concerning any topic of their choice that relates to the history of Turkey. It is designed as an interactive course with an emphasis on research and the objective of investigating events, chronologically short historical periods, as well as historic representations. Students from all departments prepare and present final projects for examination by a committee, with 10 projects chosen to receive awards.Includes bibliographical references (page 16)by Fatma Özden Mercan

Evaluation of allograft vasculopathy by computed tomography coronary angiography in cardiac transplant recipients

Amaç: Bu çalışmada kalp nakli yapılmış hastalarda bilgisayarlı tomografi (BT) koroner anjiyografinin allogreft vaskülopati tanısındaki etkinliği araştırıldı. Çalışma planı: Kalp nakli sonrası iki yılını doldurmuş ve son üç ay içerisinde kontrol koroner anjiyografisi yapılmış 10 hasta (9 erkek, 1 kadın; ort. yaş 41±9.2 yıl; dağılım 17-59 yıl) çalışmaya alındı. Bu hastalara BT koroner anjiyografi yapıldı. Tüm hastaların standart anjiyografileri aynı araştırmacı tarafından değerlendirildi. A rdından BT koroner anjiyogramlar, bu değerlendirmelerden habersiz ikinci bir araştırmacı tarafından değerlendirdi. Her iki değerlendirme sonucu, üçüncü bir araştırmacı tarafından karşılaştırıldı. Bulgular: Bilgisayarlı tomografi koroner anjiyografide sekiz hastada önemli bir patoloji gözlenmezken, iki hastada sol ön inen koroner arterde yaklaşık %50’lik darlık saptadı. Standart koroner anjiyografide de aynı hastalarda aynı yerleşimde ve benzer oranda sol ön inen koroner arter lezyonları saptandı. Tüm hastalarda standart koroner anjiyografi ve BT koroner anjiyografi sonuçları birbiriyle uyumluydu. Sonuç: Bilgisayarlı tomografi koroner anjiyografi daha az invaziv olup, hasta için daha az risk taşımaktadır. Uygulama kolaylığı ve etkin maliyet gibi bazı avantajlara da sahiptir. Hastaneye yatış gerektirmez. Kalp nakli alıcılarında koroner allogreft vaskülopatinin rutin takibinde BT koroner anjiyografi, standart koroner anjiyografiye alternatif olarak kullanılabilir

Right brachiocephalic artery reconstruction along with coronary artery bypass grafting

The presence of concomitant coronary artery and supraaortic diseases requires a management strategy for best neurological outcome. A combined operation for both innominate artery reconstruction and coronary artery bypass surgery through a single median sternotomy incision is feasible. We are presenting a concomitant repair for a 63 years old man with coronary artery disease and innominate artery occlusion at aortic arch origin

Copeptin Levels In Clinical Silent Multiple Sclerosis- Klinik Sessiz Multiple Sklerozda Copeptin Düzeyleri

ABSTRACTObjective: Hypothalamic-pituitary-adrenal (HPA) axis dysfunction is thought to appear in patients with multiplesclerosis(MS). Copeptin is a serum protein that is indicated as an indirect marker of HPA axis. The aim of this study wasto evaluate the relationship between HPA axis and clinical silent MS by evaluating copeptin levels.Materials and Methods: Sixty clinical silent MS(CSMS) patients which is defined as relapsing-remitting multiplesclerosis (RRMS) patients without attack and progression and 60 healthy individuals were included in the study fromSeptember 2016 to September 2017. All patients were in the remission period. HPA axis dysfunction was examined bymeasuring the serum copeptin levels in all individuals. Copeptin level was compared with clinical parameters in MSpatients.Results: A total of 120 individuals were composed of 60 CSMS patients and 60 healthy control. The average ages of thepatients and the control group were 37.1 ± 8 (20-52) and 35.1 ± 8.9 (18-54), respectively. The copeptin level was lowerin patients compared to control group, significantly (p&lt;0.001). In both groups, gender played no differential role incopeptin levels(p&lt;0.05). No significant correlation was determined between copeptin levels, age (r=0.121, p=0.188), lastEDSS score (r= -0.035, p=0.790) and disease duration (r=0.032, p=0.810).Conclusion: These results indicate that HPA axis may also be hypoactive in remission period in CSMS patients.According to our findings we consider copeptin levels can be used as a prognostic marker in clinically inactive MSpatients in the future.Keywords: Hypothalamic pituitary adrenal axis, Multiple sclerosis, Copeptin</p