A Brief Comparison of the Current Approaches in Teaching Pronunciation

Though pronunciation has an important place in English as a foreign language (EFL) teaching and learning, it is evident that EFL teachers experience some problems in pronunciation classes. Thus, this study aims to review some studies on teaching pronunciation to present essential information and solutions to the problems encountered in pronunciation classes. As a result of the study, it was concluded that despite the problems, pronunciation is a priority in language teaching and instructions, whereas age is a considerable factor in pronunciation instruction. It was also concluded that techniques, materials, and approaches used to teach pronunciation have significant influences on learners’ achievement. Accordingly, it is recommended that teachers should be trained to be good models for learners. For this purpose, teachers should use appropriate strategies in pronunciation to teach more effectively by the means of recent technological developments. In addition, as the lack of knowledge on appropriate strategies in pronunciation classrooms is a remarkable problem, teachers should raise their awareness of modern strategies and apply them in their classrooms. Last, teachers should examine the current and recent approaches on pronunciation and try to integrate the most suitable ones to their classes. Keywords: English as foreign language learning; pronunciation; learners; current approache

Spontaneous Coronary Artery Dissection and Woven Coronary Artery: Three Cases and a Review of the Literature

Spontaneous coronary artery dissection (SCAD) and woven coronary artery anomaly (WCAA) are relatively rare. A few of the previously reported woven coronary artery cases have involved in a single coronary artery. We present an unusual woven case involving all coronary arteries and two patient with SCAD. We have also reviewed the literature related to these disease, as they resemble one another

Relationship between plasma osmolality and neutrophil/lymphocyte ratio in heart failure with reduced ejection fraction

Aim: Heart failure (HF), a progressive disease, is accompanied by chronic inflammation and changes in osmolality. The neutrophil-to-lymphocyte ratio (NLR) demonstrates a sys- temic inflammatory response in most diseases; however, the relationship between plasma osmolality and the systemic inflammatory response in HF patients is not yet clear. There- fore, we aimed to investigate the possible associations of NLR with plasma osmolality levels in patients with HF. Materials and Methods: The present study included 189 consecutive patients with chronic HF with an ejection fraction (EF) of <40%. They were classified into four groups based on admission plasma osmolality quartiles: hypo-osmolar (first quartile), normo- hypo-osmolar (second quartile), normo-hyperosmolar (third quartile), and hyperosmolar (fourth quartile). We evaluated the relationship between NLR, plasma osmolality, type-B natriuretic peptide (BNP), and the New York Heart Association (NYHA) functional class. Results: The hyperosmolar group had an increased NLR (p = 0.007). The presence of NYHA class 3–4 functional capacity, high-sensitivity C-reactive protein, and high osmo- lality were independent predictors of increased NLR. In correlation analysis, osmolality was significantly positively correlated with NLR (r = 0.201, p = 0.011). Conclusion: Higher NLR values may be associated with increased plasma osmolality, which may indicate an increased inflammatory status in the HF phenomenon

Atipik semptomlarla seyreden sol ana koroner arter total tıkanıklığı

Sol ana koroner arter tıkanıklıkları genellikle ölümle sonuçlandığı için koroner anjiyografilerde nadir saptanır. Kliniğimize efor anjinası ve çarpıntı ile başvuran ve 6 ay önce sol ana koroneri tam tıkanıklığına bağlı terleme, baş dönmesi ve bayılma hissi hikayesi olan 55 yaşında erkek bir olguyu sunduk.Left main coronary artery total occlusion is rarely determined by coronary angiography because; it almost always results in death. Here, we report a case of a 55 year old man who was admitted to our clinic with exertional angina and palpitations. He also had a history of dizziness, sweating and faintness six months previously due to total occlusion of the left main coronary artery

Heart rate recovery may predict the presence of coronary artery disease

Objective: We investigated whether post-exercise first minute abnormal heart rate recovery (HRR1) helps to predict the presence and severity of CAD, because of some confounding data. Methods: A cross-sectional, retrospective study was performed. Two hundred individuals were included. Gensini scores and the number of coronary artery involvements were used to evaluate the severity of CAD. Student's t-test, Mann-Whitney U test and chi-square test were used for the analysis continuous and categorical data. Spearman's correlation analysis was used to determine whether there is correlation between Gensini scoring and HRR1. Univariate and multivariate logistic regression were used to determine predictors for abnormal HRR1. ROC curve analysis was performed to detect the best sensitivity and specificity value of HRR1 in predicting CAD presence. Results: Seventy subjects (35%) did not have CAD, and CAD was present in 130 patients (65%). HRR1 0.05), there was relationship CAD presence and abnormal HRR1 (OR=2.1, 95% CI: 1.1-3.9, p=0.02), but not between CAD severity and HRR1 (r=-0.13, p=0.112). The sensitivity, specificity, and the positive and negative predictive values of abnormal HRR1 <= 21 beats at first minute for predicting CAD presence were 76.1%, 41.3% (AUC=0.588, CI 95%: 0.517-0,657, p=0.039), 70.7% and 48.3%, respectively. Conclusion: In the study abnormal HRR1 predicted the presence of CAD, but not the severity of it

Anomalous origin of left internal mammary artery from distal subclavian artery

The internal mammary artery arises from the first part of the subclavian artery. The left internal mammary artery (LIMA) is an excellent graft for myocardial revascularization of the left anterior descending artery. In this article, we describe a quite important variation of an anomalous origin of LIMA, which is rarely seen. In our case, LIMA was arising from the distal of the third part of the subclavian artery. Therefore, it is of utmost importance to perform LIMA angiography before coronary artery bypass grafting surgery

Usefulness of Maximal Exercise- Corrected QT as a Predictor of Coronary Artery Disease: A Comparison of Simpler Heart Rate Corrections

29th Turkish Cardiology Congress of the Turkish-Society-of-Cardiology (TSC) with International Participation -- OCT 26-29, 2013 -- Antalya, TURKEY[No Abstract Available]Turkish Soc Cardio

Maximal Exercise-Corrected QT as a Predictor of Coronary Artery Disease: Comparison of Simpler Heart Rate Corrections

Background and Objectives: The relationship between QT prolongation and myocardial ischemia is widely known. Due to the limited value of ST depression, we aimed to evaluate, by using four simpler heart rate corrections (Bazett, Framingham, Fridericia and Hodges), the value of maximal exercise-QTc prolongation in the diagnosis of coronary artery disease (CAD) presence and severity. Subjects and Methods: We enrolled 234 subjects (mean age 57.3 +/- 9 years, 143 men) who had undergone exercise testing and coronary angiography due to a suspicion of CAD in the study. Evaluating CAD severity with Gensini scoring, the CAD group (n=122) and controls with non-CAD were compared in terms of corrected QT duration at maximal exercise. Results: Age, gender, hypertension, dyslipidemia, smoking, exercise duration, resting, and peak heart rate were similar between the two groups (all p>0.05). The CAD group had higher raw QT values than the controls {268 (169-438) vs. 240 (168-348), p= 350 ms and Fridericia QTc of >= 340 ms were seen to be useful for the diagnosis of CAD, there was no additive diagnostic value of exercise QTc in addition to ST depression. Maximal exercise-QTc Bazett (r=0.163, p=0.01), Framingham (r=0.239, p=0.001), and Fridericia (r=0.206, p=0.001) equations were weakly positively correlated with Gensini scoring. Conclusion: The patients with CAD have longer QTc intervals at peak heart rates during exercise. This finding provides insufficient evidence to support routine incorporation of QTc at peak heart rates into exercise test interpretation

Mean Platelet Volume in Patients with Obstructive Sleep Apnea and Its Relationship with Simpler Heart Rate Derivatives

Some studies show increased mean platelet volume (MPV) in obstructive sleep apnea (OSA). The aim of this study was to evaluate MPV in OSA patients without cardiovascular risk factors and the possible association of heart rate derivatives with MPV. A total of 82 patients (aged 30–70 years) were divided into 2 groups according to the presence of either OSA or non-OSA as the control group. The OSA group consisted of 52 patients and the control group consisted of 30 subjects. Neither group was significantly different in terms of MPV values as well as heart rate (HR) derivatives such as minimum HR, maximum HR, the difference between maximum HR and minimum HR, mean HR, and heart rate performance index (HRPI) [(HR max. − HR min.)/HR mean] (P > 0.05 for all variables). In multivariate analysis, platelet count and percentages of recording time spent at arterial oxygen saturation < 90% significant variables are associated with MPV (β±SE: −0.004 ± 0.002, 95% CI, −0.008 to −0.001; P = 0.034) and (β±SE: 2.93 ± 1.93, 95% CI, 0.167 to 5.69; P = 0.038). Consequently, our findings predominantly suggest that there is a casual and reciprocal interaction between MPV and autonomic activation

Severe occlusion of the left main coronary artery with preserved left ventricular systolic function

[No Abstract Available