Prognostic Variables in USAP/NSTEMI patients who treated Invasively

YÖK Tez No: 242933Amaç: USAP/NSTEMI hastaları heterojen bir gruptur; koroner yoğun bakım ve invaziv tedavi ihtiyacı olan ölüm ve MI riski yüksek hastalar yanında uygun tedavi rejimlerine yanıt veren iyi prognozlu hastalar da vardır. Bu nedenle risk sınıflaması bu hastaların tedavisinde ve yönetiminde merkezi bir rol oynar. Günümüz koşullarında akut koroner sendrom hastalarının önemli bir kısmı invaziv tedavi görmektedir. Bununla beraber sadece invaziv tedavi alan USAP/NSTEMI hastalarına yönelik bir risk skorlaması mevcut değildir. Bu çalışmada invaziv tedavi uygulanmış USAP/ NSTEMI hasta grubu özelinde klasik risk skorlama sistemlerine alternatif, klinik uygulamada kullanılabilir bir risk skorlama sistemi geliştirilmesi hedeflenmiştir.Yöntem: Bu retrospektif çalışmaya invaziv tedavi uygulanmış 192 USAP/NSTEMI hastası (131 erkek, 61 bayan) dahil edilmiştir. Hastaların 37±21 aylık takibinde major istenmeyen kardiyovasküler olay geçiren ya da ölen hastaların değerleriyle major istenmeyen kardiyovasküler olay geçirmemiş hastaların değerleri kıyaslanmıştır.Bulgular: Ölen hastaların başvuru sırasındaki yaşı, Killip skoru, kardiyak enzim değerleri ölenlerden anlamlı olarak daha yüksek iken ejeksiyon fraksiyonu anlamlı olarak daha düşüktü. Ayrıca ölen hastalarda DM ve KKY, hastane yatışı öncesi aspirin kullanımı, atrial fibrilasyon, ST ve T dalgası hareketlenme sıklığı anlamlı olarak daha fazlaydı. Korelasyon analizinde yaş , KKY öyküsü, DM, Hipertansiyon, AF, ST ve T dalgası hareketlenmeleri, nabız, killip sınıfı, CK-MB, kreatinin, HDL, pik CK-Mb, yatış öncesi ASA ve statin kullanımı, çok damar hastası, son 24 saatte ?2 ağrı atağı, yatış sırasında statin ve nitrat tedavisi mortalite ile ilişkili bulundu. HDL ve AF lojistik regresyon analizinde anlamlı mortalire belirteci olarak saptandı. TIMI puanı parametrelerine AF için 2 ve HDL si düşük(2 chest pain episodes in the last 24 hours were significantly correlated with mortality. HDL and AF were independent predictors of mortality in logistic regression analysis. A new risk estimation (RE) formula was developed by adding 2 points for AF and 1 point for low HDL < 40 mg/dl. A RE point higher than 3 could predict mortality with 84% sensitivity and 61% specificity. When the same analysis is made by TIMI risk scoring mortality rate could be predicted with 80% sensitivity and 47 %specificity.Conclusions: Addition of quickly applicable variables such as AF and HDL to the widely used TIMI and GRACE risk scoring systems, a better risk prediction can be obtaine

Before the Neolithic in the Aegean: The Pleistocene and the Early Holocene record of Bozburun-Southwest Turkey

WOS:000566620900001The renewed Mesolithic research in the Greek mainland and the islands has been providing new insights into the lively maritime activity within the region; however, the southwest coast of Turkey has been virtually devoid of related investigations until the commencement of the Bozburun Prehistoric Survey project in 2017. The aim of this paper is to give an overview of the prehistoric sites discovered at the Bozburun Peninsula during the 2017-2019 field seasons. Preliminary results indicate that the area is rich in prehistoric activity. While Middle Paleolithic chipped stone industries were identified at the sites of Kayabasi Cave, cakmak, and Sobalak, flake based microlithic chipped stone industries typical of the Aegean Late Pleistocene and Early Holocene were identified at the sites of Sarnic, Hurma, Sobalak, Zeytinlik, and cakmak. A variety of artifacts, suggestive of the Neolithic, were also recorded at the sites of Hurma, Zeytinlik, and possibly at Sobalak and Sarnic. In specific, the presence of carinated end-scrapers, burins and polyhedric cores at Sarnic, as well as some geometric microliths at Hurma, demonstrates that Bozburun was frequented during the Upper Paleolithic and the Epipaleolithic. The presence of a few geometric microliths made on Melos obsidian at Hurma also demonstrates that the region was connected to the Aegean obsidian network routes at least by the beginning of the Holocene. If our relative dating is correct, this constitutes the earliest known use of Melos obsidian in the Anatolian mainland.The permissions for the Bozburun Prehistoric Survey were provided by the Turkish Ministry of Culture and Tourism. We would like to thank Neyir Kolankaya-Bostanc and Metin Kartal for sharing their thoughts on the chipped stone assemblages of Bozburun, as well as to the three anonymous reviewers and the editors of The Journal of Island and Coastal Archaeology. This project has been supported by Turk Tarih Kurumu (Turkish Historical Association) and METU-TACDAM (Middle East Technical University - Centre for Research and Assessment of Historical Environment)

Before the Neolithic in the Aegean: The Pleistocene and the Early Holocene record of Bozburun-Southwest Turkey

The renewed Mesolithic research in the Greek mainland and the islands has been providing new insights into the lively maritime activity within the region; however, the southwest coast of Turkey has been virtually devoid of related investigations until the commencement of the Bozburun Prehistoric Survey project in 2017. The aim of this paper is to give an overview of the prehistoric sites discovered at the Bozburun Peninsula during the 2017-2019 field seasons. Preliminary results indicate that the area is rich in prehistoric activity. While Middle Paleolithic chipped stone industries were identified at the sites of Kayabasi Cave, cakmak, and Sobalak, flake based microlithic chipped stone industries typical of the Aegean Late Pleistocene and Early Holocene were identified at the sites of Sarnic, Hurma, Sobalak, Zeytinlik, and cakmak. A variety of artifacts, suggestive of the Neolithic, were also recorded at the sites of Hurma, Zeytinlik, and possibly at Sobalak and Sarnic. In specific, the presence of carinated end-scrapers, burins and polyhedric cores at Sarnic, as well as some geometric microliths at Hurma, demonstrates that Bozburun was frequented during the Upper Paleolithic and the Epipaleolithic. The presence of a few geometric microliths made on Melos obsidian at Hurma also demonstrates that the region was connected to the Aegean obsidian network routes at least by the beginning of the Holocene. If our relative dating is correct, this constitutes the earliest known use of Melos obsidian in the Anatolian mainland