Re-evaluation of the symptoms of Hirayama disease through anatomical perspective

Hirayama disease is a rare disease of the anterior horn motor neuron caused by compression of the cervical spinal cord when the neck is flexed. Cervical myelopathy may accompany the disease. It is characterized by symmetrical or asymmetrical muscle weakness and atrophy of muscles innervated by lower cervical and upper thoracic motor neurons. We recorded two male cases of Hirayama disease between the ages of 15 and 21 based on magnetic resonance imaging (MRI) features obtained from the cervical neutral state and from the flexion position which appeared in the right upper extremity. Loss of strength and atrophy in the right upper extremities was existent in clinical findings of these patients. When MRI was taken in the flexion position, there were dilated veins as hypointense signal void on T2 weighted series in posterior epidural area. The contrast enhancement was seen on these veins. It was observed that the posterior dura was displaced anteriorly and the anterior subarachnoid space was narrow. In cases which show clinical findings such as atrophy and loss of strength, having normal MRI results obtained in the neutral position makes it difficult to diagnose Hirayama Disease. In case of a suspicion of Hirayama disease the diagnosis can be made more easily by MRI taken in the flexion position. These case reports aim to bring Hirayama disease to mind and optimize the management of affected individuals

Comparison Of Adobe And Brick Walls Based On Şanliurfa Social Housing Project With The Purpose Of Reformation Of Housing Settlements In Gap Area

Tez (Yüksek Lisans) -- İstanbul Teknik Üniversitesi, Fen Bilimleri Enstitüsü, 2001Thesis (M.Sc.) -- İstanbul Technical University, Institute of Science and Technology, 2001Günümüzde hızla artan teknoloji ile birlikte dünya kaynaklarının tükeniyor olması, insanları barınma konusunda yeni arayışlara itmektedir. Bu nedenle, inşa edilecek yapıların ekonomik, sağlıklı, çevreyle uyumlu ve az enerji tüketen cinsten olması gerekmektedir. GAP’ın Güneydoğu Anadolu Bölgesi’nde yarattığı sanayi, tarım ve hizmet alanlarındaki iş potansiyeli sebebiyle bölgede istihdam artmaktadır. Yıllar önce batıya göç eden halk yaratılan iş imkanları sayesinde kendi topraklarına geri dönüş yapmaktadır. Bunun dışında Bölgede GAP kapsamında yapımı süren barajların göl aynaları altında kalan ve kalacak olan köylerde yaşayan insanların yeni iskan bölgelerine yerleştirilmesi, iç göçü hareketlendirmektedir. Tüm bunlar, Bölgedeki konut ihtiyacını artırmakla birlikte, yeni yapılacak konutların fiziksel konfor şartlarına uyumlu olmasını gerektirmektedir. Bu çalışmada, alkerin GAP Bölgesi konut yerleşimleri için ideal bir yapı malzemesi olduğunu göstermek amacıyla, Bölgedeki mevcut toplu konutlarda kullanılan yapı malzemesi olan tuğla ile karşılaştırmalı durumu incelenmiştir. Öncelikle GAP Bölgesi’nde yer alan devlet ve halkın yaptığı mevcut konutlar üzerinde çalışılmış ve karşılaştırmalar bölgedeki yerleşimlerden biri olan Şanlıurfa Toplu Konut Projesi’nde yer alan konutlar üzerinde yapılmıştır. Bu karşılaştırmalarda alker ve tuğlanın fiziksel ve mekanik özellikleri, ısı geçirgenliği açısından yapısal davranışları, üretim enerjileri ve maliyetleri incelenmiştir.Today, people search alternative solutions for housing as a result of lack in the world’s resources because of the developing technology. So, buildings should be healthy, environment friendly, economic and less energy user. In GAP Area, the employement rises because of the potential that GAP creates in agriculture, industry and service areas. People immigrate back to their lands where they left years ago to get better jobs. On the other hand, local immigration increases by the settlements of the people, whose houses sunked in the dam lakes, to the new areas. All these causes a demand in housing and these houses need to be built according to the physical comfort conditions. In this study, to show the suitability of adobe for GAP area settlements, comparisons have been made with the brick material which is used in the existing social housing project. Researches have been made on the existing houses built by the government or people living there, and comparisons have been made by taking the Şanlıurfa Social Housing Project as an example. These comparisons consist of physical and mechanical properties of adobe and brick, their heat transfer capacities, production energies and costs.Yüksek LisansM.Sc

The influence of COVID-19 pandemic on HIV care in Izmir, Turkiye

The influence of COVID-19 pandemic on HIV care in Izmir, TurkiyeA. NAZLI , S. ATALAY , N. YALCIN , G. HELVACI , H. ALTAN , D. GOKENGINDokuz Eylül University Faculty of Medicine, Infectious Diseases and Clinical Microbiology Department, Izmir, Turkey, Univesity of Health Sciences, TepecikTraining and Research Hospital, Infectious Diseases and Clinical Microbiology Clinic, Izmir, Turkey, Ege University Faculty of Medicine, Infectious Diseasesand Clinical Microbiology Department, Izmir, Turkey, Ministry of Health Siirt Training and Research Hospital, Siirt, TurkeyAbstract bodyPurpose: To analyse the impact of the COVID-19 pandemic on the management of people living with HIV (PLWH).Method: The study included individuals (≥18 years) newly diagnosed with HIV during the first year of the COVID 19 pandemic (2020-2021; Group 1), andduring the two years prior to the pandemic (2018-2019 and 2019-2020; Group 2), which were compared in terms of the time from diagnosis to treatment tothe first control visit, and the time to virologic suppression. A third group (Group 3) included PLWH who were already within the healthcare system receivingHIV care; the pre- and post-pandemic (first visit) physical and laboratory findings of this group were compared.Results: The study included 641 (88.8% male, 11.2% female) patients; 127 in Group 1, 253 in Group 2 (124 in 2019-2020, 129 in 2018-2019) and 261 inGroup 3. Overall the mean age was 39.4±12 years. Although the number of new diagnoses was reduced by 17.8% during the first eight months of thepandemic, it increased by 39.2% in the first three months of the normalization period. The time to the first viral load test results were delayed (p=0,002),the time for ART start was similar (p=0,116), the number of visits per year was lower (p=0,0001) and the percentage of undetectable RNA at 24 weeks waslower(p= 0,0001) in Group1 compared to Group 2. The comparison of remaining parameters is shown in Table 1. The mean follow-up period of 261 patientson ART was 24.7 months (12-144). Table 2 shows the pre- and post-pandemic comparison of physical and laboratory parameters of Group 3.Conclusions: The pandemic had anegative effect on the care of newlydiagnosed PLWH and those under care interms of diagnosis, virologic suppressionand metabolic conditions<img 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

Vaccination Status and Outcome of Hospitalized Patients with Coronavirus Disease 2019 Before and After the Spread of Omicron Variant: An Observational Study from İzmir, Turkey

OBJECTIVE: Despite the efforts in vaccination against coronavirus disease 2019 (COVID-19), breakthrough infections occur and the need for hospitalization continues. We aimed to determine the relationship between severe acute respiratory syndrome coronavirus 2 vaccination and the severity of COVID-19 and mortality among hospitalized patients with COVID-19.MATERIAL AND METHODS: This cross-sectional study was conducted between September 2021 and February 2022 in a university hos- pital in Turkey. Hospitalized patients with COVID-19 (both in clinics and in intensive care units), ≥18 years old, and who had no previous COVID-19 were included in the study. The demographic characteristics, clinical data, vaccination status, and outcome of the patients were analyzed retrospectively and the relationship between vaccination status and mortality was determined statistically.RESULTS: Of the 674 patients, 180 (26.7%) had no vaccination, 282 (41.8%) had incomplete vaccination, and 212 (31.5%) were fully vaccinated according to the updated vaccination recommendations. While 44.0% of the patients were fully vaccinated before the occur- rence of omicron variant, 15.9% of the patients were fully vaccinated during the wave of the omicron variant. The patients with no vaccination were younger and had fewer comorbidities. The overall mortality was 31.8%. Under 50 years old, all the patients with fully vaccination survived and the patients with no vaccination or incomplete vaccination had higher (10.1%) mortality. During the omicron period, mortality was lower in fully vaccinated pateints.CONCLUSION: Immunization with and booster doses of BNT162b2 should be encouraged to protect both healthy and vulnerable populations.</p

Infectious diseases and clinical microbiology consultations in the emergency department: A cross-sectional study at a tertiary-care hospital

Background: Although there is limited data about the role of infectious diseases and clinical microbiology(IDCM) consultations in the Emergency Department (ED), they have a key role in deciding on hospitalizationand appropriate use of antibiotics.Objectives: To evaluate demographic and clinical characteristics of patients who visited the ED of our hospitaland underwent an IDCM consultation.Materials and methods: In this cross-sectional study, were viewed the medical records of adult patientswho visited the ED of our hospital between May and August 2021 and needed IDCM consultation. The demographic data, the date and time of admission and consultation, the departments that were consultedbefore IDCM, laboratory results, diagnosis, and outcome were recorded.Results: Out of 42,116 ED visits, 1,007 (2.4%) IDCM consultations were requested. The median time between admission and IDCM consultation was 239 min (150.0–373.5). Before 56.9% of IDCM consultations,pre-consultations were requested from other departments, and the time interval was significantly longer.The median age of patients was 68 years (51–77years). Infections were confirmed by the IDCM physicianin 79.6% of the consultations. The most diagnosed infections were urinary tract infections (32.4%), skin-softtissue infections (16.9%) and lower respiratory tract infections (10.3%), whereas 9.3% of the consultationsresulted in hospitalization to the infection ward, 25.1% to other wards, and 5% to the intensive care unit (ICU).Conclusions: Two of 3 consultations resulted in hospitalization in other wards, and this shows that IDCMconsultations are beneficial for managing patients with infectious diseases hospitalized in other departments.Communication between IDCM specialists and ED colleagues is important, especially in the managementof elderly patients who require a multidisciplinary approach.</p