Türkiye'de koroner yoğun bakım ünitelerindeki hastane içi mortalite (MORCOR-TURK) çalışmasında hasta temel karakteristikleri ve öngördürücüleri

OBJECTIVE: The MORtality in CORonary Care Units in Türkiye (MORCOR-TURK) trial is a national registry evaluating predictors and rates of in-hospital mortality in coronary care unit (CCU) patients in Türkiye. This report describes the baseline demographic characteristics of patients recruited for the MORCOR-TURK trial. METHODS: The study is a multicenter, cross-sectional, prospective national registry that included 50 centers capable of 24-hour CCU service, selected from all seven geographic regions of Türkiye. All consecutive patients admitted to CCUs with cardiovascular emergencies between September 1-30, 2022, were prospectively enrolled. Baseline demographic characteristics, admission diagnoses, laboratory data, and cardiovascular risk factors were recorded. RESULTS: A total of 3,157 patients with a mean age of 65 years (range: 56-73) and 2,087 (66.1%) males were included in the analysis. Patients with arterial hypertension [1,864 patients (59%)], diabetes mellitus (DM) [1,184 (37.5%)], hyperlipidemia [1,120 (35.5%)], and smoking [1,093 (34.6%)] were noted. Non-ST elevation myocardial infarction (NSTEMI) was the leading cause of admission [1,187 patients (37.6%)], followed by ST elevation myocardial infarction (STEMI) in 742 patients (23.5%). Other frequent diagnoses included decompensated heart failure (HF) [339 patients (10.7%)] and arrhythmia [272 patients (8.6%)], respectively. Atrial fibrillation (AF) was the most common pathological rhythm [442 patients (14%)], and chest pain was the most common primary complaint [2,173 patients (68.8%)]. CONCLUSION: The most common admission diagnosis was acute coronary syndrome (ACS), particularly NSTEMI. Hypertension and DM were found to be the two leading risk factors, and AF was the most commonly seen pathological rhythm in all hospitalized patients. These findings may be useful in understanding the characteristics of patients admitted to CCUs and thus in taking precautions to decrease CCU admissions

Zırhlı askeri araçlarda kullanılan ikiz kardan millerinin süspansiyon sistemine etkisi.

Cardan joint is used for transmitting angular motion with angled connection. The more misalignment angle is implemented, the more fluctuation occurs in output shaft in terms of twist angle and angular velocity. To present fluctuations in output shaft, two different types of solution methods are proposed, which are ode23s and Newmark’s method. Due to transmission ratio relationship of cardan joint, there occurs nonlinearity in equations of motions. Therefore, proposed methods include solutions for nonlinear two degree of ordinary differential equations. In order to avoid fluctuation, Z- and W- configurations can be used. Although Z- and W- configurations prevent fluctuations in output shaft, misalignment angle can be increased only up to . By using Newmark’s and ode23s methods, twist angles and angular velocities for input, intermediate and output shafts are established. Besides, changing variables which are misalignment angle, stiffness, inertia and damping are also included in this study. For the applications which require more misalignment angle and transmitting torque and angular velocity without energy loss, double-double cardan shaft can be used. Although double-double cardan shaft system provides misalignment angle up to 47 it is not a cost effective solution. As an alternative solution, single-double establishment is also included in thesis. Twist vi angle and angular velocity comparisons of single, double-double and single-double cardan shaft are presented. Depending on the characteristics of input, intermediate and output shafts, single-double might be preferred by considering vibration levels thanks to low cost.Thesis (M.S.) -- Graduate School of Natural and Applied Sciences. Mechanical Engineering

Factors effecting on surgical site infection in hepatobiliary surgery

Cerrahi alan enfeksiyonu (CAE) ile ilgili pek çok çalışma yapılmış ve çeşitli risk faktörleri tanımlanmıştır. Ancak hepatobilier (HPB) cerrahide CAE'na etkili risk faktörlerine yönelik çalışma sayısı yok denecek kadar azdır. Bu çalışmamızda hepatobilier cerrahi için risk faktörlerini saptamayı amaçladık. Ocak 2005 ile Aralık 2009 arasında hepatobilier sistem cerrahisi geçiren 14818 hasta çalışmaya dahil edildi. Demografik veriler, hasta ve operatif süreçle ilişkili risk faktörleri, laboratuar parametreleri retrospektif olarak incelendi.HPB cerrahide CAE insidansı %3.94'tü. Tek değişkenli analizde uygulanan cerrahi prosedür, uygunsuz antimikrobiyal profilaksi (AMP), insizyon yeri, yara sınıfı, preoperatif hastanede kalış süresi, operasyon süresi, preoperatif hemoglobin düzeyi, total ve direkt bilirubin düzeyleri, bilier drenaj kateteri, acil cerrahi girişim, obezite, malignite, cilt kolonizasyonu , KOAH, DM, dren, cilt sütürü, kan transfüzyonu (p<0.0001), ASA skoru, ALT düzeyi (p=0.002), cerrah (p=0.016), preoperatif cilt traşı (p=0.036), AST düzeyi (p=0.04) ve malnutrisyon (p=0.041) CAE ile anlamlı olarak ilişkili bulundu. Ancak çok değişkenli analizde kan transfüzyonu (OR:20.9), dren varlığı (OR:10.7), 8 günden fazla preoperatif yatış süresi (OR8.1), DM (OR:6.2), KOAH (OR:6.1), uygunsuz AMP (OR:6), obezite (OR:3.2) preoperatif eksternal-internal bilier drenaj katateri varlığı (OR:2), preoperatif direkt bilirubin düzeyinin 15mg/dl'nin üzerinde olması (OR:1.4) bağımsız risk faktörleri olarak saptandı. E.Coli ve Enterococcus spp. en sık izole edilen patojen mikroorganizmalardı. Hepatobilier cerrahide etkili birçok bağımsız risk faktörü diğer abdominal genel cerrahi prosedürler için tanımlananlara benzerdir. Preoperatif bilier drenaj (özellikle eksternal-internal bilier drenaj) ve direkt bilirubin seviyesinin 15mg/dl'nin üzerinde olması hepatobilier cerrahiye özgü risk faktörleri olarak belirlenmiştir.There are plenty of studies about risk factors effecting on surgical site infection (SSI). But there are not enough studies focused on the risk factors effecting on SSI in hepatobiliary (HPB) surgery. In this study we aimed to determine risk factors related to HPB surgery. Totaly 1418 patients were included in this study who were undergone hepatobiliary system surgery in a five years period between January 2005 to December 2009. Demographical data, patient and operation related risk factors and laboratory parametres analyzed retrospectively. The overall incidence of SSI was %3.94 in HPB surgery. In univariate analysis the type of surgery, inappropriate antimicrobial prophylaxis (AMP), incision type, wound classification (p<0.0001), preoperative hospital stay, duration of operation, preoperative hemoglobin level, total and direct bilirubin levels, biliary drainage catheterisation, emergency surgery, obesity, malignancy, skin colonization, chronic obstructive pulmonary disease (COPD), DM, drains, skin sutures, blood transfusion (p<0.0001), ASA score, ALT level (p=0.002), surgeons experience (p=0.016), preoperative hair removal (p=0.036), AST level (p=0.04) and malnutrition (p=0.041) were found to be significantly related with SSI. In multivariate analysis; blood transfusion (OR:20.9), presence of surgical drains (OR:10.7), preoperative hospital stay more than 8 days (OR8.1), DM (OR:6.2), COPD (OR:6.127), inappropriate AMP (OR:6.), obesity (OR:3.2), presence of external-internal biliary drainage catheter (OR:2), direct bilirubin level over than 15mg/dl (OR:1.4) were determined as independent risk factors. E.Coli and Enterococcus spp. were most common isolated pathogene microorganisms in SSI?s.It seems that most of indepent risk factors for HPB system surgery are similar to the other abdominal general surgical procedures. But the presence of external-internal biliary drainage catheter and direct bilirubin levels over than 15mg/dl were found to be spesific risk factors for HPB surgery

FEN BİLİMLERİ ENSTİTÜSÜ/LİSANSÜSTÜ TEZ PROJESİ

SU-GAZ DEĞİŞİM TEPKİMESİNİN TEMEL VE BAKIR DESTEKLİ Fe3O4/Cr2O3 KATALİZÖRLERİ ÜZERİNDE TEORİK VE DENEYSEL İNCELENMES

FEN BİLİMLERİ ENSTİTÜSÜ/LİSANSÜSTÜ TEZ PROJESİ

SU-GAZ DEĞİŞİM TEPKİMESİNİN TEMEL VE BAKIR DESTEKLİ FE3O4/CR2O3 KATALİZÖRLERİ ÜZERİNDE TEORİK VE DENEYSEL İNCELEMES

AMONYUM BORHİDRÜRÜN ZEOLİTLER ÜZERİNDE YENİDEN HİDROJENASYONU

AMONYUM BORHİDRÜRÜN ZEOLİTLER ÜZERİNDE YENİDEN HİDROJENASYON

Small Bowel Adenocarcinoma Presenting with Brain Metastasis

Although the small bowel (SB) comprises majority of the length of alimentary tract and its surface mucosal area, adenocarcinoma of SB is rare in comparison to other gastrointestinal malignancies. The most common presenting symptom is intermittent and crampy abdominal pain. Because of the rarity of these lesions and the non-specific and variable nature of the presenting symptoms, delay in diagnosis is common. In this article, we have presented a case of adenocarcinoma of the jejunum with only neurologic symptoms due to brain metastasis

Impaired hemorheological parameters and increased carotid intima-media thickness in children with subclinical hypothyroidism

Background: Subclinical hypothyroidism (SH) is defined as elevated serum thyroid-stimulating hormone (TSH) concentration associated with normal serum-free thyroxine levels. Effects of hypothyroidism on hemorheology had widely attracted the attention of researchers during the last decade. Objective: The purpose of this study is to determine alterations in hemorheological parameters and carotid intima-media thickness (CIMT) in children with SH. Methods: Fifty-three SH children and 31 healthy controls were enrolled. Erythrocyte deformability and aggregation were determined by an ektacytometer and plasma viscosity (PV) by a cone-plate rotational viscometer. CIMT was evaluated sonographically. Results: Erythrocyte deformability of the SH group measured at 0.53 and 1.69-30 Pa was lower than that of the control group. The erythrocyte aggregation index, aggregation half time and PV were not different between the groups. However, the aggregation amplitude and mean corpuscular hemoglobin concentration were significantly higher in SH compared to the control group. There was a negative correlation between TSH and deformability values measured at 5.33-30.0 Pa. CIMT in patients with SH was significantly higher than in the control group (p = 0.001; SH = 0.48 ± 0.04 mm, control group = 0.43 ± 0.03 mm). Conclusion: Impaired hemorheology and increased CIMT are well-known risk factors for developing cardiovascular pathologies. The results of the current study suggest the treatment of children with SH in order to avoid early circulatory problems. © 2016 S. Karger AG, Basel

Investigation of Hemorheological Parameters and Determination of the Relationship between Carotid Intima-Media Thickness in Children with Subclinical Hypothyroidism

Abstract Not Availabl