A Rare Cause of Dyspnea: Sudden Rupture of Aortic Valsalva Sinus Aneurysm

Aneurysm of the sinus of Valsalva is an uncommon cardiac abnormality; however, the most common complication is rupture into the right heart chambers or rarely towards the left chambers. A ruptured aneurysm typically leads to an aortocardiac shunt and progressively worsening heart failure. We report a case of a 21-year-old male who suffered an aneurysm of the sinus of Valsalva rupture into the right atrium who underwent successful surgical repair

Evaluation of Anaesthetic Approaches in Transcatheter Aortic Valv Implantation Procedures

Objective:Transcatheter aortic valve implantation (TAVI) has emerged as an alternative to surgical aortic valve replacement and has become a popular treatment modality for inoperable or patients at high surgical risk with severe aortic stenosis. We aimed to evaluate our perioperative anaesthetic experiences with patients undergoing TAVI under sedation or general anaesthesia (GA).Methods:One hundred and fifty-nine patients who underwent TAVI procedures were enrolled. Effects on TAVI outcomes of sedation and GA were compared.Results:The duration of surgery and anaesthesia was significantly longer in patients who received GA. Insertion site complication and post-TAVI pacemaker implantation rates were similar between the groups, but the frequency of intraoperative complications (10% vs. 0.8%; P=0.015), intraoperative hypotension (35.3% vs. 70%; P < 0.001), and acute kidney injury (12.6% vs. 27.5%; P=0.028) was significantly higher in the GA group. Stroke occurred in seven patients, and all were in the sedation group.Conclusion:GA is related to increased procedure time and acute kidney injury; therefore, local anaesthesia and sedation may be the first option in patients undergoing TAVI

Decreased heart rate recovery may predict a high SYNTAX score in patients with stable coronary artery disease

An impaired heart rate recovery (HRR) has been associated with increased risk of cardiovascular events, cardiovascular, and all‐cause mortality. However, the diagnostic ability of HRR for the presence and severity of coronary artery disease (CAD) has not been clearly elucidated. Our aim was to investigate the relationship between HRR and the SYNTAX (SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery) score in patients with stable CAD (SCAD). A total of 406 patients with an abnormal treadmill exercise test and ≥50% coronary stenosis on coronary angiography were included. The HRR was calculated by subtracting the HR in the first minute of the recovery period from the maximum HR during exercise. The SYNTAX score ≥23 was accepted as high. Correlation of HRR with SYNTAX score and independent predictors of high SYNTAX score were determined. A high SYNTAX score was present in 172 (42%) patients. Mean HRR was lower in patients with a high SYNTAX score (9.8 ± 4.5 vs. 21.3 ± 9, p < 0.001). The SYNTAX score was negatively correlated with HRR (r: -0.580, p < 0.001). In multivariate logistic regression analysis, peripheral arterial disease (OR: 13.3; 95% CI: 3.120–34.520; p < 0.001), decreased HRR (OR: 0.780; 95% CI: 0.674–0.902; p = 0.001), peak systolic blood pressure (OR: 1.054; 95% CI: 1.023–1.087; p = 0.001), and peak HR (OR: 0.950; 95% CI: 0.923–0.977; p < 0.001) were found to be independent predictors of a high SYNTAX score. Our results showed that HRR is significantly correlated with the SYNTAX score, and a decreased HRR is an independent predictor of a high SYNTAX score in patients with SCAD

Frequent itemset minning with trie data structure and parallel execution with PVM

Apriori algorithm is one of the basic algorithms introduced to solve the problem of frequent itemset mining (FIM). Since there is a new generation of affordable computers with parallel processing capability and it is easier to set up computer clusters, we can develop more efficient parallel FIM algorithms for these new systems. This paper investigates the use of trie data structure in parallel execution of Apriori algorithm, the potential problems during implementation, performance comparison of several parallel implementations and in order to increase the efficiency, proposes a new way of message passing for parallel Apriori on a computer cluster with PVM

Genişlemiş spektrumlu ?-laktamaz üreten Escherichia coli izolatlarının antibiyotik duyarlılıklarının, GSBL genlerinin ve pulsed-field jel elektroforez yöntemiyle genotipik profillerinin belirlenmesi

The purpose of this study was to determine the phenotypic antibiotic susceptibility patterns, extended-spectrum ?-lactamase (ESBL) genes and genotypic profiles of ESBL-positive Escherichia coli strains isolated from urine samples obtained from outpatients with urinary tract infection in Turkey. A total of 120 E. coli strains during 2017, 2018, and 2019 (40 patients per year) were examined for antibiotic susceptibility patterns by disc diffusion method, for ESBL genes using PCR and sequencing and for molecular typing by pulsed-field gel electrophoresis (PFGE) method. The isolates were evaluated for their sensitivity to 21 different antibiotics. Four different antimicrobial resistance patterns were determined according to antibiotic susceptibility status of the isolates. The ?-lactamase genes detected in the isolates were CTX-M-15 OXA-1 (n 14), CTX-M-15 (n 24), TEM-1 CTX-M-15 (n 52), TEM-1 SHV-12 (n6), SHV-12 1 (n 6), TEM-1 CTX-M-1 (n 6), TEM-1 CTX-M-16 (n 6) and TEM-1 CTX-M-9 (n 6). The CTX-M-15 was the most prevalent ESBL enzyme in the isolates. As a result of PFGE analysis performed by XbaI enzyme restriction process, one major PFGE profile and three main groups (Group I-II-III) were observed. While antibiotic resistance profiles of the strains showed four groups (RI-RII-RIII-RIV), PFGE band profiles showed a major group (90% similarity ratio). High ESBL production and decreased susceptibility to broad-spectrum cephalosporins were observed in E. coli strains. In addition, PFGE analysis showed high clonal similarity among E. coli isolates.Bu çalışmada Türkiye’de idrar yolu enfeksiyonu bulunan hastalardan alınan idrar örneklerinden izole edilmiş olan genişlemiş spektrumlu ?-laktamaz (GSBL) pozitif E. coli suşlarının antibiyotik duyarlılık paternlerinin (fenotipik), GSBL genlerinin ve genotipik profillerinin belirlenmesi amaçlandı. Çalışmada 2017, 2018 ve 2019 yıllarında ve her yıl 40 hastadan olmak üzere, toplam 120 adet E. coli suşunun disk difüzyon yöntemi ile antibiyotik duyarlılıkları, PCR ve sekanslama ile GSBL genleri, pulsed-field jel elektroforez (PFGE) yöntemi ile moleküler tipleri belirlendi. Numunelerden elde edilen izolatların 21 farklı antibiyotiğe karşı duyarlılığı değerlendirildi. İzolatların antibiyotik duyarlılık durumlarına göre, değerlendirmede dört farklı antimikrobiyal direnç paterni tespit edildi. İzolatlarda ?-laktamaz genleri olarak CTX-M-15 OXA-1 (n 14), CTX-M-15 (n 24), TEM-1 CTX-M-15 (n 52), TEM-1 SHV-12 (n 6), SHV-12 1 (n 6), TEM-1 CTX-M-1 (n 6), TEM-1 CTX-M-16 (n 6) ve TEM-1 CTX-M-9 (n 6) tespit edildi. CTX-M-15 izolatlarda en yaygın görülen GSBL enzim tipi olarak belirlendi. PFGE analizi sonucunda, bir majör PFGE profili ve üç ana grup (Grup I-II-III) gözlendi. Suşların antibiyotik direnç profilleri, dört grupta (RI-RII-RIII-RIV) bulunurken, PFGE bant profilleri ise bir majör grup içinde bulunduğu (% 90 benzerlik oranı) belirlendi. Numunelerde E. coli yüksek GSBL üretimi ve geniş spektrumlu sefalosporinlere karşı azalan bir duyarlılık gözlendi. Ayrıca, PFGE analizi ile bu izolatların yüksek klonal benzerliğe sahip olduğu da gösterildi

An active brace for controlled transdermal drug delivery for adjustable physical therapy

Due to copyright restrictions, the access to the full text of this article is only available via subscription.This study presents an active brace which is a cost efficient precision-controlled advanced therapy medicinal product for time and rate controlled transdermal drug delivery (TDD) through the use of drug containing nanoparticles and electronics. The active brace is designed to adjust the pressure at the contact area where the medication is applied. The drug is contained in the nanoparticles produced and takes effect when the nanoparticles burst under pressure. The brace is designed to be compact and wearable which can be preprogrammed by a specialist to continue treatment sessions outside the medical facilities providing convenience and comfort to the patient

An Experimental Investigation of Ethanol-Diesel Blends on Performance and Exhaust Emissions of Diesel Engines

Ethanol is a promising alternative fuel, due to its renewable biobased origin. Also, it has lower carbon content than diesel fuel and it is oxygenated. For this reason, ethanol is providing remarkable potential to reduce particulate emulsions in compression-ignition engines. In this study, performance of ethanol-diesel blends has been investigated experimentally. Tested fuels were mineral diesel fuel (E0D100), 15% (v/v) ethanol/diesel fuel blend (E15D85), and 30% (v/v) ethanol/diesel fuel blend (E30D70). Firstly, the solubility of ethanol and diesel was experienced. Engine tests were carried out to reveal the performance and emissions of the engine fuelled with the blends. Full load operating conditions at various engine speeds were investigated. Engine brake torque, brake power, brake specific fuel consumption, brake thermal efficiency, exhaust gas temperature, and finally exhaust emissions were measured. Performance of the tested engine decreased substantially while improvement on smoke and gaseous emissions makes ethanol blend favorable

Regio- and stereoselective synthesis of 2,3,5-trienoates by palladium-catalyzed alkoxycarbonylation of conjugated enyne carbonates

Palladium-catalyzed carbonylation of 2,4-enyne carbonates in an alcohol and under balloon pressure of CO proceeds through 1,5-substitution to yield (E)-2,3,5-trienoates. The olefin geometry of the substrate is important to control the overall stereochemistry of this alkoxycarbonylation method. The reaction proceeds through successive formation of π-allylpalladium with an R3 group oriented syn and σ-allenyl palladium complexes.TUBITA

Effect of hydrogen–diesel dual-fuel usage on performance, emissions and diesel combustion in diesel engines

Diesel engines are inevitable parts of our daily life and will be in the future. Expensive after-treatment technologies to fulfil normative legislations about the harmful tail-pipe emissions and fuel price increase in recent years created expectations from researchers for alternative fuel applications on diesel engines. This study investigates hydrogen as additive fuel in diesel engines. Hydrogen was introduced into intake manifold using gas injectors as additive fuel in gaseous form and also diesel fuel was injected into cylinder by diesel injector and used as igniter. Energy content of introduced hydrogen was set to 0%, 25% and 50% of total fuel energy, where the 0% references neat diesel operation without hydrogen injection. Test conditions were set to full load at 750, 900, 1100, 1400, 1750 and finally 2100 r/min engine speed. Variation in engine performance, emissions and combustion characteristics with hydrogen addition was investigated. Hydrogen introduction into the engine by 25% and 50% of total charge energy reveals significant decrease in smoke emissions while dramatic increase in nitrogen oxides. With increasing hydrogen content, a slight rise is observed in total unburned hydrocarbons although CO 2 and CO gaseous emissions reduced considerably. Maximum in-cylinder gas pressure and rate of heat release peak values raised with hydrogen fraction

Molecular typing of drug-resistant Mycobacterium tuberculosis strains from Turkey

Appropriate antibiotic therapy and prevention of cross-contamination are the most important subjects in tuberculosis (TB) control. The aim of this study was to investigate the major phylogenetic clades and transmission rate of multidrug-resistant (MDR) Mycobacterium tuberculosis isolates (n = 200) from patients with TB in Sivas and Konya Provinces of Turkey