Thirteen Days: A Political Reading

Thirteen Days is a historical political thriller, reflecting John F. Kennedy's leadership characteristics and the decision-making process during the Cuban Missile Crisis, close to reality. The study explains the connection between fictional and real and the decision-making process through the similarities and differences between film scenes and real images. In this sense, it examines John F. Kennedy's decision-making process and leadership structure using both international relations theories and film review methods. The film has been created with a historical perspective, the character traits, crisis and resolution processes of the American president and his small group members, as well as the actors in the Soviet bloc. In addition, evaluating the attitudes and approaches of the Kennedy government and Kennedy's leadership structure are clearly reflected to the audience in the film. This study contributes to the understanding of international relations by explaining Small Thinking Decision and Rational Actor Model theories with the cooperation of the field of international relations and cinema. The sum up, to compare of film scenes and real elements is also important in terms of editing the parts that appear as black-boxes during the crisis and interpreting them close to reality

Treatment of Vasovagal Syncope

Vasovagal syncope (VVS) is the most common cause of recurrent syncope which has a good prognosis, but has a high morbidity. structural heart disease is absent in most of the patients. It is thought to be the result of neurocardiovascular system abnormality which provides the systemic and cerebral perfusion. Although VVS has a high incidence, no satisfactory treatment has been found yet. The main purpose of the treatment is to prevent the recurrent syncope episodes and injuries that may occur due to syncope and to improve the quality of life. Treatment of VVS is divided into three as nonpharmacological treatment, pharmacological treatment and cardiac pacemaker implantation. The treatment of VVS is difficult. The patient should be given detailed information about the disease, proper diet should be recommended by the life-style changes, triggerering factors of the syncope should be explained and advised to avoid these triggers. Psychological support is very important and should be maintained in these patients. Patients should be strongly encouraged to implement physical maneuvers. Medical treatment can be tried if the patients’ complaints continue. In case of recurrent syncope despite ongoing medical treatment, permanent pacemaker implantation should be considered

Pulmonary Balloon Valvuloplasty during Pregnancy

Women with valvular heart disease have an increased risk of adverse outcomes in pregnancy; however, with appropriate evaluation and treatment, most women can successfully bear healthy children. During pregnancy, pulmonary stenosis is generally well tolerated in the absence of other haemodynamically significant lesions. We present a case of a multiparous woman,who is pregnant with her sixth child, with a severe pulmonary stenosis. She presented with exertional chest pain and dyspnea. She was managed successfully with balloon valvuloplasty

The Atrial Fibrillation in Turkey: Epidemiologic Registry (AFTER)

Background: AFTER (Atrial Fibrillation in Turkey: Epidemiologic Registry) is a prospective,multicenter study designed with the aim of describing the prevalence and epidemiology ofAF practice in Turkey. This study aims to evaluate stroke risk in non-valvular atrial fi brillation(AF) and anticoagulant drug utilization within conformity to AF guidelines.Methods: Patients were recruited in 17 referral hospitals refl ecting all the population of7 geographical regions of Turkey. 2242 consecutive patients who had been admitted with AFon ECG were included in the study. 1745 of these patients, who had non-valvular AF, wereincluded in the statistical evaluation. Stroke risk was evaluated with the CHA2DS2-VASc score.Results: The average age of participants was determined to be 69.2 ± 11.5 years (56%female). Persistent-permanent AF was found to be the most common type of non-valvularAF (78%). The most common comorbid disorder was hypertension (73%). It was found thatoral anticoagulant therapy was used by 40% of all patients, 37% of whom had effective INR(2.0–3.0). Upon multivariate analysis, age was found to be the only independent predictorof stroke among the variables’ effects on thromboembolic events that created CHA2DS2-VAScabbreviations (OR 1.026, p < 0.001).Conclusions: These results suggest that stroke risk scores should be thoroughly heededbased on guidelines, and that anticoagulation must be applied according to their guidance

A Case of Triple Valve Endocarditis in a Patient on Haemodialysis

A 22 year-old male patient referred to cardiology clinic with complaints of fever, chills and malaise. He had been on haemodialysis for 12 months due to immunoglobulin A nephropathy. On admission his body temperature, pulse rate and blood pressure was 38.6°C, 115 beats/min and 110/70 mmHg, respectively. In the laboratory examination there were leukocyte, C-reactive protein and erythrocyte sedimentation rate elevation. There were vegetations on the mitral, aortic and tricuspid valves. Blood cultures were positive for Enterococcus faecalis which was susceptible to vancomycin. Since the patient did not accept the surgical operation, he died because of multi-organ dysfunction

Transkateter aort kapak implantasyonu hastalarında beslenme ve inflamatuar skorların prognostik değeri

Background: Aortic Stenosis (AS) is a common heart valve disease that especially affects the elderly population and is seen with the aging of the society. In recent years Transcatheter aortic valve replacement patients (TAVR) has been increasingly applied worldwide as a procedure for the treatment of severe AS. Recently, various biomarkers and derived marker approaches have been studied in AS patient groups as in many cardiovascular diseases. Since it has been previously shown that increased inflammatory scores and poor nutritional scores are closely associated with the development process and prognosis of cardiovascular diseases, we hypothesized that these scores may be associated with prognosis after TAVR. Therefore, in this study, we aimed to make a detailed evaluation in terms of mortality determinants after TAVR. Methods and Results: 118 TAVR patients were included in the analysis. Median follow-up of 118 patients was 40.5 months. In terms of inflammatory status scores, the systemic immune inflammatory (SII) score (p= 0.027), the neutrophil/lymphocyte ratio (NLR) score (p= 0.012), and the platelet/lymphocyte ratio (PLR) score (p= 0.012) in the death group was found to be significantly higher. As nutritional status scores, the prognostic nutritional index (PNI) score (p= 0.003) was lower in the death group and the median Controlling Nutritional Status (CONUT) score (p= 0.002)) found significantly higher. Conclusion: In severe and high-risk AS patients undergoing TAVR, measurement of malnutrition with the CONUT score and increased inflammatory status with the SII score was associated with an increased risk of all causes mortality in longterm follow-up. It has been determined that the development of complications related to the procedure is an indicator of increased mortality not only in the short term but also in the long-term follow-up.Amaç: Aort Darlığı (AD), özellikle yaşlı nüfusu etkileyen ve toplumun yaşlanmasıyla birlikte görülen yaygın bir kalp kapak hastalığıdır. Son yıllarda Transkateter aort kapak implantasyonu (TAVI), şiddetli AS tedavisi için bir prosedür olarak dünya çapında giderek daha fazla uygulanmaktadır. Son zamanlarda birçok kardiyovasküler hastalıkta olduğu gibi AD hasta gruplarında da çeşitli biyobelirteçler ve türetilmiş belirteç yaklaşımları araştırılmaktadır. Artmış inflamatuvar skorların ve kötü beslenme skorlarının kardiyovasküler hastalıkların gelişim süreci ve prognozu ile yakından ilişkili olduğu daha önce gösterildiğinden, bu skorların TAVI sonrası prognoz ile ilişkili olabileceğini varsaydık. Bu nedenle bu çalışmada TAVI sonrası mortalite belirleyicileri açısından detaylı bir değerlendirme yapmayı amaçladık. Yöntemler ve Sonuçlar: 118 TAVI hastası analize dahil edildi. 118 hastanın medyan takip süresi 40.5 aydı. İnflamatuar durum skorları açısından, sistemik immün inflamatuar (SII) skoru (p= 0.027), nötrofil/lenfosit oranı (NLR) skoru (p= 0.012) ve trombosit/lenfosit oranı (PLR) skoru (p= 0.012) ) ölüm grubunda anlamlı olarak daha yüksek bulundu. Beslenme durumu skoru olarak ölüm grubunda prognostik nütrisyon indeksi (PNI) skoru (p= 0.003) daha düşüktü ve medyan CONUT skoru (p= 0.002) anlamlı olarak daha yüksek bulundu. Sonuç: TAVI uygulanan şiddetli ve yüksek riskli AD hastalarında, CONUT skoru ile malnütrisyon ölçümü ve SII skoru ile artan inflamatuar durum, uzun dönem takipte tüm nedenlere bağlı mortalite riskinin artmasıyla ilişkilendirildi. İşleme bağlı komplikasyonların gelişmesinin sadece kısa dönemde değil uzun dönemde de mortalite artışının bir göstergesi olduğu belirlenmiştir

Reply to the letter to the editor entitled “Predictive Value of Serum Albumin in Patients With Acute Coronary Syndrome”

WOS:000595335800014PMID: 330300232 They suggested providing more detailed information on the enrolled patients regarding history of coronary artery disease (CAD). However, we consider that doing that is not needed. In studies evaluating the treatment of cardiovascular diseases (interventional treatment, drug treatment, or markers with a possible prognostic value), it is typically needed to group the patients based on the presence of hypertension, presence of diabetes with regard to HbA1c levels, treatment compliance, and duration of the diseas