Operational challenges in the COVID‐19 era: Asymptomatic infections and vaccination timing

The coronavirus disease 2019 (COVID-19) pandemic has created unprecedented challenges for solid organ transplant programs. While transplant activity has largely recovered, appropriate management of deceased donor candidates who are asymptomatic but have positive nucleic acid test (NAT) for COVID-19 is unclear as this may reflect active infection or prolonged viral shedding. Furthermore, candidates who are unvaccinated or partially vaccinated continue to receive donor offers. In the absence of prospective data, transplant professionals at U.S. adult kidney transplant centers were surveyed to determine community practice (N: 92 centers, capturing 40.8% of centers and 56.6% of transplants performed). The majority (96.8%) of responding centers declined organs for asymptomatic NAT+ patients without documented prior infection. However, 31.6% of centers proceeded with kidney transplant in NAT+ patients who were at least 30 days from initial diagnosis with negative chest imaging. Less than 7% of programs reported inactivating patients who were unvaccinated or partially vaccinated. In conclusion, despite national recommendations to wait for negative testing, many centers are proceeding with transplant in patients with positive tests due to presumed viral shedding. Furthermore, very few centers are requiring COVID-19 vaccination prior to transplantation despite early evidence suggesting reduced immunogenicity in transplant patients on immunosuppression

Urban Landscapes

The issue focuses on philosophies and designs that shape our cities on a broader scale; exploring different approaches between architecture, built environment, and nature; from material to medicinal plants, from plant scale to urban and social sciences. The issue examines the natural and built environment in Istanbul through the relationship between urban planning, urban space, architecture, and landscape architecture. It focuses on designs made in different parts of Istanbul between natural areas and built areas in the city. The urban landscape is an effective and important design process that includes the interaction of architecture, city planning, and landscape architecture disciplines and creates the living environment of people within and between buildings. It has a complementary and important effect in the process of providing and maintaining the physical, physiological, psychological, and social needs of its users. It covers structural design and furniture location selection and design as well as planting. The special issue on Urban Landscape covers this concept; It has a content setup that starts from the upper scale and shrinks towards the building scale.info:eu-repo/semantics/publishedVersio

Assessment of the requisites of microbiology based infectious disease training under the pressure of consultation needs

<p>Abstract</p> <p>Background</p> <p>Training of infectious disease (ID) specialists is structured on classical clinical microbiology training in Turkey and ID specialists work as clinical microbiologists at the same time. Hence, this study aimed to determine the clinical skills and knowledge required by clinical microbiologists.</p> <p>Methods</p> <p>A cross-sectional study was carried out between June 1, 2010 and September 15, 2010 in 32 ID departments in Turkey. Only patients hospitalized and followed up in the ID departments between January-June 2010 who required consultation with other disciplines were included.</p> <p>Results</p> <p>A total of 605 patients undergoing 1343 consultations were included, with pulmonology, neurology, cardiology, gastroenterology, nephrology, dermatology, haematology, and endocrinology being the most frequent consultation specialties. The consultation patterns were quite similar and were not affected by either the nature of infections or the critical clinical status of ID patients.</p> <p>Conclusions</p> <p>The results of our study show that certain internal medicine subdisciplines such as pulmonology, neurology and dermatology appear to be the principal clinical requisites in the training of ID specialists, rather than internal medicine as a whole.</p

Volume CXIV, Number 4, November 7, 1996

Objective: Turner syndrome (TS) is a chromosomal disorder caused by complete or partial X chromosome monosomy that manifests various clinical features depending on the karyotype and on the genetic background of affected girls. This study aimed to systematically investigate the key clinical features of TS in relationship to karyotype in a large pediatric Turkish patient population.Methods: Our retrospective study included 842 karyotype-proven TS patients aged 0-18 years who were evaluated in 35 different centers in Turkey in the years 2013-2014.Results: The most common karyotype was 45,X (50.7%), followed by 45,X/46,XX (10.8%), 46,X,i(Xq) (10.1%) and 45,X/46,X,i(Xq) (9.5%). Mean age at diagnosis was 10.2±4.4 years. The most common presenting complaints were short stature and delayed puberty. Among patients diagnosed before age one year, the ratio of karyotype 45,X was significantly higher than that of other karyotype groups. Cardiac defects (bicuspid aortic valve, coarctation of the aorta and aortic stenosis) were the most common congenital anomalies, occurring in 25% of the TS cases. This was followed by urinary system anomalies (horseshoe kidney, double collector duct system and renal rotation) detected in 16.3%. Hashimoto's thyroiditis was found in 11.1% of patients, gastrointestinal abnormalities in 8.9%, ear nose and throat problems in 22.6%, dermatologic problems in 21.8% and osteoporosis in 15.3%. Learning difficulties and/or psychosocial problems were encountered in 39.1%. Insulin resistance and impaired fasting glucose were detected in 3.4% and 2.2%, respectively. Dyslipidemia prevalence was 11.4%.Conclusion: This comprehensive study systematically evaluated the largest group of karyotype-proven TS girls to date. The karyotype distribution, congenital anomaly and comorbidity profile closely parallel that from other countries and support the need for close medical surveillance of these complex patients throughout their lifespa

Neu-Laxova syndrome in an appropriate for gestational age newborn

Neu-Laxova syndrome is a rare lethal congenital disorder involving multiple systems. Intrauterine growth retardation, ichthyosis, microcephaly, abnormal facial findings, and limb contractures are its key features. We present a case of Neu-Laxova syndrome in a male appropriate for gestational age (AGA) newborn with characteristic features including ichthyosis, microcephaly, severe ectropion, rudimentary ears, eclabion, limb contractures, and hypoplastic genitalia. The patient was born at 38 weeks of gestation to consanguinous Turkish parents. The mother was a 20-year-old primi gravida with lack of prenatal follow-up. Therefore, the case was diagnosed postnatally, and he died 5 days later. Because of the autosomal recessive inheritance of Neu-Laxova syndrome, in countries with high rates of consanguineous marriage, such as Turkey, physicians have to know this syndrome, and serial prenatal ultrasound examinations with genetic counseling should be performed on pregnant women at high risk. To the best of our knowledge, this is the first case described in an AGA newborn

Interactive Videoconference Supported Teaching in Undergraduate Nursing: A Case Study for ECG

This paper describes how interactive videoconference can benefit the Electrocardiography (ECG) skills of undergraduate nursing students. We have implemented a learning system that interactively transfers the visual and practical aspects of ECG from a nursing skills lab into a classroom where the theoretical part of the course is taught. The students and the instructor in the classroom observe the activities in the skill lab in real time, while communicating with the nurse in the lab via audio and video links. An experiment was performed with the participation of 13 male and 57 female (total 70) second year nursing students—36 of who were assigned to Videoconference group (experimental group-VCG) and the other 34 were assigned to Traditional Classroom groups (control group-TCG). In the experiment, ECG knowledge levels of participants were measured by repeated tests (pretest, posttest I and posttest II) and data were analyzed with repeated measures of variances and covariance, the results demonstrating that videoconferencing contributed significantly to the improvement of ECG skills of the participants. In addition, a questionnaire was given to students along with posttest II, and the result of which indicated overwhelming satisfaction with videoconference based lecture

Microstrip antenna design with circular patch for skin cancer detection

WOS:000461840000010Due to the many advantages of microstrip patch antennas, nowadays, microstrip patch antennas are mostly preferred in biomedical areas. This study aims two antenna structures, as both transceiver and receiver, have same dimensions are designed to produce solution of the difficulties in pathology. For antennas with an operating frequency of 2.45 GHz, FR-4 substrate material with a value of 4.4 dielectrics is used. A model has been prepared to detect the presence of skin cancer with the designed antennas. The model is a method of determining E-field and scattering parameters differences between two antennas of cancerous and normal tissue specimens placed on the glass slides. The same antennas and experimental setup were prepared with the normal and cancerous structure of the skin tissue prepared by pathologists. Thus, scattering parameters are measured, and their differences are determined. It has been shown that cancerous tissue can be determined with different values obtained as a result. Ansys HFSS program is used for designs and simulations

An alternative treatment in hypertriglyceridemia-induced acute pancreatitis in pregnancy: Plasmapheresis

Hormonal influences during pregnancy can compromise otherwise controlled lipid levels in women with familial hypertriglyceridemia and predispose to pancreatitis leading to increased morbidity in both mother and fetus. Both cholesterol and triglyceride levels in serum increase progressively during pregnancy. The mainstay of treatment includes dietary restriction of fatty meal and lipid-lowering medications. Experiences with plasmapheresis are limited. We report two cases of hypertriglyceridemia-induced acute pancreatitis during pregnancy, which were successfully treated by plasmapheresis