Panel 10. Paper 10.1: From Understanding to Action for Conservation and Sustainability of a Rural Heritage Place: Kemer, Turkey

Kemer Village, a historic rural settlement situated in western Anatolia, is a very good representative of rural heritage places of this geography. Well-preserved buildings and settlement tissue of the village, provide invaluable information about spatial and architectural features, construction materials and techniques common to this geography. However, upper scale agricultural production and settlement policies, as well as changing ways of living in time, lead to depopulation, discard, alteration and even destruction of Kemer Village. Besides the physical aspects, its intangible aspects, like local living traditions, beliefs, rituals and indigenous knowledge, are also under the risk of disappearing. Although the population of the village decreased significantly in time, there are still inhabitants and local masons living in the village. Thus, it becomes possible to understand the factors, processes and dynamics of change in this rural settlement, so as to be able to define policies, strategies and actions for the conservation and sustainability. Although the common tendency to provide an economic development to prevent depopulation of the rural historic areas is to bring touristic activities, this decision disturbs the integrity of social and physical environment. In Kemer Village this tendency has not been initiated yet. Therefore, Kemer Village is on the border of being abandoned or being a touristic destination. This presentation explains the rural architectural and settlement features of the historical village of Kemer Village, together with indigenous knowledge on living and building traditions, resources and processes. It also discusses the factors, processes and dynamics affecting Kemer Village as an historic rural settlement, and consequently, proposes principles, policies, strategies and actions for the conservation and sustainability of rural heritage place by including all the decision makers, inhabitants and experts to the shared decision-making process

Use of Tigecycline for Diabetic Foot Infections

WOS: 000424372500007Objective. The aim of this study is to evaluate tigecycline for diabetic foot infections (DFIs). Materials and Methods. In this prospective observational study, the investigators included patients who had consultation with the Diabetic Foot Council of Ege University Faculty of Medicine (Izmir, Turkey) between March 2013 and July 2015 and who used tigecycline during their treatment. Treatment success was assessed by design-specific criteria for each evaluation. Results. The study included 105 cases. Of those, 37 (35.2%) were women (mean [+/- standard deviation] age, 61.9 +/- 11.9 years). The success rate of tigecycline treatment was 93.3% in mild infections, 56.2% in moderate, 57.7% in severe, and 61.9% in all cases. The authors found a 9-fold decrease (P = .046) in the success of tigecycline treatment among those who developed moderate or severe DFIs and a 6.4-fold decrease (P < .0001) among those who had arterial stenosis. For 33 (71.7%) of 46 (43.8%) patients who experienced a side effect, tigecycline treatment was continued as it could be tolerated. Conclusions. If tigecycline is to be the treatment choice, extra attention must be paid to patients with arterial stenosis, severe DFIs, and side effects. The common disadvantage is the high side effect rate, especially nausea. However, it is generally not necessary to discontinue the medication incases with nausea. Therefore, tigecycline may be used as a choice of therapy in mild DFIs

The receptor for advanced glycation end product (RAGE) pathway in COVID-19

Introduction: Coronavirus disease-2019 (COVID-19) with lung involvement frequently causes morbidity and mortality. Advanced age appears to be the most important risk factor. The receptor for advanced glycation end-product (RAGE) pathway is considered to play important roles in the physiological aging and pathogenesis of lung diseases. This study aimed to investigate the possible relationship between COVID-19 and RAGE pathway. Materials and methods: This study included 23 asymptomatic patients and 35 patients with lung involvement who were diagnosed with COVID-19 as well as 22 healthy volunteers. Lung involvement was determined using computed tomography. Serum soluble-RAGE (sRAGE) levels were determined using enzyme-linked immunosorbent assay. Results: The sRAGE levels were significantly higher in the asymptomatic group than in the control group. Age, fibrinogen, C-reactive protein, and ferritin levels were higher and the sRAGE level was lower in the patients with lung involvement than in the asymptomatic patients. Conclusions: In this study, patients with high sRAGE levels were younger and had asymptomatic COVID-19. Patients with low sRAGE levels were elderly patients with lung involvement, which indicates that the RAGE pathway plays an important role in the aggravation of COVID-19

Can we predict patients that will not benefit from invasive mechanical ventilation? A novel scoring system in intensive care: the IMV mortality prediction score (IMPRES)

KUCUK, Ahmet Oguzhan/0000-0002-6993-0519; Kirakli, Cenk/0000-0001-6013-7330; KUCUK, Mehtap PEHLIVANLAR/0000-0003-2247-4074; Aksoy, Iskender/0000-0002-4426-3342WOS: 000504051300010PubMed: 31655511Background/aim: The present study aimed to define the clinical and laboratory criteria for predicting patients that will not benefit from invasive mechanical ventilation (IMV) treatment and determine the prediction of mortality and prognosis of these critical ill patients. Materials and methods: The study was designed as an observational, multicenter, prospective, and cross-sectional clinical study. It was conducted by 75 researchers at 41 centers in intensive care units (ICUs) located in various geographical areas of Turkey. It included a total of 1463 ICU patients who were receiving invasive mechanical ventilation (IMV) treatment. A total of 158 parameters were examined via logistic regression analysis to identify independent risk factors for mortality; using these data, the IMV Mortality Prediction Score (IMPRES) scoring system was developed. Results: The following cut-off scores were used to indicate mortality risk: 8, very high risk. There was a 26.8% mortality rate among the 254 patients who had a total IMPRES score of lower than 2. The mortality rate was 93.3% for patients with total 1M PRES scores of greater than 8 (P < 0.001). Conclusion: The present study included a large number of patients from various geographical areas of the country who were admitted to various types of ICUs, had diverse diagnoses and comorbidities, were intubated with various indications in either urgent or elective settings, and were followed by physicians from various specialties. Therefore, our data are more general and can be applied to a broader population. This study devised a new scoring system for decision-making for critically ill patients as to whether they need to be intubated or not and presents a rapid and accurate prediction of mortality and prognosis prior to ICU admission using simple clinical data