Sakarya İli SARS-CoV-2 Olgularında İnme Sıklığının Araştırılması

Aim: The aim of this study is to identify the frequency of stroke among severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cases in Sakarya city, to find out the clinical characteristics of patients diagnosed with stroke and to contribute to the national database. Material and Methods: This retrospective study was carried out with 783 cases diagnosed with SARS-CoV-2 between April-June 2020 at the pandemic hospital in Sakarya city. Patients were compared in terms of age, National Institute of Health Stroke Scale (NIHSS), risk factors, radiological findings, inpatient treatment, intubation, and mortality rates. Results: Out of 26 cases of ischemic stroke, 11 (42.3%) were male and 15 (57.7%) were female. In terms of infarction localization, the cause was medial cerebral artery (MCA) in 4 (15.4%) patients, top of the basilar in 2 (7.7%) patients, basilar artery in 1 (3.8%) patient, lacunar in 9 (34.6%) patients and anterior system in 10 (38.5%) patients. There was no significant difference in terms of D-dimer and C-reactive protein (CRP) levels according to disease severity (both p=0.262). Three (0.38%) patients presented with stroke findings and were diagnosed with SARS-CoV-2. Cryptogenic stroke was detected in 8 (30.8%) of the SARS-CoV-2 cases. Stroke frequency was calculated as 3.3% among the SARS-CoV-2 cases in Sakarya city. Conclusion: This is the first study to identify the frequency of stroke among SARS-CoV-2 patients in Sakarya city and Turkey. Our study is important as it shows that preventing or treating ischemic stroke in SARS-CoV-2 cases contributes greatly to the reduction of mortality.Amaç: Bu çalışmanın amacı Sakarya ilindeki şiddetli akut solunum yolu sendromu koronavirüsü 2 (severe acute respiratory syndrome coronavirus 2, SARS-CoV-2) olgularında inme sıklığını tespit etmek, inme tanısı almış olan hastaların klinik özelliklerini ortaya koyabilmek ve ulusal veri tabanına katkıda bulunmaktır. Gereç ve Yöntemler: Bu çalışma, Sakarya ilindeki pandemi hastanesinde Nisan-Haziran 2020 tarihleri arasında SARS-CoV-2 tanısı alan 783 olgu ile geriye dönük olarak yürütüldü. Hastalar, yaş, Ulusal Sağlık Enstitüleri İnme Skalası (National Institute of Health Stroke Scale, NIHSS), risk faktörleri, radyolojik bulgular, yatarak tedavi, entübe olma durumları ve mortalite oranları bakımından karşılaştırıldı. Bulgular: Yirmi altı iskemik inmeli olgunun 11 (%42,3)’i erkek ve 15 (%57,7)’i kadın idi. Enfarkt lokalizasyonu bakımından 26 hastanın 4 (%15,4)’ü orta serebral arter (medial cerebral artery, MCA), 2 (%7,7)’si baziller tepe, 1 (%3,8)’i baziller arter, 9 (%34,6)’u laküner, 10 (%38,5)’u arka sistemden kaynaklanmaktaydı. D-Dimer ve C-reaktif protein (C-reactive protein, CRP) düzeyleri bakımından hastalık şiddetine göre anlamlı bir farklılık yoktu (her iki p=0,262). Üç (%0,38) hasta inme bulgusuyla gelip SARS-CoV-2 tanısı almıştı. SARS-CoV-2 olgularının 8 (%30,8)’inde kriptojenik inme tespit edildi. Sakarya ilinde SARS-CoV-2 olgularında inme sıklığı %3,3 olarak hesaplandı. Sonuç: Bu çalışma SARS-CoV-2 hastalarında inme sıklığını tespit etmeye yönelik Sakarya ilinde ve Türkiye’de yapılmış ilk çalışmadır. Çalışmamız, SARS-CoV-2 olgularında iskemik inmenin önlenebilmesi ve tedavi edilebilmesinin mortalitenin azalmasına belirgin katkı sunduğunu göstermesi bakımından önemlidir

Hemodiyaliz Hastalarında COVID-19 Toraks Bilgisayarlı Tomografi Bulgularının Değerlendirilmesi

Aim: Coronavirus disease 2019 (COVID-19) is an unprecedented cause of pandemics affecting all segments of society. It is not known whether hemodialysis patients form a different patient group in terms of susceptibility to COVID-19 infection or severe disease. In this study, thorax computed tomography (CT) findings were evaluated in hemodialysis patients diagnosed with COVID-19 infection during the pandemic period. Material and Methods: CT findings of 32 hemodialysis patients diagnosed with COVID-19 with real-time polymerase chain reaction or thorax CT examination were evaluated retrospectively. Radiological findings were classified as ground glass, consolidation, mixed type involvement (ground glass and consolidation), crazy paving appearance, interlobular septal thickening, nodule, halo-reverse halo finding, air bronchogram finding, subpleural curvilinear opacities and tree-in-bud views. Results: A total of 32 patients were included in the study. Twenty-one (65.6%) of the patients were male and 11 (34.4%) were female. The mean age was 67.5±8.5 years. All patients had chronic kidney failure. Thorax CT examination revealed ground-glass opacities in 14 (43.8%) patients, consolidation in 3 (9.4%) patients, and mixed type involvement (ground-glass opacities and consolidation) in 15 (46.9%) patients. The accompanying CT findings were pleural effusion in 23 (71.9%) patients, subpleural curvilinear opacities in 13 (40.6%) patients, bronchial wall thickening in 11 (34.4%) patients, lymphadenopathy in 7 (21.9%) patients, bronchiectasis in 4 (12.5%) patients and pleural thickening in 4 (12.5%) patients. Conclusion: When hemodialysis patients are infected with COVID-19 infection, they differ significantly from other COVID-19 patients in terms of symptoms, clinical course, and prognosis, as well as imaging findings.Amaç: Koronavirüs hastalığı 2019 (coronavirus disease 2019, COVID-19) toplumun her kesimini etkileyen benzeri görülmemiş bir pandemi sebebidir. Hemodiyaliz hastalarının, COVID-19 enfeksiyonuna ya da şiddetli hastalığa yatkınlık açısından farklı bir hasta grubunu oluşturup oluşturmadıkları bilinmemektedir. Bu çalışmada pandemi döneminde COVID-19 enfeksiyonu tanısı alan hemodiyaliz hastalarında toraks bilgisayarlı tomografi (BT) bulguları değerlendirilmiştir. Gereç ve Yöntemler: Gerçek zamanlı polimeraz zincir reaksiyonu veya toraks BT incelemesi ile COVID-19 tanısı konulan 32 hemodiyaliz hastasının BT bulguları geriye dönük olarak değerlendirildi. Radyolojik bulgular; buzlu cam, konsolidasyon, karışık tip tutulum (buzlu cam ve konsolidasyon), kaldırım taşı görünümü, interlobüler septal kalınlaşma, nodül, halo-ters halo bulgusu, hava bronkogram bulgusu, subplevral kürvilineer opasiteler ve tomurcuklanmış ağaç görünümleri olarak sınıflandırıldı. Bulgular: Çalışmaya toplam 32 hasta dahil edildi. Hastaların 21’i (%65,6) erkek, 11’i (%34,4) kadındı. Yaş ortalaması 67,5±8,5 yıl idi. Tüm hastalarda kronik böbrek yetmezliği mevcuttu. Toraks BT incelemesinde hastaların 14'ünde (%43,8) buzlu cam görünümü, 3'ünde (%9,4) konsolidasyon ve 15'inde (%46,9) karışık tip tutulum (buzlu cam görünümü ve konsolidasyon) görüldü. Eşlik eden BT bulguları 23 (%71,9) hastada plevral effüzyon, 13 (%40,6) hastada subplevral kürvilineer opasiteler, 11 (%34,4) hastada bronşiol duvar kalınlaşması, 7 (%21,9) hastada lenfadenopati, 4 (%12,5) hastada bronşektazi ve 4 (%12,5) hastada plevral kalınlaşma idi. Sonuç: Hemodiyaliz hastaları COVID-19 enfeksiyonuna yakalandıklarında semptom, klinik seyir ve prognostik açıdan olduğu gibi görüntüleme bulguları açısından da diğer COVID-19 hastalarından önemli farklılıklar göstermektedir

Primary retrograde transpedal approach for revascularization of chronic total occlusions of the superficial femoral artery and re-route technique using percutaneous puncture for re-entry

PURPOSEWe aimed to demonstrate the safety and feasibility of revascularization of chronic total occlusion of the superficial femoral artery (SFA) using the transpedal approach and describe a new technique called “re-route”.METHODSThe study included all consecutive patients who had chronic total occlusions at the level of SFA and underwent retrograde treatment through a pedal artery intervention between September 2017 and October 2019. Balloon angioplasty was applied as the first treatment option. After angioplasty, bailout stenting was performed when necessary in patients with indications. If the common femoral artery lumen could not be reached from the SFA ostium, the re-route technique was used. Technical success was defined as revascularization with residual stenosis of less than 30%.RESULTSTwenty-five SFAs were revascularized in 23 patients (17 males; mean age, 66±7.3 years) by angioplasty in 5 SFAs and angioplasty and stents in 20 SFAs. While the transpedal approach was applied after the failure of antegrade recanalization in three patients, it was used as the first treatment route in the remaining cases. The re-route technique was applied in 7 patients, with a 100% technical success rate. The mean follow-up was 15.3 months (range, 12–18 months). The primary patency rate was 78% at one year.CONCLUSIONThe retrograde transpedal approach is a safe and successful technique for chronic total occlusion recanalization and carries a low risk of complications. In order to increase technical success, the re-route technique can be used as an alternative re-entry method

Successful treatment of unexpected complication during aortic stent-grafting: retrieval of broken stent-graft tip by coaxial technique

Thoracic aortic endovascular repair (TEVAR) is increasingly preferred as a treatment of choice in thoracic aortic diseases. Intravascular foreign body is one of the TEVAR-related complications similar to the other endovascular operations. Here, to the our best knowledge for the first time in the English literature, this report presents an extremely rare complication of a broken and stuck tip part of aortic stent-graft in the intravascular space and successful removal by using the coaxial technique. Thoracic aortic endovascular repair (TEVAR) has been increasingly preferred as the treatment of choice in thoracic aortic diseases (1). Endovascular treatment has been gaining popularity compared with open surgery due to its less invasive approach and rapid application, and allows the patient to easily return to daily life (2). However, TEVAR is associated with several specific complications including paraplegia, stroke, vascular injuries and local complications. These complications depend on vascular or nonvascular comorbidities, vascular anatomy, equipment, and experience of the provider (3–6). Intravascular foreign body could be among TEVAR-related complications similar to other endovascular operations (7). Several types of equipment, including guidewire, vascular sheath, or suboptimally uncoiled stents may get stuck in the intravascular space, causing complications (8). Herein, to the best of our knowledge, we present the first report in the English literature of broken and stuck tip part of an aortic stent-graft in the intravascular space and its successful removal using the coaxial technique

Clearlumen-II thrombectomy system for treatment of acute lower limb ischemia with underlying chronic occlusive disease

We aimed to present a case of effective and successful endovascular treatment of acute lower limb thromboembolism with Clearlumen-II, a new aspiration thrombectomy device. Also, we emphasize the superiority of endovascular treatment compared with surgery, especially together with acute and chronic occlusive diseases, as in our case

Total endovascular aortic arch repair using chimney and periscope grafts for treatment of ruptured aortic arch pseudoaneurysm

Aortic arch pseudoaneurysms are rare but quite fatal when ruptured. Owing to its less morbidity and mortality compared with the surgical approach, endovascular and hybrid treatment methods are increasingly preferred. In this report, we present a 58-year-old male patient who has a ruptured saccular aortic arch pseudoaneurysm treated by endovascular approach using parallel grafts

Contribution of real-time elastography in diagnosis of polycystic ovary syndrome

PURPOSEWe aimed to assess the feasibility and reproducibility of real-time elastography (RTE) for displaying the effects of morphological changes in the ovary in polycystic ovary syndrome (PCOS).METHODSForty-eight patients diagnosed with PCOS and 48 healthy women were enrolled in the study. Ultrasonography and RTE were performed on the 3rd day of the menstrual cycle. Evaluations were performed independently by two radiologists. Ovarian volume, number of follicles, elasticity pattern, and strain ratio were measured. Elasticity patterns were assessed as hard (type 1; blue or blue-green), moderate (type 2; green or green-yellow) or soft (type 3; red or orange-red).RESULTSBoth radiologists determined the elasticity pattern as mostly type 1 in the PCOS group and type 3 in the control group (P < 0.01). The mean strain ratios obtained by the first and second radiologist were 6.1±1.8 (2.7–10.1) and 6.0±1.5 (3.0–9.0) in PCOS and 3.3±1.2 (1.7–7.2) and 3.2±0.9 (1.7–6.8) in the control group, respectively (P < 0.001). Interobserver agreement was moderate for the elasticity pattern (κ=0.48) and good for the strain ratio (intraclass correlation coefficient, 0.77). A strain ratio of 3.8 was determined as the optimized cutoff point by receiver operating curve analysis. Strain ratio was correlated with the ovarian volume and the number of detected follicles (P < 0.001).CONCLUSIONElasticity pattern and strain ratio can help identify morphological changes that make PCOS ovaries stiffer than normal ovaries

Refik Özdek’in roman ve hikâyelerinde yapı ve tema

Refik Özdek, Cumhuriyet Dönemi’nde gazeteci ve çevirmen kimliğiyle ön plana çıkmış yazar ve şairlerdendir. Yazar, roman ve hikâyelerinde çok sayıda bireysel ve sosyal temayı işler. Eserlerinde başta eğitim meselesi ve teknolojinin yanlış kullanımı gibi sorunlara çözüm önerileri getirmeye çalışır. Refik Özdek Türk edebiyatında modern/post-modern eğilimlerin hâkim olduğu bir dönemde fazlaca eser vermesine karşın bu eğilimlerin dışında gelenekçi bir tutum sergiler. Zaman zaman modernist yazarlarla benzer konulara değinmesine rağmen modernist edebiyatın imgesel unsur ve tekniklerini kullanmaz. Roman ve hikâyelerinde çocuk ve gençleri eğitmeye çalışır; didaktik bir tutum sergiler. Çalışmanın I. (giriş) bölümünde Refik Özdek’in Türk edebiyatı tarihindeki yeri, devrin edebî ve sosyal şartları da göz önünde bulundurularak değerlendirilmiştir. II. bölümde yazarın hayatı, edebî kişiliği ve eserleri üzerinde kısaca durulmuştur. III. bölümde Refik Özdek’in roman ve hikâyeleri yapı bakımından incelenmiş, eserlerin yapısını oluşturan materyal unsurlar arasındaki organik ilişki ortaya konulmuştur. Yapı bölümü, “Olay Örgüsü, Anlatıcı ve Bakış Açısı, Kişiler, Zaman, Mekân ve Dil ve Anlatım Unsurları” başlıkları altında ele alınmıştır. IV. bölümde ise roman ve hikâyeler tematik olarak incelenmiştir. Tema bölümü “Sosyal Temalar ve Bireysel Temalar” başlıkları altında değerlendirilmiştir. Sonuç bölümünde yazarın roman ve hikâyeleri üzerine genel bir değerlendirme yapılmıştır. Anahtar Kelimeler: Refik Özdek, roman, hikâye, yapı, tema, dil ve anlatım unsurları. ABSTRACT Refik Ozdek is one of the writers and poets of Republican Era who is well-known with his identity of a journalist and a translator. Ozdek deals with numerous individual and social themes in his novels and stories. He tries to present solutions to the questions such as education and the misuse of technology. Although he produced many of his works in a time while modern and post-modern tendencies were prevailing, his attitude was traditional. He sometimes mentions about the same issues with the modernist writers but he does not deploy the symbolic elements and techniques of modernist literature. He tries to educate children and youngsters in his novels and stories. In the first section of the thesis (introduction), I evaluate the place of Refik Ozdek in Turkish literature considering the conditions of the era. In the second part, I briefly mentioned about life, works and artistic personality of the writer. In the third chapter, the novels and stories of Ozdek are examined structurally, and the organic relations between the material elements that construct his work is presented. The structural part is investigated under the titles of "Incidence Pattern, The Narrator and the Point of View, People, Time, Space, and Elements of Language and Narration". In the fourth chapter the novels and stories are examined thematically. The theme section includes under the titles of "Social Themes and Individual Themes". I conclude my thesis with a general evaluation of the works of the writer. Keywords: Refik Özdek, novel, short story, structure, theme, elements of language and narration

Literature and ideology: Identity corruption in the Soviete literature after the October 1917 example of Azerbaijan literature

Bu çalışma, 1917 yılında gerçekleşen Ekim Devrimi sonrasında sosyalist ideoloji temelinde şekillenen Sovyet edebiyatının Azerbaycan sahasına yansırken dinî ve millî kimliği yozlaştırmaya yönelik kullandığı söylemlerin tespiti ve incelenmesi hakkındadır. Çalışmada ideolojilerin kendi meşruiyet alanlarını devam ettirecek kimlik kurguları oluşturmak için edebiyattan faydalandıkları öne sürülmüş, bu kabulden hareketle Azerbaycan edebiyatındaki toplumsal kimlikle ilgili metinlerin Sovyet edebiyatının ideolojik arka planıyla ilişkilendirilmesi amaçlanmıştır. "Giriş" bölümünde edebiyat-ideoloji ilişkisi ortaya konulmuş, ideolojilerden arındırılmış bir edebiyatın imkânı sorgulanmış ve açıktan belli bir ideolojinin propagandasını yapan metinlerin nitelikleri ele alınmıştır. "Birinci Bölüm"de, devrim öncesindeki sosyal ve siyasî yapı göz önünde bulundurularak Marksist propaganda edebiyatının Ekim Devrimi'ne giden yolda üstlendiği rol incelenmiş, bu süreçte Bolşeviklerin geçici olarak ortaya koyduğu özgürlükçü söylemlerden yararlanan Azerbaycanlı yazarların modern anlamda millî kimlik inşası için edebiyatı nasıl kullandıkları araştırılmıştır. "İkinci Bölüm", edebiyat-kimlik ilişkisine ayrılmış, sosyalist realizm anlayışıyla yazılan metinlerdeki yeni Sovyet kimliğini oluşturma çabası incelenmiştir. Çalışmanın "Üçüncü Bölüm"ünde Azerbaycan-Sovyet edebiyatındaki yozlaşmış kimlik oluşturma yöntemleri şiir, poema, tiyatro, roman ve hikâye türlerinde ele alınmıştır. Devrim öncesinde düzenle iş birliği yapan beyler ve hanlar, Çarlık taraftarı milliyetçiler, sahtekâr din adamları ve devrimci bilinçten yoksul insanlardan hareketle Türk ve Müslüman kimliğinin ötekileştirildiği ve tahrip edilmeye çalışıldığı saptanmıştır. Sosyalist realizmin "olumlu kahraman" ilkesi doğrultusunda kurgulanan işçi, aydın ve askerlerin ideal birer Marksist tip olarak Türk ve Müslüman kimliğinin anti-tezini oluşturduğu ortaya konmuştur. Kadın sorunu üzerinden geleneksel kimlik değerlerini hedef alan söylem biçimleri analiz edilmiş ve kapitalizm, faşizm ve din düşmanlığı üzerinden propaganda yapan metinler ele alınmıştır. Hümanizm ve enternasyonalizm/halkların kardeşliği söylemleri üzerinden yapılan propagandanın kimlik tahribatına etkisi araştırılmıştır. Çalışmada Azerbaycan-Sovyet edebiyatının kendi oluşturduğu ideolojik/modern mit ve söylem biçimleri yoluyla kimlik yozlaşmasına hizmet ettiği gösterilmiştir. Anahtar Kelimeler: Azerbaycan edebiyatı, ideoloji, kimlik yozlaşması, Ekim Devrimi, sosyalist realizm.This study is about the detection and analysis of the discourses used by the Soviet literature, which was formed on the basis of socialist ideology after the October Revolution in 1917, to debase the religious and national identity while reflecting on the field of Azerbaijan. In the study, it is suggested that ideologies use literature to create identity constructs that will continue their legitimacy, and from this point of view, it is aimed to relate the texts related to social identity in Azerbaijani literature with the ideological background of Soviet literature. In the "Introduction" section, the relationship between literature and ideology is revealed, the possibility of a literature free of ideologies is questioned, and the qualities of the texts that propagates of a certain ideology are discussed. In the "First Chapter", the role of the Marxist propaganda literature on the road to the October Revolution is examined by considering the pre-revolutionary social and political structure, and in this process, how the Azerbaijani writers, who benefited from the liberal discourses temporarily opened by Bolshevists, used literature for the construction of national identity in the modern sense. The "Second Part" is devoted to the relationship between literature and identity, and the effort to create the new Soviet identity in the texts written with the understanding of socialist realism is examined. In the "Third Chapter" of the study, corrupt methods of creating identity in Azerbaijan-Soviet literature are discussed in poetry, poema, theater, novel and story genres. It is determined that the Turkish and Muslim identity was marginalized and tried to be destroyed with reference to the lords and khans who cooperated with the order before the revolution, pro-Tsarist nationalists, dishonest clergymen and poor people from the revolutionary consciousness. It is demonstrated that workers, intellectuals and soldiers, constructed in line with the "positive hero" principle of socialist realism, constitute the anti-thesis of Turkish and Muslim identity as ideal Marxists. The forms of discourse targeting traditional identity values through woman problem are analyzed and the propaganda texts on capitalism, fascism and religious hatred are discussed. The effect of humanity and internationalism / the fraternity of peoples propaganda on identity destruction is also investigated. In the study, it is shown that Azerbaijani-Soviet literature serves identity corruption through ideological-modern myth and discourse forms. Key Words: Azerbaijani literature, ideology, identity corruption, October Revolution, socialist realism