Upgrades from Previous Cardiac Implantable Electronic Devices Compared to De Novo Cardiac Resynchronization Therapy Implantations: Results from CRT Survey-II in the Turkish Population

Objective: Cardiac resynchronization therapy is the guideline-directed treatment option in selected heart failure with reduced left ventricular ejection fraction patients. Data regarding the contemporary clinical practice of cardiac resynchronization therapy in Turkey have been published recently. This sub-study aims to compare clinical and periprocedural characteristics between cardiac resynchronization therapy upgrade and de novo implantations. Methods: Turkish arm of the Cardiac Resynchronization Therapy Survey-II was conducted between October 1, 2015, and December 31, 2016, at 16 centers. All consecutive patients who underwent an upgrade to cardiac resynchronization therapy system (n=60) or de novo cardiac resynchronization therapy implantation (n=335) were eligible. Results: Distribution of age, gender, and heart failure etiology were similar in the 2 groups. Atrial fibrillation, valvular heart disease, and chronic kidney disease were more common in cardiac resynchronization therapy upgrade patients. Narrow intrinsic QRS duration and left ventricular ejection fraction being 75% in both groups, and only beta-blockers were prescribed at rates of >90% in both groups. Conclusion: Cardiac resynchronization therapy upgrades are performed with high procedural success rates and without excess periprocedural complication risk. Feared complications of cardiac resynchronization therapy upgrades due to the pre-existing device should not delay the procedure if indicated.publishedVersio

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Serda hıyar fusarium solgunluğu (Fusarium oxysporum f. sp. cucumerinum)'na karşı biyolojik savaş odaklı önlemler üzerinde araştırmalar

Toprak kaynaklı bir etmen olan Fusarium oxysporum f. sp. cucumerinum hıyar bitkisini tüm gelişme dönemlerinde hastalandırabilmektedir. Çalışmamızda Fusarium oxysporum f. sp. cucumerinum'un önlenmesinde özellikle besin elementi rekabeti ve uyarılmış dayanıklılığa dayanan biyolojik mücadele, çeşit dayanıklılığı ve Fusarium oxysporum f. sp. cucumerinum'un duyarlılık gösterdiği farklı besin kombinasyonlarının hastalığa karşı entegrasyonu yapılmaya çalışılmıştır. 161 adet floresan pseudomonas izolatı Fusarium oxysporum f.sp. cucumerinumʼa karşı aynı anda in vitro ve in vivo koşullarda antagonistik yetenekleri açısından taranmıştır. Bu denemeler sonucunda seçilen 5 adet floresan pseudomonas izolatı ile çeşit denemeleri yapılmıştır. Deneme sonucunda etkili olan çeşit + floresan pseudomonas kombinasyonu ile besin maddesi denemesi yapılmıştır. Pseudomonas putida straini olan 24/2 nolu floresan pseudomonas Fusarium solgunluğuna karşı uyarılmış dayanıklılık mekanizmasıyla % 55.48 etki göstermiştir

Identification of race 2.5 of leaf mold (Passalora fulva, syn. Cladosporium fulvum) on tomato

WOS: 000392201900004Leaf mold caused by the fungus Passalora fulva has been a serious disease in greenhouse tomatoes in Turkey. This study was conducted to determine races of tomato leaf mold that caused by the P. fulva. Single-spore cultures of twenty-two isolates were obtained from infected samples that are collected from different greenhouses which product tomato in Fethiye and Ortaca. According to the morphological characters, all of the 22 isolates were identified as P. fulva. All isolates of P. fulva were highly pathogenic to the susceptible tomato cultivars (Moneymaker (MM)-Cf-0). These isolates were tested for determination of races of P. fulva on a set of tomato differentials (MM-Cf-0, MM-Cf-2, MM-Cf-4, MM-Cf-5, MM-Cf-9) with different Cf resistance genes. To our knowledge, according to the result of this study, physiological races of this pathogen were identified as race 2.5 for the first time in Ortaca and Fethiye districts of Mugla province

Patateste yumuşak çürüklük etmeni (Erwinia carotovora subsp. carotovora (Jones) bergey et al. )'ya karşı fluoresent pseudomonaslarla biyolojik savaş araştırmaları

Erwinia carotovora subsp carotovora is an important disease agent of potato. This pathogen causes preemergence seed piece decay, blackleg, soft stem rot and soft rot of daughter tubers. There is not known chemical treatment. Only cultural precautions are not enough. Therefore biological control is important and succesful results have been obtained. This study was made with fluorescent pseudomonads for biological control against E.c. subsp carotovora. Fluorescent pseudomonads were isolated from the surfaces of fresh potato tubers from commercial potato fields in the Ödemiş. These fluorescent pseudomonads were tested against E.c. subsp. carotovora in vitro and in vivo. In vitro tests, the biological control activity of 151 fluorescent pseudomonas against E. c. subsp carotovora were evaluated according to 0-5 scale. Approximately, 84 % of isolates were placed in category 2, forming inhibition zone between 3 and 9 mm. Because of usual discordence between in vitro and in vivo tests the isolates from each category were selected for in vivo test. Pathogenicity tests were made with 50 selected isolates and 10 of them were found to be pathogens. 40 non-pathogenic isolates were tested for inhibition of soft rot by using the tuber slice assay. The most of isolates inhibited soft rot on slices at low rate. In the experiments with regardless variety of potato the highest inhibition rate was 52 %. However in tests carried out with variety Marfona the inhibition rate was 40 %. These results showed that inhibition of soft rot on slices by fluorescent pseudomonads varied depending on the variety of potato.Keywords: Potato, Biological control, Fluorescent pseudomonas JLrwinia carotovora subsp carotovoraPatates dünyada halkın beslenmesinde ağırlık kazanan temel ürünler bakımından 3üncü sırada gelmektededir. Patatesteki önemli hastalık etmenlerinden birisi de Erwinia carotovora subsp carotovora' dır. Bu etmen patateslerde sap, gövde ve hasat öncesi ve sonrası yumru çürüklüklerine neden olur. Bu hastalık ile kimyasal savaşım yöntemi bulunmamaktadır. Kültürel önlemler ise tek başına yeterli gelmemektedir. Bu nedenle, biyolojik savaş çalışmalarına ağırlık verilmiş ve başarılı sonuçlar elde edilmiştir. Bu çalışma, fluoresent pseudomonaslar ile E. c. subsp carotovora'ya karşı biyolojik savaş amacıyla yapılmıştır. Bunun için Ödemiş ilçesi ve çevresindeki patates üretim alanlarından temin edilen taze patates yumru örneklerinden fluoresent peudomonaslar izole edilmiştir. İzole edilen fluoresent pseudomonaslar in vitro ve in vivo koşullarda E.c. subsp carotovora 'ya karşı testlenmiştir. İzole edilen 151 adet fluoresent pseudomonas ile yapılan in vitro testlerin sonuçlan 0-5 ıskalasına göre değerlendirilmiştir. Bu ıskalaya göre izolatların büyük bir çoğunluğu yaklaşık % 84'ü 2 nolu kategoride yer almıştır.V ÖZET(Devam) Bu kategoride yer alan izolatlar 3 ile 9 mm arasında inhibisyon zonu oluşturmuşlardır. 0-5 ıskalasına göre değerlendirilen izolatlar in vitro- in vivo uyumsuzlukları da dikkate alınarak her kategoriden belirli oranda in vivo testler için seçilmiştir. İn vivo testleri için seçilen 50 adet izolat patojenisite testine tabi tutulmuştur. Patojenisite testi sonucunda 10 adet izolat patojen bulunmuştur. Patojen olmayan 40 adet izolat çeşidi belli olan ve belli olamayan yumrular ile dilim testine tabi tutulmuştur. Bu in vivo testler sonucunda izolatların çoğunun çürüklüğü engelleme yüzdeleri düşük olmuştur. Çeşidi belli olmayan testte izolatların çürüklüğü engelleme yüzdeleri %52 olmuştur. Morfana cinsi yumrularla yapılan dilim testinde ise %40 olmuştur. Bu çalışmada izolatların etki düzeylerinin düşük olması nedeniyle çeşit aktörü ön plana çıkmıştır. Çürüklüğü engelleme etkisi patates çeşidine göre düşmüş veya yükselmiştir

Determination of incidence, disease severity and prevalence of powdery mildew in hazelnut orchards in Düzce province

Bu çalışma 2016 yılında Düzce ili fındık bahçelerinde epidemi yapan külleme hastalığının bulunma oranının, hastalık şiddetinin ve yaygınlığının belirlenmesi amacıyla yapılmıştır. Survey çalışmaları esnasında 62 adet fındık bahçesinde 800 ocakta örnekleme yapılmıştır. Survey çalışmalarında ilçelerdeki fındık ocaklarının yaklaşık olarak 1/40.000'i incelenmiştir. Örneklemeler haziran-temmuz aylarında gerçekleştirilmiştir. Hastalık şiddetini belirlemek amacıyla her bir ocağın dört yönünden, dallar üzerindeki sürgünlerden en dipteki iki yaprak haricindeki yapraklardan tesadüfen 40'ar yaprak alınmış ve hastalık şiddeti 0-4 skalasına göre değerlendirilmiştir. Değerlendirmeler sonucunda Düzce ilinde fındıkta külleme hastalığına neden olan etmenin ülkemizde varlığı bilinen Erysiphe (Seksiyon: Microsphaera) sp. ve Phyllactinia guttata olduğu belirlenmiştir. İl genelinde fındık bahçelerinde külleme hastalığının yaygınlık oranı, bulunma oranı ve hastalık şiddeti sırasıyla %100, %87.38 ve%35.01'dir.This study was carried out to determine the incidence, disease severity and prevalence of powdery mildew disease, which turned into an epidemic disease, in hazelnut orchards of Düzce in 2016. During the survey, sampling was carried out in 800 plant plot in 62 hazelnut orchards. In the survey, approximately 1/40.000 of hazelnut plant plot in the districts have been examined. Samplings were carried out between June and July. To determine the disease severity, 40 leaves randomly were collected from 4 different direction of each plant plot, except for the two leaves at the bottom of the shoots on the branches and disease severity was evaluated according to 0-4 scale. As a result of this study, it was determined that the main pathogens of powdery mildew disease in hazelnut in Düzce were Erysiphe sp. (Section Microsphaera) and Phyllactinia guttata which were known to occur on hazelnut in Turkey. The prevalence, incidence and severity of the disease in the orchards of the province were 100%, 87.38% and 35.01%, respectively

Determination of Insect Pests and Fungal Pathogens in Storages of Hazelnut in Duzce Province

Zararlı böcekler ve hastalık etmenleri fındığın depolanması sırasında önemli ekonomik kayıplara nedenolmaktadır. Bu çalışma fındığın depolanması sırasında görülen zararlıların ve hastalık etmenlerinin belirlenmesiamacıyla yapılmıştır. Bu amaçla, Düzce il merkezi ve ilçelerinden 49 depodan fındık örnekleri alınmış velaboratuvarda incelenmiştir. İncelenen örneklerin %51.02’sinde (25 örnekte) böceklerden kaynaklı zarar tespitedilmiştir. Bu örneklerde Curculio nucum, Plodia interpunctella ve Rhyzopertha dominica zararı tespitedilmiştir. Böcek yoğunluğu ise 0-6.67 (%) arasında değişiklik göstermiştir. İncelenen örneklerin % 97.96’sında(48 örnekte) ise fungal hastalık etmenlerine rastlanmıştır. Fungal patojenlerden kaynaklı hastalık şiddeti(çürüklük oranı) ise 5.56-20.67 (%) arasında değişiklik göstermiştir. İç çürüklüğe neden olan fungal etmenler,Aspergillus sp., Penicillium sp., Alternaria sp., Fusarium sp., Chaetomium sp., ve Trichothecium sp. olarakbelirlenmiştir. Bu çalışma neticesinde fındıkta zarar oluşturan ve çürüklüğe neden olan önemli zararlı ve fungaletmenler belirlenmiştir. Fındığın zararlı ve hastalıklardan korunması fındığın ekonomik değeri açısından oldukçaönem taşımaktadırPest insects and fungal pathogens cause important economic loss in hazelnut during the storage period. In thisstudy, we investigated these damaging agents in hazelnut storages. For this purpose, hazelnut samples werecollected from 49 storages representing different location of Duzce and were checked in laboratory. Pest insectdamage was determined in 25 storage samples (51.02%). In these samples, hazelnut damage was detected causedby Curculio nucum, Plodia interpunctella and Rhyzopertha dominica. Pest insect intensity (%) varied from 0 to6.67 for Duzce province. Fungal pathogens were determined in the 48 storage samples (97.96%). Prevalence rate(%) of fungal pathogens varied among 5.56-20.67 in storages of Duzce. Isolating fungal agents from the insideof hazelnut were identified as Aspergillus sp., Penicillium sp., Alternaria sp., Fusarium sp., Chaetomium sp., and Trichothecium sp. In this study, important pest insects and fungal pathogens were detected causing damage androt in hazelnut. Protection of the hazelnut storages from these agents is very important for the economic value ofhazelnut

Serada Hıyar Fusarium Solgunluğu (Fusarium oxysporum f. sp. cucumerinum)'na Karşı Floresan Pseudomonasların Etkinliğinin Belirlenmesi

Fusarium oxysporum f.sp. cucumerinum is a soil-borne pathogen and can invade the host plant in all stages of developmental period. in our study, the biological control methods based on the nutritional competence and induced resistance which inhibits the F. oxysporum f. sp. cucumerinum were studied in order to achieve best integration. Fluorescent pseudomonad isolates (161) were screened for their antagonistic activity at both in vivo and in vitro conditions simultaneously, against F. oxysporum f. sp. cucumerinum. At the end of these experiment, 20 of fluorescent pseudomonas isolates, which are chosen, was tested in the terms of siderophore effect. Chosen 20 of fluorescent pseudomonas isolates, it is detected that it"s in vitro activity is generally resistant to siderophpre effect. İn the experiments which is done with this isolates, it is seen that in the assessment with in vivo, the effect changes between 7.69% and 38.4%Toprak kaynaklı bir etmen olan Fusarium oxysporum f. sp. cucumerinum hıyar bitkisini tüm gelişme dönemlerinde hastalandırabilmektedir. Çalışmamızda Fusarium oxysporum f. sp. cucumerinum'un önlenmesinde özellikle besin elementi rekabeti ve uyarılmış dayanıklılığa dayanan biyolojik mücadelede hastalığa karşı en iyi entegrasyon yapılmaya çalışılmıştır. 161 adet floresan pseudomonas izolatı Fusarium oxysporum f.sp. cucumerinum"a karşı aynı anda in vitro ve in vivo koşullarda antagonistik yetenekleri açısından taranmıştır. Bu denemeler sonucunda seçilen 20 adet floresan pseudomonas izolatının siderefor etki yönünden testlemeleri yapılmıştır. Seçilen 20 adet floresan pseudomonas izolatının in vitro etkinlikleri genelde siderofor etkiye dayandığı belirlenmiştir. Bu izolatlar ile in vivoda yapılan değerlendirmede ise etkinin %7,69 ile %38,4 arasında değiştiği görülmüştü