13 yaşlı bir köpekte “old dog ensefalit” olgusu: Köpek distemper’ının ender formu

13 year-old male dog with complaints of fever, loss of appetite, stagnation as well as respiratory signs such as purulent nasal and eye discharge, cough and neurologic signs including apathy, ataxia, quadriplegia, muscular atrophy and myoclonus which admitted to the Animal Hospital of Faculty of Veterinary Medicine of Selcuk University. “Old dog encephalitis” was determined by clinical, laboratory examinations and rapid distemper test. Clinical findings revealed hyperthermia, tachypnea and tachycardia. Intravenous 0.9% NaCl and 5% dextrose solution, vitamin and amino acids, ceftriaxone, n-acetylcysteine for improving clinical appearance and for controlling myoclonus pregabalin were used. In conclusion canine distemper virus may affect mature dogs over six years old as “old dog encephalitis” and this condition may provide a valuable model for further study of demyelinating diseases including measles in humans.13 yaşlı erkek bir köpek ateş, iştahsızlık, durgunluk gibi genel; purulent burun ve gözyaşı akıntısı, öksürük gibi respiratorik; apati, ataksi, kuadripleji, kas atrofisi ve miyoklonus gibi nörolojik bulgular ile Selçuk Üniversitesi Veteriner Fakültesi Hayvan Hastanesine getirilmiştir. Klinik muayene, laboratuvar analizleri ve yapılan distemper hızlı kiti ile “old dog ensefalit” tespit edilmiştir. Klinik muayenede vücut ısısı, solunum sayısı ve kalp ritminde artış belirlenmiştir. Tedavi olarak intravenöz 0.9% NaCl ve 5% dekstroz solüsyonları, vitamin ve aminoasitler, seftriakson, N-asetil sistein, miyoklonusu kontrol altına almak için pregabalin uygulanmıştır. Sonuç olarak köpeklerin distemper virüsünün 6 yaşından büyük erişkin köpekleri “old dog ensefalit” olarak etkileyebileceği ve bu durumun insanlarda kızamık dahil demiyelinizasyon hastalıklarının daha ileri çalışmaları için değerli bir model olabileceği kanısına varılmıştır

YÜKSEK FREKANSLI İŞLEMLER SONRASI BORSA İSTANBUL'DA PİYASA ETKİNLİĞİNİN TEST EDİLMESİ

Yüksek frekanslı işlemlerin sermaye piyasalarında kullanımıyla birlikte yatırım ortamı değişmiş, yüksek frekanslı işlemlerin piyasa etkinliğinin tespitine ilişkin çalışmalarda araştırılması önem kazanmıştır. Yüksek frekanslı işlemlerin, kullanıldıkları piyasalarda hız ve teknoloji avantajları nedeniyle piyasa etkinliğini etkiledikleri ve kısa zaman aralıklarında zayıf formda piyasa etkinliğinin reddedilmesine yol açtıkları gözlemlenmiştir. Borsa İstanbul’un BISTECH sistemine geçmesiyle 2016 yılından itibaren yüksek frekanslı işlemler Türkiye piyasalarında kullanılmaya başlanmıştır. Bu çalışmada yüksek frekanslı işlemler dikkate alınarak, etkin piyasa hipotezinin Borsa İstanbul’daki geçerliliği sınanmıştır. Zayıf formda piyasa etkinliğinin tespiti için literatüre benzer bir şekilde varyans oranı testi kullanılarak rassal yürüyüş hipotezi test edilmiştir. Veri seti olarak Borsa İstanbul’un temel göstergesi olan BIST100 endeksinin 05/02/2019 ve 05/02/2020 dönemleri arasındaki dakikalık getirileri kullanılmıştır. Borsa İstanbul’un dakikalık zaman dilimlerinde zayıf formda etkin olmadığı gözlemlenmiştir. Yüksek frekanslı işlemlerin kullanıldığı Borsa İstanbul’da rassal yürüyüşün olmadığı, durağanlığın mevcut olduğu tespit edilmiştir. Bu sonuç Borsa İstanbul’da yüksek frekanslı işlemler kullanılarak piyasanın üzerinde getiri elde etmenin mümkün olduğunu ifade etmektedir

Astronomical Site Selection for Turkey Using GIS Techniques

A site selection of potential observatory locations in Turkey have been carried out by using Multi-Criteria Decision Analysis (MCDA) coupled with Geographical Information Systems (GIS) and satellite imagery which in turn reduced cost and time and increased the accuracy of the final outcome. The layers of cloud cover, digital elevation model, artificial lights, precipitable water vapor, aerosol optical thickness and wind speed were studied in the GIS system. In conclusion of MCDA, the most suitable regions were found to be located in a strip crossing from southwest to northeast including also a diverted region in southeast of Turkey. These regions are thus our prime candidate locations for future on-site testing. In addition to this major outcome, this study has also been applied to locations of major observatories sites. Since no goal is set for \textit{the best}, the results of this study is limited with a list of positions. Therefore, the list has to be further confirmed with on-site tests. A national funding has been awarded to produce a prototype of an on-site test unit (to measure both astronomical and meteorological parameters) which might be used in this list of locations.Comment: 17 pages, 10 figures, accepted by Experimental Astronom

X-ray detector XRD on BeEagleSat and the development of the improved x-ray detector iXRD

Many interesting astrophysical objects are intense X-ray emitters. Hard X-ray observatories in various sizes have been operating in space and providing exciting scientific results that we cannot obtain in our laboratories on Earth. Nanosatellites with CdZnTe hard X-ray detectors have been launched into orbit as well, and the future holds great promise with such small satellites contributing significantly to high energy astrophysics. One of those satellites is the BeEagleSat which carried the X-ray detector (XRD)to low Earth orbit. The XRD has a 15⨯15⨯3 mm 3 volume CdZnTe detector, a cross-strip electrode design, a RENA readout chip controlled by an MSP 430 microcontroller. Due to a communication problem with the receiver, no science data could have been downloaded from the XRD. Recently, an improved version of the XRD has been designed (called the iXRD)and currently it is in the production phase. The improvements compared to the XRD are the larger volume crystal with almost three times the collecting area, a collimator to limit the field of view for focused scientific return, and a motherboard-daughterboard design to reduce electronic noise

Explaining the decline in coronary heart disease mortality in Turkey between 1995 and 2008.

BACKGROUND: Coronary heart disease (CHD) mortality rates have been decreasing in Turkey since the early 1990s. Our study aimed to determine how much of the CHD mortality decrease in Turkey between 1995 and 2008 could be attributed to temporal trends in major risk factors and how much to advances in medical and surgical treatments. METHODS: The validated IMPACT CHD mortality model was used to combine and analyse data on uptake and effectiveness of CHD treatments and risk factor trends in Turkey in adults aged 35-84 years between 1995 and 2008.Data sources were identified, searched and appraised on population, mortality and major CHD risk factors for adults those aged 35-84 years. Official statistics, electronic databases, national registers, surveys and published trials were screened from 1995 onwards. RESULTS: Between 1995 and 2008, coronary heart disease mortality rates in Turkey decreased by 34% in men and 28% in women 35 years and over. This resulted in 35,720 fewer deaths in 2008.Approximately 47% of this mortality decrease was attributed to treatments in individuals (including approximately 16% to secondary prevention, 3% angina treatments, 9% to heart failure treatments, 5% to initial treatments of acute myocardial infarction, and 5% to hypertension treatments) and approximately 42% was attributable to population risk factor reductions (notably blood pressure 29%; smoking 27%; and cholesterol 1%). Adverse trends were seen for obesity and diabetes (potentially increasing mortality by approximately 11% and 14% respectively). The model explained almost 90% of the mortality fall. CONCLUSION: Reduction in major cardiovascular risk factors explained approximately 42% and improvements in medical and surgical treatments explained some 47% of the CHD mortality fall. These findings emphasize the complimentary value of primary prevention and evidence-based medical treatments in controlling coronary heart disease

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

Proximal Tibiofibular Syndesmosis Injury in a Professional Football Player: Case Report

Tibiofibular syndesmosis is defined as a fibrous complex of the intraosseous membrane, the anterior and posterior tibiofibular ligaments connecting tibia and fibula to each other. Proximal tibiofibular syndesmosis injuries, especially without tibiofibular dislocation are very rarely seen in the literature. In this paper, the case of a professional football player with proximal tibiofibular syndesmosis injury is presented. He was a 26 year old football player who could not resume the game after an opponent’s tackle. On examination, meniscal and ligamentous tests were normal, but edema, pain with palpation and (+) tinel sign with percussion of the fibular head were obtained. Additionally, increase in mobility of the fibular head was observed. After all radiological tests, the patient was diagnosed with “Proximal Tibiofibular Syndesmosis Sprain Grade-II”, and a return to play period of 4-6 weeks was predicted. The player started to train with the team following the 30 days long rehabilitation protocol. There is no specific information about clinical and radiological signs to explain proximal tibiofibular joint (PTFJ) injuries in textbooks of orthopedics and sports medicine. Therefore, PTFJ injuries can be missed or misdiagnosed due to lack of information and experience. Our case is one of the two cases in the literature with no dislocation of PTFJ. Studies with larger series will help physicians to cover the lack of information and experience about proximal syndesmosis injuries. Moreover, it will help obtaining the right treatment protocol, and receiving a more effective answer without delay

P-17: Profesyonel Futbolcuda Proksimal Tibiofibular Sindesmoz Yaralanması

GİRİŞ: Tibia ve fibulayı birbirine bağlayan, interosseöz membran ve anterior, posterior tibiofibular bağlardan oluşan fibröz yapı "tibiofibular sindesmoz" olarak adlandırılır. Sindesmoz yaralanması dendiğinde genellikle, ayak bileği inversiyon torsiyonu sonrası meydana gelen üst ayak bileği yaralanmaları akla gelir. Literatür incelendiğinde tibiofibular dislokasyon olmaksızın proksimal sindesmoz bağ yaralanmasının oldukça ender rastlanan bir durum olduğu görülmektedir. Burada, Türkiye Süper Liginde mücadele eden profesyonel bir futbol oyuncusunda meydana gelmiş proksimal sindesmoz yaralanması sunulmaktadır.OLGU: 26 yaşında erkek futbol oyuncusu, maç sırasında rakibinin yaptığı müdahale sonucu oyuna devam edememiştir. İlk muayene neticesinde menisküs ve bağ testlerinin normal olduğu gözlenmiş ancak fibula başı düzeyinde ödem, palpasyon ile ağrı ve perküsyon ile tinel bulgusu saptanmıştır. Ayrıca fibula başının mobilitesinde artış olduğu gözlenmiştir. Sırasıyla bilateral diz grafisi, EMG, BT ve diz MRG tetkikleri yapılmıştır. EMG sonucunun normal olması ile superfisyal peroneal sinir yaralanması ekarte edilmiş olup görüntüleme tetkikleri neticesinde sol fibula başının sağa kıyasla posterolaterale deviye olduğu ancak disloke olmadığı, interosseöz membranda intensite değişiklikleri olduğu rapor edilmiştir. Sporcuya, fizik muayene ve radyolojik görüntüleme tetkikleri sonucunda "Proksimal Sindesmoz Sprain Evre-2" tanısı koyulmuş ve 4-6 hafta iyileşme süresi öngörülmüştür. Sporcu, rehabilitasyon süreci neticesinde 30 gün sonra takımla birlikte çalışmaya başlamıştır. TARTIŞMA: Klasik ortopedi ve spor hekimliği ders kitaplarında Proksimal tibiofibular eklem (PTFE) yaralanmalarını açıklayacak spesifik klinik test ve radyolojik belirtilerle ilgili bilgi olmadığı görülmektedir. Bu nedenle oldukça ender görülen PTFE yaralanmaları, bilgi ve deneyim eksikliği ile birleşince sıklıkla gözden kaçabilmektedir. Proksimal sindesmoz yaralanması ise daha da nadir görülmekte ve bu nedenle klinik olarak şüphe duyulmadığı için teşhis ve tedavide zorluklar yaşanmaktadır. Literatürde PTFE yaralanmaları incelendiğinde, bu vaka dislokasyon olmaksızın sindesmoz yaralanmasına değinen iki olgudan biridir.SONUÇ: Proksimal sindesmoz yaralanması ile ilgili daha geniş serilerle yapılacak çalışmalar, hekimlerin bilgi ve deneyim eksikliğini gidermesine yardımcı olacak, ayrıca tedavide izlenecek yolun belirlenmesi ve daha kısa sürede, daha efektif yanıt alınmasını sağlayacaktır