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Substance use disorder is a global health issue that profoundly affects both individuals and societies. Social stigma acts as a significant barrier to treatment motivation. Mass media plays a substantial role in shaping societal perceptions. This study aims to identify stigmatizing attitudes in news narratives concerning substance use disorder as portrayed in digital newspapers. We examined news articles from the top eight national digital newspapers published during 2022 by using quantitative and retrospective content analysis. Following the review, we collected 1.233 news articles, removed 480 articles which were irrelevant or duplicate, and analyzed the remaining 753 articles using quantitative content analysis methods on SPSS 26.0. The majority of news articles depict substance use disorder in a negative consideration. The analysis revealed that nearly all news sources were news agencies and only 11% of the articles offered potential solutions. Alarmingly, 69.7% of the articles contained stigmatizing content, while 53.1% directly impacted the social lives of individuals with substance use disorder. Furthermore, 44.1% of the articles reinforced a dangerous perception associated with individuals with substance use disorder. To address these issues, we recommend a more empathetic portrayal of substance use disorder, support for help-seeking behavior, and advocacy for effective solutions in news coverage.

Trust in instructors is one of the most important variables affecting university reform and students' college life. The research focused on the trust in the instructors which is considered to have an influence on class participation and school engagement. Accordingly, the aim of this study is to examine the relationship between trust in faculty members and class participation and school engagement with regard to faculty of sport sciences. The study group in this research consisted of y 552 students (194 female, 358 male) – voluntary participation - who were studying in the physical education and sports teaching, sports management, coaching education and recreation departments in the Faculty of Sports Sciences at Selçuk University. The study was carried out through a quantitative approach. Student Trust in Professors Scale, Student Engagement Scale and School Engagement to Higher Education Scale were used in order to collect data in the study. Study data were analyzed via arithmetic mean, standard deviation, confirmatory factor analysis, correlation analysis and structural equation modeling. As a consequence of this study, positive relationship was found between students’ trust in the instructors and students’ participation in the course and their school engagement. Moreover, the study shows that the positive effect of students’ trust in the instructor on school engagement is more effective than its effect on their participation in the course.

Objective: In this study, it was aimed to compare pet owners and non-pet owners in terms of depression, anxiety and quality of life. Methods: A total of 397 healthy volunteers over the age of 18, 192 pet owners, and 205 non-pet owners were included in our study. Sociodemographic data form, World Health Organization Quality of Life Scale-Short Form (SF-36), and Hospital Anxiety and Depression Scale (HADS) were administered to all participants. Results: Of all participants, 60.2% (n=239) were female and 39.8% (n=158) were male. The mean age of pet owners (36.74±9.56) was similar to non-pet owners (35.52±9.16) (p=0.194). The mean depression scores of pet owners (4.39±3.37) were significantly lower than non-pet owners (6.02±3.72) (p

Sometimes positive and sometimes negative meanings can be attributed to fanaticism in sports. In addition to the fact that fanatics, which are very attractive for sports marketers, are valuable customers of a brand, whereas social identity, relationship, and self-esteem researchers see fanaticism as a social endorsement, they also see extreme behaviors, including violence, as socially unacceptable. This study, which was carried out due to the need for a valid and reliable measurement tool to measure sports fanaticism for these different fields of study, aims to determine the validity and reliability of the Sport Fanaticism Scale developed by Dwyer, LeCrom and Greenhalgh (2018) in Turkish conditions. The 5-point Likert type scale consisting of 12 items was applied to 528 participants who are supporters of Besiktas, Fenerbahce, Galatasaray and Trabzonspor clubs. Confirmatory factor analysis (CFA) was conducted to examine the four-factor structure of the scale. It was observed that the values of fit indices are at good or excellent level in all parameters (χ²/sd= 2.81); RMSEA=.058; GFI=.96; CFI=.95; IFI=.95; AGFI =.93). The results show that the 12-item scale is consistent with the original four-factor structure and is compatible with the data. For the reliability of the scale, the internal consistency coefficients of the entire scale and its sub-dimensions were checked. In addition, Cronbach's Alpha and AVE and CR values were also calculated within the scope of the internal consistency reliability of the scale and the coefficients were found to be sufficient. Test-retest reliability analysis of the scale was also performed at three-week intervals. In the light of these findings, it was concluded that the "Sports Fanaticism Scale" is a valid and reliable measurement tool that is compatible with the Turkish cultural structure.

Internet has become an important source of health information that enables people to access a large portion of medical information. Cyberchondria is defined as behavior seeking information about health from the Internet. It can be mentioned as an internet-mediated version of hypochondriasis. It is emphasized that health anxiety is at the forefront in the etiology. Information pollution on the Internet is an important risk factor. There are no diagnostic criteria. It is not included in the DSM classification. Although there are various assessment scales, the most commonly used assessment tool is the Cyberchondria Severty Scale. It is a psychometric scale with 34 questions to measure the level of cyberchondria. Psychoeducation is the main approach in the treatment and no specific pharmacological treatment has been defined.

Türkiye is considered an important evolutionary area for Chukar partridge (Alectoris chukar), since it is both a potential ancestral area and a diversification center for the species. Using 2 mitochondrial (Cty-b and D-loop) and 13 polymorphic microsatellite markers, we investigated the geographic genetic structure of A. chukar populations to determine how past climatic fluctuations and human activities have shaped the gene pool of this species in Türkiye. Our results indicate, firstly, that only A. chukar of the genus Alectoris is present in Türkiye (Anatolia and Thrace), with no natural or artificial gene flow from congenerics. Secondly, the geographic genetic structure of the species in Türkiye has been shaped by topographic heterogeneity, Pleistocene climatic fluctuations, and artificial transport by humans. Third, there appears to be three genetic clusters: Thracian, Eastern, and Western. Fourth, the post-LGM demographic expansion of the Eastern and Western populations has formed a hybrid zone in Central Anatolia (~8 kyBP). Fifth, the rate of China clade-B contamination in Türkiye is about 8% in mtDNA and about 12% in nuDNA, with the Southeastern Anatolian population having the highest contamination. Sixth, the Thracian population was the most genetically distinct, with the lowest genetic diversity and highest level of inbreeding and no China clad-B contamination. These results can contribute to the conservation regarding A. chukar populations, especially the Thracian population.

Novel coronavirus disease (COVID-19) pandemic has been affecting the whole world since December 2019. During the pandemic, healthcare professionals are at the forefront of the fight against COVID-19, and many healthcare workers died during this fight. Healthcare workers, who are at the forefront of the pandemic, are under intense mental and physical stress along this period. This disease makes increase psychiatric symptoms for general population and especially in health professionals at pandemic conditions. In particular, the symptoms of burnout, depression, and anxiety have rised significantly. With this case report, we present a physician who had symptoms that started during the COVID-19 pandemic, had depression accompanied by suicidal thoughts, and went into complete remission with electroconvulsive therapy. The mental health effects of healthcare workers who have had COVID-19 are discussed within the frame of this case report.

Ketiapin yaygın kullanılan, baş dönmesi, sedasyon ve metabolik yan etkiler gibi birçok yaygın yan etkisi olan bir antipsikotik ilaçtır. Bunlara ek olarak, ilacın bazı nadir yan etkileri de mevcuttur. Bunlar arasında ilaca bağlı interstisyel akciğer hastalığı (drug-induced interstitial lung disease, DI-ILD) çok az bilinmektedir. Bu olgu sunumunda ketiapin kullanımının akciğer yan etkilerini tartışmayı amaçladık. Elli dört yaşında erkek bir şizofreni hastasında ketiapin kullanımını takiben ortaya çıkan, nadir görülen bir yan etki olan interstisyel akciğer hastalığı olgusu sunulmaktadır. Olgumuzda, ketiapin tedavisinin başlamasından sonra ortaya çıkan ve ketiapin kesildikten sonra gerileyen akciğer bulguları nedeniyle DI-ILD düşünülmüştür. Klinisyenler, ketiapin kullanımının bir sonucu olarak ortaya çıkabilecek DI-ILD gibi nadir akciğer yan etkileri konusunda dikkatli olmalıdır.

The aim of this study is to determine the self-efficacy perceptions and time management belief levels of the public and sports club managers working in Turkey and to examine the relationship between them by examining them according to some demographic variables. In this research, a method for descriptive and relational screening was used to reveal the current situation. The sample group of the public and sports club managers working in Turkey consists of public sports managers (n = 55) and sports club managers (n = 99) who volunteered to participate in the study. Personal Information Form, Sport Managers Self-Efficacy Scale and Time Management Scale were used as data collection tools. In the analysis of data, since the data and groups are not distributed homogeneously and the data is skewed to the left, non-parametric Mann Whitney U and Kruskal Wallis test techniques were used to determine the differences between the groups in the sub-dimensions of self-efficacy and time management, and Spearman Correlation Analysis technique was used in the relationship between Sport Managers' Self-Efficacy Scale and Time Management Scale. At the end of the study, there were no significant differences between Sport Managers Self-Efficacy and Time Management beliefs and Personal variables (age, gender, marital status, education level, year of service, management year and sports history), while a significant difference was determined between the time attitude sub-dimension of time management and the sector variable in favor of sports club managers. In addition, a weak positive and significant (p lt;0.05) relationship was found between general time management and sports managers' self-efficacy (decision-making, personal characteristics, Knowledge and Interpersonal Roles).

Abstract While the function of ornaments shaped by sexual selection is to attract mates or drive off rivals, these signals may also evolve through social selection, in which the social context affects the fitness of signallers and receivers. Classical ‘mate choice’ experiments often reveal preferences for ornaments, but few studies have considered whether these are strictly sexual or reflect general social preferences. Indeed, an alternative possibility is that ornaments evolve through ‘non-sexual social selection’ (hereafter ‘social selection’). We examined the role of ornamentation (yellow ventral patch) and familiarity (individuals recognize group mates with which they have had previous interactions) on mate choice (opposite-sex stimuli preference) and social choice (same-sex stimuli preference) in both male and female white-eyed bulbuls (Pycnonotus xanthopygos). In the mate choice test, females preferred unfamiliar males with increased yellow. There were no biologically important differences in male preferences based on familiarity or intensity of patch colour. In the social choice test, females preferred to associate with familiar females. Males preferred to associate with familiar males but also preferred to associate with less ornamented males. Our results suggest that ornamentation and familiarity are important features, playing different roles in males and females, in both social and sexual selection processes.

A challenging problem in the field of avian ecology is deriving information on bird population movement trends. This necessitates the regular counting of birds which is usually not an easily-achievable task. A promising attempt towards solving the bird counting problem in a more consistent and fast way is to predict the number of birds in different regions from their photos. For this purpose, we exploit the ability of computers to learn from past data through deep learning which has been a leading sub-field of AI for image understanding. Our data source is a collection of on-ground photos taken during our long run of birding activity. We employ several state-of-the-art generic object-detection algorithms to learn to detect birds, each being a member of one of the 38 identified species, in natural scenes. The experiments revealed that computer-aided counting outperformed the manual counting with respect to both accuracy and time. As a real-world application of image-based bird counting, we prepared the spatial bird order distribution and species diversity maps of Turkey by utilizing the geographic information system (GIS) technology. Our results suggested that deep learning can assist humans in bird monitoring activities and increase citizen scientists’ participation in large-scale bird surveys.

Transcatheter Aortic Valve Implantation [TAVI] is widespread worldwide as an alternative therapy procedure to the patients suffering from severe aortic valve stenosis. However, we shouldn’t forget that the conventional surgical aortic valve replacement is still the gold standard therapy for severe aortic valve stenosis. For the patients who cannot be treated conventionally because of high risk comorbid diseases and older age, TAVI is an effective alternative therapy method. The indications should be limited, concerning the high mortality rate, 10% within 30 days of intervention. Long term efficacy data are still inadequate. Although the indications are restricted to older patients with a STS score >10 or log-Euro Score >20, age is not a definite indication for this treatment. The patients should be assessed by a heart team including a non-interventional cardiologist, interventional cardiologist, cardiac anesthesiologist and cardiac surgeon according to their general status, frailty and STS- Euro score. In other words, assessment and treatment of the patient by a heart team is the main factor besides the limited power of the scoring systems. The treatment should be applied to the patients with an aortic annulus diameter between 18-27 mm and a life expectancy of at least over 1 year. The currently ongoing investigations are focused on parameters like safety, efficiency and long term reliability of TAVI. The scientific and technical developments lead to new definitions and parameters regarding the treatment indications of severe aortic valve stenosis. In this review, we present the actual data about TAVI and also our own experiences.

Scientific BACKGROUND: Syphilis is an systemic infection that can effect the central nervous system in all stages. Without treatment, it reaches the primary, secondary and tertiary stages, it also affects heart, central nervous system and other organs. OBJECTIVE: With the introduction of penicillin, effects of syphilis on central nervous system are decreased. Spinal cord involvement is very rare manifestation of syphilis. Syphilis should be kept in mind in transverse myelitis cases that presented with acute paraparesis. CASE: A 61 years old man presented with acute paraparesis, hyperestesia below level of T9 dermatom, fecal and uriner retantion. CONCLUSION: Our case is presented due to rare manifestation of syphilis like spinal myelitis with acute paraparesia and concomitant cardiac, cerebral, renal, aortic and retinal involvement by syphilis

Scientific BACKGROUND: Paget’s disease is mostly asymptomatic. Neurological syndromes are uncommon but include headache, dementia, brain stem and cerebellar dysfunction, cranial neuropathies, myelopathy, cauda equina syndrome and radiculopathies. While she was in a symptomatic treatment by the diagnosis of cluster headache, our case was hospitalized to our clinic and reported after diagnosed cranial Paget’s disease according to the results of clinical, radiological and laboratory findings. OBJECTIVES: In our case of cluster headache, we aim to discuss the headaches that have different characters and the other properties due to Paget’s disease. RESULTS: While 61 year old female case was in the medical treatment of cluster headache, she was examined by the complaints of headache that was constant and localized on the right orbito-frontal region, tinnitus and hearing loss. On neurological examination, in addition to headache, she had mixed type hearing loss in the right ear, but sensorineural hearing loss in the left ear. Alcaline phosphatase levels were high in the serum and hydroxyprolin levels were high in the urine. In the cranial radiography, there was diffused osteoporosis, circumscripta, osteolytic areas, sclerosis in petrous bone, increasing diploe spaces in the skull base and diffuse cotton wool rough granular osteolytic spaces in the right lower part of frontal bone and basilar invagination. There was an appearance of bone-within-bone without any symptom in L2-L3 vertebrae. In her bone scintigraphy, other bones were normal but osteoblastic activity involvements in the head bones. After all the examinations of the headache, we thought that it was originated from two different causes like cluster headache and cranial Paget’s disease. CONCLUSION: In Paget’s disease, cranial headaches are intermittent in early stages and may be confused by the primary headaches. In late stages, it is violent and continuous. Cranial headaches are due to different causes as cluster headache associated with cranial Paget’s disease like our case. We wanted to emphasize the other etiologic causes to be considered in cranial headaches

Severe symptomatic aortic stenosis (AS) in a multimorbid 77 year old female was treated with transapical aortic valve implantation with a 23 mm Edwards Sapien valve. Severe valvular regurgitation following implantation, probably due to structural valve failure, was treated successfully with a second valve-in- valve implantation. During a follow-up time of 2,5 years no further problems occurred.

A stroke attack in the brainstem area as a serious complication of atrial fibrillation (AF) in a 51 year old woman with known paroxysmal AF (CHADS² score 3) was treated with LAA occlusion procedure after the complication of arterial bleeding secondary to anticoagulation therapy. LAA closure device embolisation was developed following the LAA occlusion procedure. The device was located and removed successfully from the systemic circulation.

The aim of this study was to examine the proactive personality and psychological needs in sport of the students studying at the faculty of sport sciences according to the various and to determine whether there is a relationship between proactive personality and psychological needs in sport. The research was conducted according to the survey model from quantitative approaches. 315 students studying at Karamanoğlu Mehmetbey University, Faculty of Sport Sciences participated in the study voluntarily. Psychological Need Status in Sport Scale, Proactive Personality Scale and personal information form created by the researchers were used in the study. Non-parametric tests were used to analyze the data. According to the findings, a significant difference was found in favor of female students in the autonomy satisfaction and proactive personality scale, and in favor of male students in the belonging dissatisfaction sub-dimension. Also, there was a significant difference in favor of students between the ages of 18-21 in the autonomy satisfaction sub-factor, and in favor of students aged 22 and over in the belonging dissatisfaction sub-dimension. In addition, it was found that students interested in individual sports had higher autonomy satisfaction than students interested in team sports. The scores related to both scales and sub-factors did not differ in terms of the variables of the department and the year of sport. Finally, there was a positive and significant relationship between the psychological need status in sport and proactive personalities of the students of the faculty of sport sciences.

Objective: Acute reperfusion therapy is a critical intervention for stroke patients with the aim of restoring blood flow. The presence of anatomical anomalies, such as fetal posterior cerebral artery (fPCA) and posterior communicating artery (PCOM) variations, can impact treatment outcomes and patient prognosis. This study aimed to assess the potential influence of these anomalies on patients undergoing acute reperfusion therapy. Materials and Methods: Demographic characteristics of patients who underwent acute reperfusion therapy for stroke were considered among three distinct groups: the PCOM group, fPCA group, and control group. The demographic attributes examined for each group included gender distribution, mean age, presence of comorbidities, thrombolysis in cerebral infarction, national institutes of health stroke scale (NIHSS), and European cooperative acute stroke study II (ECASS II) scores. The significance of differences in these attributes among the groups was assessed. Results: The study included a total of 106 patients: 42 patients in the PCOM group, 31 patients in the fPCA group, and 33 patients in the control group. No significant differences in demographic data were observed among the groups. The greatest decrease in NIHSS at the 24th hour was observed in the PCOM group, whereas the least decrease on day 7 was observed in the fPCA group. No differences were detected in the NIHSS values on the 24th hour and 7th day among the groups. When the 24th hour computed tomography scans of the groups were evaluated according to the ECASS II criteria, no significant differences were observed among the groups. Hemorrhage was not observed in 52.4% of patients in the PCOM group and 66.7% of patients in the control group. Conclusion: The impact of fPCA and PCOM anomalies on patients undergoing acute reperfusion therapy for stroke was evaluated. Although no significant demographic differences were found among the groups, the study highlights the importance of further research to better understand their potential impact on treatment outcomes.

Background: The aim of this study is to examine the hematological and biochemical variables in patients diagnosed with cancer-related stroke who have different types of cancer and to evaluate the effects of these variables. Methods: This retrospective study was conducted at a tertiary hospital stroke center and included 153 patients diagnosed with cancer-related stroke. Comprehensive etiological investigations were performed, and patients were classified according to the Trial of Org 101072 in Acute Stroke Treatment (TOAST) classification. Laboratory parameters including d -dimer, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and fibrinogen levels were collected from blood samples taken at the time of stroke. Statistical analysis was performed using 1-way analysis of variance to assess differences in laboratory parameters across different cancer types. Results: The study found significant variations in hematological and biochemical parameters among different cancer types. Specifically, glomerular filtration rate, activated partial thromboplastin time, prothrombin time, and international normalized ratio levels showed significant differences across cancer types ( P

We report an interesting case of a man with a persistent left superior vena cava (PLSVC) with left azygos vein who underwent electrophysiological evaluation. Further evaluation revealed congenital dilated azygos vein, while a segment connecting the inferior vena cava (IVC) to the hepatic vein and right atrium was missing. The azygos vein drained into the superior vena cava, and the hepatic veins drained directly into the right atrium. The patient did not have congenital anomalies of the remaining thoracoabdominal vasculature.

Introduction: Inflammation is one of the factors involved in the occurrence and progression of acute kidney injury (AKI). We evaluated the relationship between preoperative systemic inflammatory markers and early postoperative AKI development in pediatric liver transplantation (LT) patients. Methods: Data from 190 pediatric patients were retrospectively analyzed. The preoperative neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), and pan-immune-inflammation value (PIV) levels were calculated. AKI was classified according to the Kidney Disease: Improving Global Outcomes staging. Patients who did not develop AKI in the early postoperative period were classified as group 0, patients with stage 1 AKI were classified as group 1, and patients with stage 2-3 AKI were classified as group 2. The relationship between the inflammatory parameters and AKI was evaluated. Results: AKI developed in 20% of patients, and 16.31% of these patients had severe AKI. The NLR, SII, and PIV values were significantly higher in patients with severe AKI (p

Dietary modification and supplementation play an increasingly important role in the conservative treatment of cardiovascular disease. Current interest has focused on n-3 polyunsaturated fatty acids (PUFA) and vitamin D. Clinical trial results on this subject are contradictory in many aspects. Several studies indicate that n-3 PUFA consumption improves vascular and cardiac hemodynamics, triglycerides, and possibly endothelial function, autonomic control, inflammation, thrombosis, and arrhythmia. Experimental studies show effects on membrane structure and associated functions, ion channel properties, genetic regulation, and production of anti-inflammatory mediators. Clinical trials evaluating a possible reduction in cardiovascular disease by n-3 PUFA have shown different results. Supplementation of vitamin D is common regarding prevention and treatment of osteoporosis. But vitamin D also seems to have several effects on the cardiovascular system. Vitamin D deficiency appears to be related to an increase in parathyroid hormone levels and can predispose to essential hypertension and left ventricular hypertrophy, increased insulin resistance, and eventually to atherosclerosis and adverse cardiovascular events. Randomized prospective clinical trials are needed to determine whether vitamin D and omega-3 FA supplementation therapy should be recommended as a routine therapy for primary or secondary prevention of cardiovascular disease.

Purpose. In this study, our purpose was to investigate the diagnostic efficacy of the dynamic contrast-enhanced magnetic resonance imaging (MRI) method in the patients with bile duct obstruction. Materials and Methods. 108 consecutive patients (53 men, 55 women, mean age; 55.77±14.62, range 18–86 years) were included in this study. All the patients underwent conventional upper abdomen MRI using intravenous contrast material (Gd-DTPA) and MRCP in 1.5 Tesla MRI scanner. MRCP images were evaluated together with the T1 and T2w images, and both biliary ducts and surrounding tissues were examined for possible pathologies that may cause obstruction. Results. MRI/MRCP findings compared with final diagnoses, MRI/MRCP in the demonstration of bile duct obstruction sensitivity 96%, the specificity 100%, and accuracy 96.3%, in the detection of presence and level of obstruction, the sensitivity 96.7%, specificity 100%, and accuracy 97.2%, in the diagnosis of choledocholithiasis, the sensitivity 82.3%, specificity 96%, and accuracy 91.7%, and in the determination of the character of the stenosis, sensitivity 95.6%, specificity 91.3%, and accuracy 94.5% were found. Conclusion. The combination of dynamic contrast-enhanced MRI and MRCP techniques in patients with suspected biliary obstruction gives the detailed information about the presence of obstruction, location, and causes and is a highly specific and sensitive method.

Tako-Tsubo cardiomyopathy (TTC) is an acute reversible cause of segmental myocardial dysfunction that is poorly understood and cannot be explained by the occlusion of a single coronary vessel. Its clinical presentation is similar to that of acute coronary syndrome and is often precipitated by a severe psychological or physical stress.

Effective cardiac resynchronization therapy (CRT) requires an accurate atrio-biventricular pacing system. The innovative Quartet lead is a quadripolar, over-the-wire left ventricular lead with four electrodes and has recently been designed to provide more options and greater control in pacing vector selection. A lead with multiple pacing electrodes is a potential alternative to physical adjustment of the lead and may help to overcome high thresholds and phrenic nerve stimulation (PNS).

Objective: To reveal the profile and practice in patients with acute stroke who received intravenous tissue plasminogen activator (IV tPA) and/or neuro-interventional therapy in Türkiye. Materials and Methods: On World Stroke Awareness Day, May 10, 2018, 1,790 patients hospitalized in 87 neurology units spread over 30 health regions were evaluated retrospectively and prospectively. Results: Intravenous tPA was administered to 12% of 859 cases of acute ischemic stroke in 45 units participating in the study. In the same period, 8.3% of the cases received neurointerventional treatment. The rate of good prognosis [modified Rankin score (mRS) 0–2] at discharge was 46% in 83 patients who received only IV tPA [age: 67 +- 12 years; National Institutes of Health Stroke Scale (NIHSS): 12 +- 6; hospital stay, 24 +- 29 days]; 35% in 51 patients who underwent thrombectomy (MT) alone (age: 64 +- 13 years; NIHSS: 14.1 +- 6.5; length of hospital stay, 33 +- 31 days), 19% in those who received combined treatment (age: 66 +- 14 years; NIHSS: 15.6 +- 5.4; length of hospital stay, 26 +- 35 days), and 56% of 695 patients who did not receive treatment for revascularization (age: 70 +- 13 years; NIHSS: 7.6 +- 7.2; length of hospital stay, 21 +- 28 days). The symptom-to-door time was 87 +- 53 minutes in the IV treatment group and 200 +- 26 minutes in the neurointerventional group. The average door-to-needle time was 66 +- 49 minutes in the IV tPA group. In the neurothrombectomy group, the door-to-groin time was 103 +- 90 minutes, and the TICI 2b-3 rate was 70.3%. In 103 patients who received IV tPA, the discharge mRS 0–2 was 41%, while the rate of mRS 0–1 was 28%. In 71 patients who underwent neurothrombectomy, the mRS 0–2 was 31% and mRS 0–1 was 18%. The door-to-groin time was approximately 30 minutes longer if IV tPA was received (125 +- 107 and 95 +- 83 minutes, respectively). Symptomatic bleeding rates were 4.8% in IV recipients, 17.6% among those who received only MT, and 15% in combined therapy. Globally, the hemorrhage rate was 6.8% in patients receiving IV tPA and 16.9% in MT. Conclusion: IV thrombolytic and neurointerventional treatment applications in acute ischemic stroke in Türkiye can provide the anticipated results. Heterogeneity has begun to be reduced in our country with the dissemination of the system indicated by the 'Directive on Health Services to be Provided to Patients with Acute Stroke.'

Objective: Atrial fibrillation (AF) is the most common directly preventable cause of ischemic stroke. There is no dependable neurology-based data on the spectrum of stroke caused by AF in our country. Within the scope of NeuroTek-Turkey, hospital-based data on acute stroke patients with AF were collected to contribute to the creation of acute stroke algorithms. Materials and Methods: Atrial fibrillation (AF) is the most common directly preventable cause of ischemic stroke. There is no dependable neurology-based data on the spectrum of stroke caused by AF in Türkiye. Within the scope of NöroTek-Türkiye (TR), hospital-based data on acute stroke patients with AF were collected to contribute to the creation of acute-stroke algorithms. Results: The rate of AF in patients hospitalized for ischemic stroke/TIA was 29.8%, of which 65% were known before stroke, 5% were paroxysmal, and 30% were diagnosed after hospital admission. The proportion of patients with AF who received 'effective' treatment [international normalization ratio ≥2.0 warfarin or non-vitamin K antagonist oral anticoagulants (NOACs) at a guideline dose] was 25.3%, and, either no medication or only antiplatelet was used in 42.5% of the cases. The low dose rate was 50% in 42 patients who had a stroke while taking NOACs. Anticoagulant was prescribed to the patient at discharge at a rate of 94.6%; low molecular weight or unfractionated heparin was prescribed in 28.1%, warfarin in 32.5%, and NOACs in 31%. The dose was in the low category in 22% of the cases discharged with NOACs, and half of the cases, who received NOACs at admission, were discharged with the same drug. Conclusion: NöroTekTR revealed the high but expected frequency of AF in acute stroke in Türkiye, as well as the aspects that could be improved in the management of secondary prophylaxis. AF is found in approximately one-third of hospitalized acute stroke cases in Türkiye. Effective anticoagulant therapy was not used in three-quarters of acute stroke cases with known AF. In AF, heparin, warfarin, and NOACs are planned at a similar frequency (one-third) within the scope of stroke secondary prophylaxis, and the prescribed NOAC dose is subtherapeutic in a quarter of the cases. Non-medical and medical education appears necessary to prevent stroke caused by AF.

Background: Atrial fibrillation (AF) is the most common cause of cardioembolic ischemic strokes. It causes large-vessel occlusions and a poor prognosis. Regardless of ischemic stroke etiology, hyperacute therapy strategies are effective treatment modalities. Methods: Patients who were diagnosed as having AF were classified as AF (+) and others without AF were classified as AF (-). It is not clear which treatment should be preferred in patients with stroke who are AF (+). We studied demographic characteristics, recanalization rates, and clinical outcomes in acute patients with ischemic stroke with or without nonvalvular AF who underwent hyperacute treatments. Results: We detected that clinical findings were more severe and the NIHSS scores were significantly higher at admission inpatients who were AF (+). In our study, mechanical thrombectomy rates were high in patients who were AF (+), whereas intravenous tissue plasminogen activator treatment rates were higher in patients who were AF (-). Thrombolysis in cerebral infarction scores were similar in our patient groups. We found high rates of both symptomatic (PH 2) and asymptomatic hemorrhagic transformation in patients who were AF (+) in 24th-h cranial computed tomography. A positive correlation was found between symptom-admission, symptom-needle, and symptom-groin times and discharge-modified Rankin Scale scores regardless of the hyperacute treatments in all patient groups. Conclusion: As a result, physicians should focus on the diagnosis of AF, and appropriate anticoagulant treatment is important for primary prevention.

Aim: The Willis polygon variant, specifically the presence of a fetal posterior cerebral artery (fPCA), can have implications for the treatment and prognosis of patients with acute stroke. This study aimed to investigate the effect of fPCA variations on treatment, follow-up, and prognosis in patients with acute stroke who underwent reperfusion therapies. Materials and Methods: The study analyzed a total of 62 patients, including 33 without any posterior system variant (normal group) and 29 with only the fPCA variant (variant group). Demographic characteristics, clinical features, and computed tomography (CT) findings were compared between the two groups. Treatment methods, acute stroke therapies, and clinical outcomes were evaluated. Results: No significant differences were observed in age, sex, smoking status, or comorbidities between the normal and fPCA groups. Cardiac parameters were similar between the groups. Treatment approaches, artery territories, acute stroke therapies, and time intervals did not differ significantly between the two groups. The National Institutes of Health Stroke Scale scores, modified Rankin Scale scores, and CT findings were also similar between the groups. A significant difference was observed in the presence of hemorrhage at 24 h, with higher rates in the normal group. Conclusion: The presence of fPCA does not significantly influence age-related risk factors or comorbidities in patients with acute stroke. Treatment approaches and clinical outcomes were similar regardless of the presence of fPCA, except for a higher risk of hemorrhage in the normal group. The lateral status of the variants did not significantly impact the distribution of risk scores and CT findings.

Objective: Nutritional status assessment, dysphagia evaluation and enteral feeding decision are important determinants of prognosis in acute neurovascular diseases. Materials and Methods: NöroTek is a point prevalence study conducted with the participation of 87 hospitals spread across all health sub regions of Turkey conducted on 10-May-2018 (World Stroke Awareness Day). A total of 972 hospitalized neurovascular patients [female: 53%, age: 69+-14; acute ischemic stroke in 845; intracerebral hematoma (ICH) in 119 and post-resuscitation encephalopathy (PRE) in 8] with complete data were included in this sub-study. Results: Gastrostomy was inserted in 10.7% of the patients with ischemic stroke, 10.1% of the patients with ICH and in 50% of the patients with PRE. Independent predictors of percutaneous endoscopic gastrostomy (PEG) administration were The National Institutes of Health Stroke Scale score at admission [exp (β): 1.09 95% confidence interval (CI): 1.05-1.14, per point] in ischemic stroke; and mechanical ventilation in ischemic [exp (β): 6.18 (95% CI: 3.16-12.09)] and hemorrhagic strokes [exp (β): 26.48 (95% CI: 1.36-515.8)]. PEG was found to be a significant negative indicator of favorable (modified Rankin's scale score 0-2) functional outcome [exp (β): 0.032 (95% CI: 0.004-0.251)] but not of in-hospital mortality [exp (β): 1.731 (95% CI: 0.785-3.829)]. Nutritional and swallowing assessments were performed in approximately two-thirds of patients. Of the nutritional assessments 69% and 76% of dysphagia assessments were completed within the first 2 days. Tube feeding was performed in 39% of the patients. In 83.5% of them, tube was inserted in the first 2 days; 28% of the patients with feeding tube had PEG later. Conclusion: The NöroTek study provided the first reliable and large-scale data on key quality metrics of nutrition practice in acute stroke in Turkey. In terms of being economical and accurate it makes sense to use the point prevalence method.

Dünya genelinde son yıllarda ortaya çıkan sosyal ve teknolojik gelişmeler, turizmi hem daha kolay satın alınabilir hem de daha kolay erişilebilir hale getirmiştir. Turizm böylece insanların gündelik çevresinde mevcut olmayan hoş vakit geçirilebilecekleri, verimli bir eğlenme–dinlenme faaliyeti alternatifine ve aynı zamanda hem fiziki hem de entelektüel kişiliklerini keşfettikleri bir gelişim formuna dönüşmüştür. Bu dönüşüm geleneksel doğa turizmi, deniz, kum ve plaj turizminden gastronomi, inanç, eğitim ve folklor gibi kültürel cazibe boyutlarına yönelerek kültürel miras turizmi kapsamında dünya turizm endüstrisinin en hızlı gelişen pazarı halini almıştır. Kültürel miras turizminin bileşenleri oldukça geniş bir yelpaze oluştururken, önemli bir bileşeni de arkeolojik kültür varlıklarıdır. Bu varlıklar, eskinin kültür mirasına dönük doğru ve tarafsız bir kanıt belge oluşturmaktadırlar. Geçmişin kültür mirası somut buluntuları, o kültürün sosyal mozaiğini, geleneklerini, sanat anlayışını, inançlarını, tabularını, sevinçlerini, kederlerini ve dolayısıyla o kültürün çeşitliliğini ve karakterini yansıtır. Arkeologlar elde edilen bu belgelerin güzelliği ya da ne kadar ekonomik değeri olduğu ile değil, o varlıkları üreten kültür ile ilgilenirler ve böylece bu mirası bilimsel yöntemlerle çalışarak yukarıda bahsi geçen boyutlarda insanlığın ortak kültürüne yönelik ilgi ve bilgi üretirler. Kültürel miras turizminin önemli bir bileşeni olan arkeolojik kültür varlığı turizmi arkeoturizm hem dünyada hem de Türkiye’de bilimsel temelde yeni çalışılan bir alt disiplindir. Özellikle Anadolu Asia Minor arkeolojik kültür varlıkları açısından oldukça zengin bir coğrafyadır. Bu varlıklar Türkiye’nin dünya kültür mirası turizmi endüstrisinden daha yüksek bir pay alabilmesinde yüksek önemde değer taşımaktadır. Ancak mevcut durumda bu zenginlikler, potansiyeline oranla oldukça düşük seviyelerde değer üretmekte ve ülke ekonomisine yeterince katkı yapamamaktadır. Görülmektedir ki, Türkiye’de arkeolojik kültür varlıkları son zamanlara kadar süregeldiği şekliyle sadece turizm profesyonellerine bırakılamayacak kadar önemli bir turizm destinasyon kaynağı iken sadece arkeologlara da bırakılamayacak değerde bir hazinedir. Arkeolojik çalışmaların sonunda bir turizm ürünü ortaya çıkmasına rağmen, yapılan arkeolojik çalışmaların ayrıca bir arkeoturizm planlaması içermediği açıktır. Arkeologların turizmin dinamiklerinden uzak olduğu, turizmcilerin de arkeoloji gibi özellikli bir alana hakim olmadıkları beklenen bir sonuçtur. Bu bakımdan, her iki meslek alanının da tüm ilgili aktörlerin ihtiyaçlarına cevap verebilecek bir arkeoturizm planlamasını oluşturacak multidisiplinli bir çalışma ekibinin parçası olması bir zorunluluktur. Arkeologların böylesi bir topluluk içinde sağlayacağı katkıların kapsamı ve içeriği üzerine yapılan çalışmalar son derece önemlidir.

Objectives: Idiopathic Parkinson's Disease (IPD) is a movement disorder that cause tremor, rigidity, bradykinesia, postural instability and deterioration quality of life. To assess the disease different scales can be used: The Unified Parkinson's Disease Rating Scale (UPDRS) for clinical severity, Parkinson's Disease Questionnaire (PDQ39) to assess quality of life, Beck Depression Scale (BD) for mood assessment and Hoehn Yahr Scale (HY) for clinical staging. The International Classification of Functioning, Disability and Health (ICF) is a classification to develop an international common language for the evaluation of the functionality and disability of patients. We aimed to compare validity and efficacy of ICF classification with other scales. Materials and Methods: Thirty-one patients with idiopathic Parkinson's disease were evaluated. PDQ39, UPDRS, Hoehn Yahr, Beck Depression Scale and 'Brief ICF core set for hand condition' which was recommended for Parkinson's disease were applied to patients. The brief ICF core set and other scales were compared and assessed if there was any correlation. For analyzes, the MedCalc Statistical Software version 12.7.7 programme was used. Results: The mean age of the IPD patients was 68.3 ± 6.9 years and 71% of them were female (22) and 29% were male (9). According to ICF codes, patients who have eight or more corrupted codes were recorded as 'major code impairment patients', and those with less than eight codes recorded as 'minor code impairment patients'. The total UPDRS score of major code impairment patients was 58.4 ± 29.8, while the mean score of minor code impairment patients was 21.2 ± 14.05. The PDQ39 score of major code impairment patients was 66.4 ± 24.1, while the mean score of minor code impairment patients was 19.3 ± 13.5. According to Hoehn Yahr stage, the ratio of stage 1 were higher in minor ICF patients. Conclusion: While assessing the functioning of the Parkinson's disease patients, we need comprehensive scales that include many parameters. The ICF coding system is an international system, which is very important to develop a common language. The significant correlation between ICF coding system and other scales in our Parkinson's patients, shows the validity of the coding system.

Aim This study aims to investigate the intricate interplay between lesion localization and kappa light chain (KLC) levels in patients diagnosed with Secondary Progressive Multiple Sclerosis (SPMS), unraveling the underlying mechanisms contributing to lesion distribution and potential drivers of the observed relentless progression of neurological disability in SPMS.Material and Methods An observational study was conducted with a cohort of 23 SPMS patients meeting diagnostic criteria. Clinical, demographic data, and MRI scans were collected of 14 patients who had received any treatment in the past year. Serum KLC levels were measured, and statistical analyses were performed to identify correlations between age, KLC levels, and lesion distribution.Results The study revealed a significant positive correlation between age and the number of periventricular lesions, indicating a potential influence of aging processes on lesion distribution dynamics. Serum KLC levels showed a noteworthy positive correlation with the number of infratentorial lesions. However, no significant correlations were observed between Expanded Disability Status Scale (EDSS) scores and lesion counts.Conclusion The findings underscore the complex and multifaceted nature of SPMS pathogenesis. While age and serum KLC levels demonstrated associations with periventricular and infratentorial lesions, the lack of correlation between EDSS scores and lesion counts emphasizes the heterogeneous aspects of SPMS progression. These insights highlight the importance of a comprehensive understanding beyond lesion quantification to unravel the intricate mechanisms driving disability progression in SPMS.

A 51-year-old male presented with dysarthria and weakness on his left side. In his history, he had an operation due to aortic coarctation 13 years ago, and 5 years ago, he had a transient ischemic attack along with difficulty in speaking. During his neurological examination, he was conscious, cooperative, and oriented. Mild dysarthria and left hemiparesis were seen (4/5, 4/5). He smoked at least one cigarette packet per day for 30 years. Vascularization was performed only by narrowed right vertebral artery on cranial and cervical magnetic resonance angiography. He had a mild increase in his left hemiparesis during his stay in the hospital (2/5, 4/5). A stent had been inserted into his right vertebral artery during digital subtraction angiography. In his last neurological examination, he was conscious, cooperative, and oriented. We started prasugrel (10 mg/day) and acetylsalicylic acid (300 mg/day) for his mild dysarthria and mild hemiparesis. In this case, we explain that although there was three-vessel occlusion and narrowing in the right vertebral artery, the patient’s neurologic status was not too bad due to collateral circulation around the cerebral arteries. This showed us the importance of collateral circulation between cerebral arteries.

Osteogênese imperfeita (OI) é o resultado de uma mutação genética que causa a formação defeituosa ou insuficiente de colágeno. OI pode causar várias complicações anestésicas por causa do manejo difícil das vias aéreas, da presença de deformidade da coluna vertebral, de doenças respiratórias, anomalias cardíacas, distúrbio da função plaquetária, risco de hipertermia, invaginação bacilar, deformidades ósseas e distúrbios metabólicos. A abordagem anestésica de pacientes com OI deve ser feita com cautela, por causa do risco de certas complicações respiratórias. Esses riscos são causados por deformidade do tórax, fraturas ósseas durante o movimento ou mudança de posição, fraturas mandibulares e cervicais relacionadas à intubação, intubação difícil e hipertermia maligna. As técnicas anestésicas com o uso de anestesia venosa total (AVT) e máscara laríngea são adequadas para o manejo de paciente pediátrico com OI. No entanto, essas técnicas ainda não foram mencionadas como úteis em relatos de casos neurocirúrgicos. Neste estudo, apresentamos o uso de AVT e máscara laríngea ProSeal (MLP) em uma criança com OI e hemorragia epidural. Concluímos que a MLP e a AVT podem ser usadas com segurança no manejo anestésico de pacientes com OI e problemas anestésicos graves.

Osteogenesis Imperfecta (OI) results from gene mutation that causes defective or insufficient collagen formation. It may cause various anesthetic complications due to the difficulty in airway management, existence of spinal deformity, respiratory disorders, cardiac anomalies, thrombocyte function disorder, risk of hyperthermia, bacillary invagination, bone deformities and metabolic disorders. The anesthesia management of OI patients should be exercised with caution given certain risks of respiratory disorders. These risks are due to thorax deformity, bone fractures during moving or changing position, mandibular and cervical fractures related with intubation, difficult intubation and malignant hyperthermia. The anesthetic technique using Total Intravenous Anesthesia (TIVA) and laryngeal mask airway is suitable for pediatric patient care with OI. However, these techniques have not yet been reported as useful in neurosurgery case reports. In this study, we present the use of TIVA and ProSeal Laringeal Mask in a child with OI and epidural hemorrhage. We came to the conclusion that LMA and TIVA can safely be used in the anesthetic management of OI patients with severe anesthetic problems. Keywords: Anesthesia, Anesthesia, Intravenous, Hematoma, Epidural, Cranial, Laryngeal Masks, Osteogenesis Imperfect.

Myasthenia gravis is an autoimmune disease of the nicotinic acetylcholin receptors at the postsynaptic membrane of the neuromuscular junction. Myasthenic crisis, defined as respiratory failure requiring mechanical ventilation is a common life-threatening complication that occur approximately 15% to 20% of patients with MG. Endotracheal intubation and invasive mechanical ventilation have a number of complications and a high mortality. On the other hand, noninvasive mechanical ventilation is being successfully used in many pulmonary and neuromuscular diseases . There are few reports about the use of noninvasive mechanical ventilation in myasthenic crisis. We present a case with myasthenic crisis who was treated with noninvasive mechanical ventilation. (Journal of the Turkish Society Intensive Care 2012; 10: 20-2)

In adults, the main causes of iron poisoning are intake suicide attempts and an overdose of iron during pregnancy. The severity of intoxication depends on the amount of iron. When serum iron level exceeds the iron binding capacity of the body, free radicals occurs, leading to lipid peroxidation and cellular membrane damage. In iron poisoning, especially the liver, heart, kidney, lung, and hematologic systems are affected negatively. Acute iron poisoning can cause serious complications resulting in death. Clinical, laboratory observation and early treatment are important. In this case report, we examined to approach the acute iron poisoning with the occasion of high-dose iron intake for suicide attempt. (Journal of the Turkish Society Intensive Care 2011; 9: 107-9)ntakeforsuicideattempt. (Journal of theTurkishSocietyIntensiveCare 2011; 9: 107-9)