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Gazete köşe yazarları temsilcisi oldukları yayın kuruluşunun ideolojisini çeşitli stratejiler yoluyla metne aktarmakta; bu ideolojiler Eleştirel Söylem Çözümlemesi’nin (ESÇ) sunduğu çözümleme araçları ile ortaya koyulabilmektedir. Bu çalışmanın amacı, 25 Haziran 2020 tarihinde Fatih Sultan Mehmet’in İtalyan ressam Bellini tarafından yapılan tablosunun İstanbul Büyükşehir Belediyesi tarafından satın alınmasının farklı ideolojik yönelimlere sahip Sözcü ve Yeni Akit gazetelerinde yer alan köşe yazılarında yansıtılma biçimlerinin incelenmesidir. Bu amaçla, söz konusu tablonun satın alınmasının konu edildiği iki köşe yazısı Söylem Tarihsel Yaklaşım’ın (Reisigl & Wodak, 2009) yükleme stratejisi çerçevesinde çözümlenmiştir. Bulgular, Yeni Akit gazetesindeki köşe yazısında yükleme stratejisinin biz ve onlar ayrımını yansıtma amacıyla; Sözcü gazetesindeki köşe yazısında ise, beklenenin aksine, biz ve onlar ayrımını hafifleterek farklı ideolojik eğilimlere sahip toplumsal aktörler arasında benzerlik kurma amacıyla kullanıldığını göstermiştir. Bu bulgu, gazete köşe yazarlarının ideolojilerini metne aktarmasında belirleyici etmenin ele alınan konu olduğunu ve yükleme stratejisinin gazete köşe yazarları tarafından temelde hedef kitleyi ikna etme amacıyla kullanıldığını ortaya koymaktadır., Op-ed writers reflect the ideology of their media organizations in their columns using various linguistic strategies. These strategies can be manifested using the analytic tools provided by Critical Discourse Analysis (CDA). The aim of this study is to analyze how the portrait of Mehmed II painted by the Italian artist Bellini being purchased by Istanbul Metropolitan Municipality on 25 June 2020 is reflected in two op-ed articles in the Sözcü and Yeni Akit newspapers which represent contrasting ideologies. The op-ed articles have been analyzed using the Predication strategy within the framework of Discourse-Historical Approach (Reisigl & Wodak, 2009). Our findings have revealed that predication strategy has been used in the op-ed article in Yeni Akit newspaper to present the opposition between us and them, while it has been used in the op-ed article in Sözcü to create a similarity between the social actors with different ideological orientations by mitigating the distinction between us and them. It has been concluded that the topic at hand is the determining factor for the op-ed writers in conveying their ideologies in the text and that the predication strategy is mainly used to persuade the target audience.

Ödünleyici ilişkiler alanyazında şaşırma, karşıt beklenti, iki tümce arasında uyumsuzluk, çatışma ya da uygunsuzluk olarak tanımlanmıştır. Ödünleme çeşitli dilsel kaynaklar kullanılarak açık biçimde işaretlenebildiği gibi, örtük olarak da gerçekleştirilebilmekte ve bağlamsal bilgiye dayalı olarak dinleyici tarafından algılanabilmektedir. Önceki çalışmalarda ödünlemenin karşıtlığın gösterilmesi, olası yanlış anlaşılmaların önlenmesi, düzeltme/onarım, uzlaşma ve konu yönetimi işlevleriyle kullanıldığı ortaya konmuştur. Diğer taraftan, dil kullanımı ve cinsiyet ile ilgili geleneksel bakış açısı, kadınların ortak paydada buluşma, anlaşmazlıktan kaçınma ve kibar dil kullanma eğiliminde olduğunu savlamaktadır. Ödünlemenin söylemsel işlevleri dikkate alındığında, kadınların ödünlemeyi erkeklerden daha sık kullandığı öngörülebilmektedir. Bu nedenle, bu çalışmanın amacı Türkçe sözlü söylemde (i) ödünlenmenin işaretlenmesi ve ödünleyici dilsel kaynakların kullanımında ve (ii) ödünlemenin işlevlerinde (varsa) cinsiyet farklılıklarının Etkileşimsel Dilbilim çerçevesinde belirlenmesidir. Çalışmanın veri tabanı altı saatlik Türkçe gündelik söylem kayıtlarından elde edilen çevriyazı metinlerinden oluşmaktadır. Bulgularımız, ödünlemenin en çok açık biçimde gerçekleştirildiğini (83.5%), ancak cinsiyetler arasında anlamlı bir fark olmadığını göstermiştir. Türkçe sözlü söylemde en sık kullanılan ödünleyici dilsel kaynağın ama olduğu saptanmıştır (33.7%). Ödünlemenin işlevleri açısından ise, veri tabanımızda ödünlemenin en çok karşıtlığın gösterilmesi (49.4%) amacıyla kullanıldığı, ancak cinsiyetler açısından istatistiksel olarak anlamlı bir fark olmadığı ortaya konmuştur. Çalışmamızda ödünlemenin işaretlenmesi ve işlevleri bakımından cinsiyete dayalı bir farklılık saptanmamıştır. Bu bulgular, dil kullanımının konuşucuların cinsiyetine göre değil, söylem bağlamına göre biçimlendiği ortaya koyması bakımından cinsiyet ve konuşma biçemleri ile ilgili güncel görüşü desteklemektedir., Concessive relations have been defined in terms of concepts such as surprise, counter-expectation, incompatibility or conflict between clauses in literature. Concession can be marked explicitly by a range of linguistic resources or expressed implicitly and perceived by the hearer based on contextual cues. In previous studies, various functions of concession including expressing a contrast, preventing potential misunderstandings, correction/repair, alignment and topic management have been reported. Traditional view on gender and language allege that women tend to seek common ground, avoid disagreement and be polite. The current view, on the other hand, claim that discourse context is determinant on such tendencies. Considering the discursive functions of concession, it can thus be presumed that women opt for concession more frequently than man do. Therefore, the aim of this study is twofold: to determine (if any) gender-based differences (i) in the marking and use of concessive resources and (ii) in the functions of concession in Turkish spoken discourse within the framework of Interactional Linguistics. The database of the study consists of the transcriptions of six-hour daily Turkish conversations. Findings have revealed that concession is mostly marked explicitly (83.5%) with no significant difference between genders and the most commonly used concessive marker is ama (but) by both genders (33.7%). As for the functions, the concessions are mostly used to express a contrast (49.4%) with no significant difference between male and female speakers. These findings support the view that it is not the gender of the speakers but the discourse context that shapes the language use.

Cardiomyopathy is a major factor contributing to mortality and morbidity in patients with Duchenne and Becker muscular dystrophies (DMD/ BMD), and is therefore among the increasingly important findings. These X-linked recessive disorders involve the deficiency or absence of dystrophin in the skeletal muscle as well as the myocardium. This defect brings about changes in the cardiac muscle in three phases: an initial hypertrophic stage, followed by an arrhythmogenic stage, and finally end-stage dilated cardiomyopathy due to increased loss of myocytes. While cardiac involvement can be observed in carriers of BMD and DMD, the incidence of dilated cardiomyopathy is reported to be higher in BMD patients than DMD patients. The only curative treatment option for medically refractory dystrophinopathic end-stage heart failure is heart transplantation. In this report, we present two patients, 14 and 15 years of age, who presented with dilated cardiomyopathy and were diagnosed with muscular dystrophy. One of the patients remains under follow-up with a left ventricular assist device as a bridge-to-transplantation, while the other underwent successful orthotopic heart transplantation.

Hz. Muhammed’in Mescid-i Haram’dan Mescid-i Aksâ’ya yaptığı yolculuğunu ifade eden miraç, Kur’an-ı Kerim’de Hz. Muhammed’in tek mucizesi olarak geçmekte ve göğe çıkma olarak tanımlanmaktadır. Bu olayın aşamalarının anlatıldığı miraçnameler, sahip oldukları resimli örnekleri ile İslam resim sanatının önemli yapıtlarındandır. İlhanlı döneminden Nakkaş Ahmet Musa’nın 1317-1335 civarlarına tarihlenen miraçnamesi ile 1436’da Timurlu Hükümdarı Şahruh için hazırlanan miraçname bu üretimin bilinen örneklerdendir. Farklı dönemlere ait bu iki eserde, Hz. Muhammed’in beyaz horoz suretinde bir melekle tanışmasını betimleyen sahnelere yer verilmiştir. Çalışmanın amacı, örneğine az rastlanan bu sahnenin resim programına dâhil edilmesinde nakkaşların ana motivasyonunu araştırmaktır. Bu doğrultuda, horozun İslam inancındaki yerine değinilerek İlhanlı ve Timurlu miraçnamelerindeki beyaz horozun neyi temsil ettiği incelenecektir. Son olarak İslam inancındaki beyaz horoz temsili ile bu iki miraçnamedeki beyaz horoz figürü arasındaki bağlantılar değerlendirilecektir.

This study aims to identify students’ approaches toward courses lectured by visual arts teachers with elements of popular culture with a view to enabling students to attain 7th grade targeted achievements. To this end, the multiple-case design, one of the qualitative research methods, was utilized in the study. The sample of the study comprised 11 visual arts teachers working at secondary schools located in three central districts of the Bursa province of Turkey. As the data collection tools, two interview forms and document review were used. The obtained findings were evaluated through the thematic analysis technique and were compiled under the theme of ‘implications on students’. As per the research results, it was discerned that there were certain differences in the students’ approaches toward the course along with employment of elements of popular culture in the visual arts course. It may be alleged that, of these differences, the primary ones were attraction of students’ attention to the course, active participation into the course and facilitation of comprehension.

Kawasaki disease, known as mucocutaneous lymph node syndrome, is a multi-system disease of unknown aetiology that occurs in young children under 5 years of age. The recurrence rate of Kawasaki disease is as rare as 1–3%. Especially in cases with coronary artery involvement, recurrent Kawasaki disease should be investigated in terms of underlying rheumatologic diseases such as periodic fever syndromes, microscopic polyangiitis, polyarteritis nodosa, and systemic-onset juvenile arthritis. In this study, we report homozygote mutations in mevalonate kinase and familial Mediterranean fever genes in a recurrent Kawasaki disease with coronary dilatation.

Introduction The results of standard chemotherapy in lung cancer are not very satisfactory, so it is important to identify genetic mutations that provide targeted therapies. Recent reports have suggested influences of racial difference on the frequency of mutation in lung cancer. We aimed to determine the frequency and regional distribution of genetic mutations of non-small cell lung cancer (NSCLC) in Turkey. Materials and Methods Regional distribution of genetic mutations in lung cancer in Turkey (REDIGMA) study was carried out as a prospective, cross-sectional, observational study in a large number of centers in which lung cancer patients were followed and could perform genetic mutation analysis on patients' biopsy materials. Result The 703 patients (77.7% male, mean age 63.3 ± 12.5 years) who were diagnosed as NSCLC from 25 different centers were included in the study. Tumor samples from patients were reported as 87.1% adenocarcinoma, 6.4% squamous cell carcinoma and 6.5% other. Mutation tests were found to be positive in 18.9% of these patients. The mutations were 69.9% EGFR, 26.3% ALK, 1.6% ROS and 2.2% PDL. Mutations were higher in women and non-smokers (p

We aimed to evaluate cardiac functions and electrocardiogram (ECG) parameters that are determinant in the development of atrial and ventricular arrhythmia in children with celiac disease.Twenty-eight patients with celiac disease followed up between March 2017 and June 2020 were evaluated retrospectively. 33 age-and sex-matched healthy children were included as the control group. Echocardiography (ECHO) and 12-lead ECG were performed in all patients and controls. Of the 28 patients, 16 were girls (57.1%) and their mean age was 9.46±4.20 years. The mean duration time of celiac disease was 2.17±2.21 years. The Tp-e interval, QTc, QTc dispersion, and Tp-e / QT ratio were detected longer in celiac patients than in the control group (p, Çölyak hastalığı tanılı çocuk hastalarda atriyal ve ventriküler aritmi gelişiminde belirleyici olan elektrokardiyogram (EKG) parametrelerini ve kardiyak fonksiyonları değerlendirmeyi amaçladık. 2017 Mart-2020 Haziran dönemlerinde çölyak hastalığı tanısı ile takip edilen 28 hasta retrospektif olarak değerlendirildi. Yaş ve cinsiyet uyumlu 33 hasta kontrol grubu olarak alındı. Tüm hasta ve kontrol grubuna Ekokardiyografi (EKO) ve 12 kanallı elektrokardiyogram tetkiki yapıldı. Hastaların 16'sı kız (%57,1) olup ortalama yaşları 9,46±4,20 yıl idi. Ortalama çölyak hastalığı takip süresi 2,17±2,21 yıl idi. Çölyak hastalarında Tp-e intervali, QTc, QTc dispersiyonu, Tp-e/QT ve Tp-e/QTc oranları kontrol grubuna göre daha uzun saptandı (p

İran’ın Fars eyaletinde yer alan ve önemli bir kültür sanat merkezi olan Şiraz, 14. yüzyıl başlarından 16. yüzyılın ortalarına kadar bu özelliğini korumuştur. İran edebiyatına ait çeşitli eserlerin olduğu, resimli el yazmaları bu kentte, süreklilik içerisinde ve zaman zaman yerel metotlarla hazırlanmıştır. Bu metotla üretim, eserlerin sayı olarak artışına katkı sağlamıştır. El yazmaların sayı olarak arttığı zaman aralığı Türkmen Dönemi olarak bilinen Karakoyunlu (1351-1469) ve Akkoyunlu (1340- 1514) beyliklerinin var olduğu zaman dilimine denk gelmiştir. Böylece yeni üretim metodu ile birlikte yeni bir dönemde Şiraz’da yerleşik olan resim üslubu yeniden yorumlanmıştır. Bu çalışmada, Şiraz kentinin önemli sanat merkezi olmasını etkileyen başlıca unsurlardan bahsedildikten sonra kentte gerçekleştirilen kitap üretimi ve mevcut üretimi şekillendiren bazı unsurlar üzerinde durulmuştur. Üretim ile birlikte Şiraz’da hazırlanan resimli kitaplarda var olan resim üslubundan bahsedilmiş ve Türkmen dönemindeki durum değerlendirilmiştir. Üslubun şekillenmesine etki eden nedenler ve konunun odaklanıldığı dönemdeki resim üslubundaki dönüşüm eldeki mevcut bilgiler ışığı altında ele alınmıştır.

Aim: Congenital heart disease is the most common congenital anomaly innewborns. The aim of this study is to evaluate the congenital heart disease innewborns referred to the pediatric cardiology outpatient clinics.Material and Method: A total of 607 patients admitted to the PediatricCardiology Outpatient Clinics between March 2017 and June 2018 during the first30 days of life were evaluated retrospectively. Electrocardiogram was performedon all newborns. The cardiovascular system examination, electrocardiogram evaluationand echocardiography were performed to all newborns.Results: 271 (44.6%) of the patients were female. The mean age and weight was12.25±8.93 days (0-30 days) and 3.57 ± 0.64 kg (1.85-6.0), respectively. Themost frequent presenting cause was murmur. 19 of the patients have congenitalanomaly. The most frequently detected anomaly was Down syndrome.Echocardiographic evaluation showed no abnormal findings in 168 (27.7%) of thepatients. The most common congenital heart disease was atrial septal defect andsecondly ventricular septal defect.Conclusion: Echocardiographic examination was normal in most of the patients. Themost frequent presenting cause was murmur. Echocardiographic examination shouldbe performed on patients suspected of having congenital heart disease becausethe patients may have any different findings and symptoms during neonatalperiod. Early cardiologic evaluation is very important in the early diagnosisand treatment of congenital heart diseases., Amaç: Doğumsal kalp hastalığı yenidoğanlarda en sık görülen doğumsalanomalidir. Çalışmamızın amacı çocuk kardiyolojipolikliniğine başvuran yenidoğan dönemindeki olguları doğumsal kalp hastalığıyönünden değerlendirmektir.Gereç ve Yöntem: Mart 2017-Haziran 2018 tarihleri arasında çocuk kardiyoloji polikliniğine yaşamın ilk 30gününde başvuran 607 vaka geriye dönük olarak değerlendirildi. Tüm olgularaelektrokardiyogram çekildi. Kardiyovasküler sistem muayenesi, Elektrokardiyogram değerlendirilmesi ve ekokardiyografiyapıldı. Bulgular: Olguların 271'si (%44,6)kız idi. Ortalama yaşı 12,25±8,93 gün (0-30gün) ve kilosu 3,57±0,64 kg (1,85-6,0) idi. En sık başvuru nedeni üfürüm idi.Hastaların 19'unda ek anomali mevcuttu, en sık saptanan anomali ise Down sendromu idi.Ekokardiyografik değerlendirmede hastaların 168’inde (%27,7) herhangi biranormal bulguya saptanmadı. En sık tespit edilen doğumsal kalp hastalığıatriyal septal defekt idi, ikincisıklıkta ise ventriküler septal defekt idi.Sonuç: Çocuk kardiyolojipolikliniğine en sık başvuru nedeni üfürüm olup olguların çoğununekokardiyografisi normal idi. Yenidoğan döneminde doğumsal kalp hastalığıbulguları farklılık gösterebileceği ve hatta hiçbir bulgu vermeyebileceği içinşüphe duyulan hastalarda mutlaka ekokardiyografik inceleme yapılmalıdır. Erkenkardiyolojik değerlendirme kalp hastalıklarının erken tanı ve tedavisinde çokönemlidir.

Neisseria gonorrhoeae, dünyada cinsel temasla bulaşan hastalıklarda saptanan en önemli patojen mikroorganizmalardandır. N. gonorrhoeae neden olduğu ve toplum sağlığı açısından önem arz eden infeksiyonlar dışında, özellikle son yıllarda tedavide kullanılan antibiyotiklere karşı gelişen direnç nedeniyle önem kazanmıştır. Son yıllarda tedavide önerilen ve sıklıkla kullanılmaya başlanan üçüncü kuşak sefalosporinlere duyarlılığın azalmasıyla birlikte, daha önceleri kullanılan penisilin, tetrasiklin, makrolid, trimetoprim-sülfametoksazol ve kinolonlar gibi antibiyotik grupları bir arada değerlendirildiğinde N. gonorrhoeae’nin çoklu ilaca dirençli bir bakteri haline geldiği bildirilmektedir. Bu bildiride, üretral akıntı şikayetiyle başvuran bir hastadan yapılan üretral sürüntü kültüründen Türkiye’de ilk kez izole edilen sefuroksime dirençli bir N. gonorrhoeae suşu bildirilmiştir., Neisseria gonorrhoeae is one of the most important pathogenic microorganisms in sexually-transmitted diseases in the world. N. gonorrhoeae is an important problem for the community health due to the emerging resistance to antibiotics which has been used in the treatment in recent years, as well as the infections caused by it. When the antibiotic groups which were preferred in the past such as penicillins, tetracyclines, macrolides, trimethoprim-sulphametoxazole and quinolones are evaluated together, N. gonorrhoeae has been reported to become a multidrug-resistant organism with reduced susceptibility to third-generation cephalosporins, which has been recommended in the last few years and started to be used widely. We herein present the first cefuroxime-resistant N. gonorrhoeae strain in Turkey, which was isolated from urethral swab culture taken from a patient presenting with complaint of urethral discharge.

Objective: The aim of this study was to use tissue Doppler imaging to evaluate the left atrial systolic and the left ventricular (LV) diastolic function as well as the left atrial ejection force in children who underwent transcatheter closure of a secundum atrial septal defect (ASD). Methods: Tissue Doppler measurements of the left atrial ejection force, the mitral valve, and left atrial volume were performed before the ASD closure procedure, and on the 1st day, 10th day, and 1st and 3rd months after the procedure in 56 patients and in 28 healthy controls. Results: There was a significant decrease in the septal and lateral a' velocities on the first day (p

Congenital left atrial appendage aneurysm (LAAA) is a very rare condition and occurs as a result of congenital dysplasia of musculi pectinate. These patients may be asymptomatic and/or may present with dyspnea, and thromboembolic events. The most common complications are life-threatening thromboembolic events and supraventricular tachyarrhythmias. Transthoracic echocardiography plays a very important role in the diagnosis of LAAA. Herein, we present a rare case of giant congenital LAAA.

Background: Type 1 Diabetes Mellitus (DM), autoimmune disorders, relatives of celiac patients have higher risk of developing celiac disease (CD) because they share the same HLA type. Celiac disease and type 1 DM are autoimmune and common in children. According to international guidelines, serological screening for CD in children and adults with type 1 DM is recommended but there is no consensus on how often it will be performed. Objectives: We aimed to investigate the prevalence of CD in children with type 1 diabetes mellitus (DM). Methods: This current study was carried out between 01 March 2017 and 15 December 2018. 273 children with type 1 DM were included in the study. Tissue transglutaminase antibody IgA (tTG IgA) and total IgA levels were measured in all patients. The patients with tTG IgA positivity underwent gastroduodenoscopy. Results: Of the 273 patients (139 girls), the mean age was 11.61 ± 3.73 years. tTG IgA was positive in 23 patients, and 2 of them refused the process of endoscopy. Gastroduodenoscopy was performed on other patients. 11 patients with Marsh 3, 2 patients with Marsh 2, 4 patients with Marsh 1, and 4 patients with Marsh 0 were detected in the present study. In other words, 12 patients were diagnosed with CD. Nine of 12 patients diagnosed with CD were diagnosed within the first 5 years after the diagnosis of type 1 DM. Conclusions: We found that the prevalence of biopsy-proven CD in children with type 1 DM was 4.4%, which was approximately 9 times higher than the prevalence of CD in the general population. In the current study, 9 of 12 patients diagnosed with CD were diagnosed within the first 5 years after DM. According to our results, we recommend that screening tests for CD should be performed at least once a year for 5 years in children with Type 1 DM, even if the patients are asymptomatic.

To investigate the clinical impact of vancomycin-resistant enterococci (VRE) colonization in patients with hematologic malignancies and associated risk factors.Patients colonized and infected with VRE were identified from an institutional surveillance database between January 2010 and December 2013. A retrospective case-control study was performed to identify the risk factors associated with development of VRE infection in VRE-colonized patients.Fecal VRE colonization was documented in 72 of 229 children (31.4%). Seven VRE-colonized patients developed subsequent systemic VRE infection (9.7%). Types of VRE infections included bacteremia (n=5), urinary tract infection (n=1), and meningitis (n=1). Enterococcus faecium was isolated in all VRE infections. Multivariate analysis revealed severe neutropenia and previous bacteremia with another pathogen as independent risk factors for VRE infection development in colonized patients [odds ratio (OR): 35.4, confidence interval (CI): 1.7-72.3, p=0.02 and OR: 20.6, CI: 1.3-48.6, p=0.03, respectively]. No deaths attributable to VRE occurred.VRE colonization has important consequences in pediatric cancer patients.Amaç: Hematolojik malignitesi olan pediatrik hastalarda vankomisine dirençli enterokok (VDE) kolonizasyonunun klinik öneminin araştırılması ve eşlik eden risk faktörlerinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Ocak 2010-Aralık 2013 tarihleri arasında yapılan VDE sürveyans kayıtlarından faydalanılarak VRE ile kolonize ve/veya enfekte olmuş hastalar belirlenmiştir. VDE ile kolonize hastalarda VRE enfeksiyonu gelişimi ile ilişkili risk faktörlerini belirlemek amacıyla retrospektif olgu-kontrol çalışması yapılmıştır. Bulgular: Çalışma süresince yatırılan 229 hastanın 72’sinde (%31,4) rektal VRE kolonizasyonu saptanmıştır. VRE kolonize hastaların yedisinde (%9,7) kolonizasyon sonrası sistemik VRE enfeksiyonu gelişmiştir. Beş hastada bakteriyemi (n=5), bir hastada idrar yolu enfeksiyonu (n=1) ve bir hastada menenjit (n=1) gözlenmiştir. Tüm enfeksiyonlarda ilgili klinik örneklerde Enterococcus faecium üretilmiştir. Multivaryant analiz sonucunda, ciddi nötropeni ve başka bir patojene bağlı bakteriyemi öyküsü VDE kolonize hastalarda VDE enfeksiyonu gelişimi için risk faktörleri olarak bulunmuştur [odds ratio (OR): 35,4; güven aralığı (GA): 1,7-72,3; p=0,02 ve OR: 20,6; GA: 1,3-48,6; p=0,03; sırasıyla]. VDE enfeksiyonuna bağlı mortalite saptanmamıştır. Sonuç: Pediatrik kanser hastalarında VDE kolonizasyonunun önemli klinik sonuçları olduğu gözlenmiştir.

Streptococcus agalactiae (Group B streptococcus, GBS), a member of normal flora of human gastrointestinal and genitourinary systems, is a leading cause of sepsis, meningitis, and pneumonia particularly in newborn. GBS can also cause severe infections in pregnant women and adults with underlying disease, as well as mild diseases, such as urinary tract infections (UTIs). GBS strains exhibit 10 different serotypes, and the identification of serotype distribution is important epidemiologically. The role of biofilm production is one of the virulence factors that has been discussed in the pathogenesis of GBS infections. Although resistance to penicillin and ampicillin has not been documented in GBS, different rates of resistance has been reported for the alternative antibiotics to penicillin. The aim of this study was to investigate the serotype distribution, the ability of biofilm formation and the antibiotic susceptibilities of S.agalactiae strains isolated from urine cultures. A total of 60 strains were included in the study, 40 of them were isolated from patients (38 female 2 male; mean age: 36.7 years) with urinary tract complaints whose cultures yielded single type of colonies in the number of ≥ 50.000 cfu/ml, whereas 20 of them were isolated from patients (19 female 1 male; mean age: 37.2 years) without urinary tract complaints whose cultures yielded mixed colonies in the number of ≤ 20.000 cfu/ml. Chromogenic media were used for the isolation and the isolates were identified by conventional methods. The isolates were then serotyped by latex agglutination method and their antibiotic susceptibilities were determined by disk diffusion method recommended by CLSI documents. Biofilm formation of the strains were investigated by microplate and Congo red agar (CRA) methods. In our study, the most frequently detected serotypes were V (n= 18; 30%) and II (n= 14; 23.3%), followed by serotype Ia (n= 10; 16.7%), III (n= 9; 15%), Ib (n= 3; 5%), VI (n= 1; 1.7%) and VII (n= 1; 1.7%). Serotype IV, VIII and IX were not detected, while four (6.7%) isolates were untypeable. Serotype V (13/40; 32.5%) and serotip II (6/20; 30%) were in the first line among the strains isolated from patient and control groups, respectively. All of the GBS isolates were found susceptible to penicillin, vancomycin and cefotaxime. The rates of resistance against ofloxacin, erythromycin and clindamycin in patient group were found as 22.5%, %10 and 5%, respectively. In the control group resistance rates against erythromycin and clindamycin were both 10%, while no resistance was detected to the other antibiotics. The ofloxacin resistance in the patient group was found significantly higher than that of control group (p= 0.02). By microplate method, the percentage of moderate/strong biofilm producers was found as 42.5% (17/40) in the patient group and 20% (4/20) in the control group, however the difference between the groups was not statistically significant (p= 0.08). All GBS strains were detected as positive by the CRA method, and it has been suggested that this might have been due to the binding of Congo red to sialic acid found in the GBS capsule, therefore this method thought to be improper for the investigation of biofilm formation in GBS strains. In conclusion, the most frequent serotypes of the GBS urinary isolates in our study were similar with the frequent serotypes reported in other studies. Our data have pointed out that the biofilm formation of GBS may not play a role in the pathogenesis of UTIs. In the meantime the high quinolone resistance detected in our study should be considered in the treatment of UTI due to GBS.

Alpay, Yeşim (Balikesir Author), Bronchocentric granulomatosis is a necrotizing granulomatous lesion of the bronchi and bronchioles and a rare disease, which is not associated with any clinical or radiological findings. It usually affects adults and is often incidentally diagnosed on chest X-ray. The diagnosis is confirmed by histopathological evaluations of the lung biopsy specimens. The present study reports the case of a 58-year-old male patient with pulmonary nodules observed on chest X-ray performed as part of general screening. Thoracic computed tomography confirmed the presence of multiple nodular lesions. Both invasive and non-invasive methods failed to remove the masses, and an open lung biopsy was performed. The histopathological diagnosis reported bronchocentric granulomatosis. This case has been presented to highlight the importance of multidisciplinary management of all conditions, which helps in the accurate detection of rare diseases, such as bronchocentric granulomatosis.

Fibrinous bronchitis, also known as plastic bronchitis or pseudomembranous bronchitis, usually manifests clinically with non-productive cough and dyspnea. Prior to the expectoration of plaque formations, patients have a history of viral or other respiratory disease. Plastic bronchitis is an extremely rare and fatal complication associated with Fontan procedure. The condition is characterized by the formation of inspissated bronchial casts which may cause life-threatening airway obstructions. Although the pathogenesis of this condition remains unclear, it is believed to involve elevated pulmonary venous pressure, increased central venous pressure, and endobronchial lymphatic leakage. A 9-year-old male patient with Down syndrome underwent Fontan procedure 29 months earlier due to complete endocardial cushion defect and single ventricular physiology. The patient presented to the emergency department due to sudden-onset respiratory distress and fever (38.5 °C). Bilateral diffuse sibilant rhonchi, secretory rales, and intercostal retractions were noted during pulmonary system examination. Posterior-anterior chest x-ray showed cardiomegaly (cardiothoracic ratio=0.6) and bilateral diffuse infiltration. While under treatment, the patient experienced sudden-onset cough with expectoration of rubbery sputum in the form of branching bronchi-shaped casts. Samples of the inspissated sputum were sent to the Pathology and Microbiology departments for examination. The pathology report indicated fibrinoid material composed of a small number of inflammatory cells and bacterial plaques. Normal bacterial flora was identified in microbiological culture. Clinical presentation can vary from mild clinical findings to life-threatening symptoms. As in our patient, the diagnosis is made clinically, based on expectoration of bronchial casts or their detection during bronchoscopy. As our patient responded well to medical treatment, we proceeded with clinical follow-up. Plastic bronchitis is a very rare entity, and carries a poorer prognosis when it develops after congenital heart disease, as in our case.

The Eurasia Tunnel, a 5.4-km tunnel connecting the Asian and European sides of Istanbul, Turkey, was opened for operation in December 2016. This paper describes the air quality modeling that was conducted during the design phase of the structure, to evaluate the impact of the tunnel traffic on ambient air quality in the vicinity of the tunnel. The ventilation of the tunnel consists of longitudinal forced ventilation with vertical extraction through two stacks located near the Asian and European portals of the tunnel. The analysis was conducted using the AERMOD computer program for three pollutants CO, NO2, and PM10. Model results show that pollutants will rapidly disperse once released from the stack and will not affect air quality in the vicinity of the tunnel. The most critical parameters which controlled the ventilation system design were found to be NO2 and PM10. Maximum concentrations are not expected to violate the pertinent Turkish and EU air quality standards. Overall, this analysis shows that the ventilation system is efficient for the dispersion of the pollutants.

Cutis laxa tip1b is a rare autosomal recessive disorder caused by FBLN 4 mutation and primarily characterized by vascular anomalies. Herein, we present five patients who are the members of the same family. The primary cardiac findings of these patients were giant aortic aneurysms. One 2.5-year-old patient with a massive aneurysm of the ascending aorta died as a result of compression to the heart chambers, trachea, and bronchi. The bentall procedure was performed in three of our patients who are under follow-up. One patient is still under clinical follow-up without surgery. After the diagnosis of the first patient, a genetic study was performed in which FBLN 4 mutations were investigated. Four new patients were detected during genetic screening of the family. Other 29 family members were screened bur were negative in physical examinations and echocardiography. Pedigree is important for early diagnosis of genetic diseases in asymptomatic individuals.

28th International Congress of the European-Respiratory-Society (ERS) -- SEP 15-19, 2018 -- Paris, FRANCE, WOS: 000455567103370, …, European Respiratory Soc

Esra Ertan Yazar,1 Tevfik Özlü,2 Muzaffer Sarıaydın,3 Mahşuk Taylan,4 Aydanur Ekici,5 Derya Aydın,6 Ä°brahim Güven Coşgun,7 Nagihan Durmuş Koçak8 On behalf of the COHOV Study Group 1Department of Pulmonology, Yedikule Chest Disease and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey; 2Department of Pulmonology, School of Medicine, Karadeniz Technical University, Trabzon, Turkey; 3Department of Pulmonology, School of Medicine, Afyon Kocatepe University, Afyon, Turkey; 4Department of Pulmonology, School of Medicine, Dicle University, Diyarbakır, Turkey; 5Department of Pulmonology, School of Medicine, Kırıkkale University, Kırıkkale, Turkey; 6Department of Pulmonology, Balıkesir Chest Disease Government Hospital, Balıkesir, Turkey; 7Department of Pulmonology, Afyonkarahisar Government Hospital, Afyonkarahisar, Turkey; 8Department of Pulmonology, Sureyyapasa Chest Disease and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey Background: Domiciliary noninvasive ventilation (NIV) use in stable hypercarbic COPD is becoming increasingly widespread. However, treatment compliance criteria and factors related to compliance remain to be defined. Methods: This research was designed as a prospective, cross-sectional, multicenter real-life study. Chronic hypercapnic COPD patients who were using domiciliary NIV for at least 1 year and being followed up in 19 centers across Turkey were included in the study. The patients who used NIV regularly, night or daytime and ≥5 hours/d, were classified as “high-compliance group,” and patients who used NIV irregularly and

To determine the incidence of vancomycin-resistant enterococcus (VRE) colonization in our neonatal intensive care unit (NICU) over five-year period, rate of progression to VRE infection and associated risk factors.A retrospective analysis of a prospective surveillance for VRE colonization and health care-associated infections was made. Contact precautions were taken against colonization, although the application varied over the years due to repairs in the unit.VRE rectal colonization was detected in 200/1671 neonates (12%) admitted to NICU. It showed great interannual variability from 1.9% to 30.3%. Sytemic VRE infection developed in 6/200 VRE-colonized patients (3%) within a median of 9 days (range: 3-58 days). The risk factors for VRE infection development identified in the univariate analysis were long hospital stay (≥30 days), necrotizing enterocolitis, surgical procedure, extraventricular drainage, receipt of amphotericin B and receipt of glycopeptides after detection of VRE colonization. Crude in-hospital mortality was higher in neonates who developed a systemic VRE infection (p 0.001).Maintaining physical conditions in the unit favorable for infection control and rational use of antibiotics are essential in the control of VRE colonization and resultant infections. Special attention should be directed to VRE-colonized babies carrying the risk factors.

Summarization: In the past decades, subsurface non-aqueous phase liquid (NAPL) contamination has been recognized as one of the most widespread and challenging environmental problems. Thus, researchers have focused their efforts on developing and testing the efficiency of remediation methodologies, able to address the unique nature of these contaminants. Recently, in-situ flooding techniques for the accelerated removal of NAPLs trapped in the subsurface have been proposed, where additives are injected together with water upgradient of the NAPL-contaminated area in order to alter the physio-chemical properties of the contaminants, such as interfacial tension, and enhance their solubilities. In this work, the efficiency of ethanol enhanced NAPL remediation is addressed. To this end, a non-linear, multi-objective optimization strategy is developed by combining a multiphase flow simulation model with evolutionary algorithms. Two conflicting optimization objectives are considered: minimizing operation cost and maximizing remediation efficiency, while preventing uncontrolled NAPL mobilization. More specifically, the first objective involves the operation cost of the procedure, which is directly proportional to the pumping rate, duration and ethanol volume used. The second represents the environmental considerations of the problem that, in this work, are described by the maximization of free product removal and the prevention of DNAPL vertical spreading. Presented on: Procedia Engineering

We report a 9-year-old boy with atypical presentation of subacute sclerosing panencephalitis (SSPE). He was admitted due to staring spells and cognitive deterioration. Electroencephalography (EEG) demonstrated bilaterally symmetrical, synchronous, frontal sharp-and-slow wave discharges in 80% of the record. Diazepam or midazolam administration during EEG recording attenuated the sharp-and-wave discharges, but revealed no periodic complexes. Magnetic resonance imaging delineated bilateral frontal T2-weighted hyperintense foci. Fluorodeoxyglucose-positron emission tomography imaging indicated bilaterally decreased glucose metabolism in frontal cortex. The other laboratory tests including measles antibody in cerebrospinal fluid and serum suggested no specific etiology. Interestingly, a month later, the previously detected sharp-and-slow wave discharges disappeared, and periodic slow-wave paroxysms appeared on EEG recording. Measles antibody titers showed seroconversion and confirmed the diagnosis of SSPE. The present case suggests that clinicians be cautious while excluding SSPE.

Background Transcatheter closure of a patent ductus arteriosus (PDA) has always been considered risky for infants weighing