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Patent foramen ovale closure is recommended for patients who are at risk for recurrent paradoxical embolism and cryptogenic stroke. The standard technique of patent foramen ovale closure is established from the femoral vein. However, alternative methods may be necessary for patent foramen ovale closure as in every interventional procedure. A 45-year-old female patient with an intramural giant uterine myoma had a history of recurrent deep vein thrombosis and stroke. A diffuse thrombus was detected in both iliac veins associated with inferior vena cava compression of the myoma. Also, a patent foramen ovale was revealed on echocardiography as a cause of embolic events. Hysterectomy was initially planned by gynaecology, but due to the possible risk of embolisation of inferior vena cava thrombus and stroke after removal of the compressive mass during hysterectomy, initial patent foramen ovale closure and then hysterectomy was scheduled in the Gynecology-Cardiology-Cardivascular Surgery council. Patent foramen ovale closure was performed via the right jugular vein approach. But because of the tight left atrial ostium of the patent foramen ovale, the catheter could not pass to the left atrium from the right atrium. With an anchor of a 5.0 × 15 mm coronary balloon over a 0.014-inch guidewire to the pulmonary vein, we were able to reach the left atrium. The patent foramen ovale was closed successfully, and the patient underwent a hysterectomy after closure without any embolic event. The patient was asymptomatic at 6 months of control.

Aim: Investigations into Ankaferd Blood Stopper® (ABS) on bone healing have revealed positive bone regeneration effects. The exact mechanism of this positive bone tissue metabolism effect is unknown. This study’s aim is a biomechanic and biochemical investigation of the effects of local ABS application on the osseointegration of titanium implants. Methodology: Sprague Dawley rats were divided into four groups of ten rats each. The control group (n=20) received no treatment during the experimental period, while the ABS group (n=20) had ABS applied locally during the surgical application of the titanium implant before insertion into the bone sockets. After 2 (controls n=10 and ABS n=10) and 4 weeks (controls n=10 and ABS n=10) experimental periods, the rats were sacrificed and implants with surrounding bone tissues were removed for reverse torque analysis (Newton), blood sample collection, and biochemical analysis. Results: The biomechanic bone implant contact ratio detected was higher in week 4 than in week 2 in the ABS group (p

Air pollution is the fourth cause of premature mortality (HEI, 2020) and in Europe, more than 0.3 million premature deaths are due to air pollution (EEA, 2021). In urban environments, people are exposed to a complex mixture of air pollutants with a large spatial variability. However, highly spatially resolved measurement data on air pollutants is lacking. These fine-grained data is needed to correctly assess personal exposure to air pollution for epidemiolocal studies and to support air quality management scenarios.Within RI-URBANS different innovative approaches to get insights into novel air quality parameters, source contributions, exposure to air pollution and associated health effects will be developed and tested. One of the approaches relies on mobile measurements with citizens to derive spatial air pollution maps. Mobile measurements can contribute to understand spatial variability of short-living constituents of air pollution from a diversity of pollution sources.The monitoring campaign is performed with volunteers, who are all employees of DCMR or the city of Rotterdam. They are asked to measure during their daily bicycle commutes. Before the measurement campaign, a training session was organized for the volunteers. Measurements were performed in winter (November 2022 – February 2023) and will be repeated in spring 2023.Measurements are based on the airQmap approach; more information on the approach and previous studies can be found on https://www.airQmap.com. Measurements of Black Carbon (BC) are performed using a microaethalometer (microAeth®, AE51, AethLabs) and a GPS. BC is measured at 1s temporal resolution and a flow rate of 150 mL min-1. To reduce the noise in BC measurements, the ONA (Optimized Noise-reduction Averaging, Hagler et al., 2011) algorithm was used with an attenuation threshold of 0.05. The geo-tagged measurements were aggregated (trimmed mean) and attributed to fixed points 20 m apart from each other along the cycling route.The dataset will be used to test different data processing techniques (a.o. temporal aggregation, background correction approaches) to construct representative BC maps. The collected spatiotemporal BC measurements will be analysed to identify main sources of BC in the area. The pilot study will result in guidance on best practices for mobile air quality monitoring involving citizens.This paper will present the results of the winter campaign.____________________EEA, 2021. HI of Air Pollution in EUHagler, G.S., Yelverton, T.L., Vedantham, R., Hansen, A.D., Turner, J.R., 2011. Postprocessing method to reduce noise while preserving high time resolution in Aethalometer real-time black carbon data. Aerosol Air Qual. Res. 11, 539-546.HEI, 2020. State of Global Air

Although strain tolerance to high product concentrations is a barrier to the economically viable biomanufacturing of industrial chemicals, chemical tolerance mechanisms are often unknown. To reveal tolerance mechanisms, an automated platform was utilized to evolve Escherichia coli to grow optimally in the presence of 11 industrial chemicals (1,2-propanediol, 2,3-butanediol, glutarate, adipate, putrescine, hexamethylenediamine, butanol, isobutyrate, coumarate, octanoate, hexanoate), reaching tolerance at concentrations 60%–400% higher than initial toxic levels. Sequencing genomes of 223 isolates from 89 populations, reverse engineering, and cross-compound tolerance profiling were employed to uncover tolerance mechanisms. We show that: 1) cells are tolerized via frequent mutation of membrane transporters or cell wall-associated proteins (e.g., ProV, KgtP, SapB, NagA, NagC, MreB), transcription and translation machineries (e.g., RpoA, RpoB, RpoC, RpsA, RpsG, NusA, Rho), stress signaling proteins (e.g., RelA, SspA, SpoT, YobF), and for certain chemicals, regulators and enzymes in metabolism (e.g., MetJ, NadR, GudD, PurT); 2) osmotic stress plays a significant role in tolerance when chemical concentrations exceed a general threshold and mutated genes frequently overlap with those enabling chemical tolerance in membrane transporters and cell wall-associated proteins; 3) tolerization to a specific chemical generally improves tolerance to structurally similar compounds whereas a tradeoff can occur on dissimilar chemicals, and 4) using pre-tolerized starting isolates can hugely enhance the subsequent production of chemicals when a production pathway is inserted in many, but not all, evolved tolerized host strains, underpinning the need for evolving multiple parallel populations. Taken as a whole, this study provides a comprehensive genotype-phenotype map based on identified mutations and growth phenotypes for 223 chemical tolerant isolates.

This study aimed to evaluate the utility of the systemic immune-inflammation index (SII) in predicting the development of Cardiac Implantable Electronic Device (CIED) infections. A retrospective analysis was performed using the medical records of 2185 patients who underwent CIED (including de novo, revision, or upgrade) implantation at our institution from January 2012 to December 2019. We recorded CIED infections and risk factors according to the patient, device, and procedural characteristics during the median 28.7 months (6.2–56.8) follow-up. CIED infections were identified in 52 patients. Diabetes, chronic renal disease, SII before implantation, new cardiac resynchronization therapy (CRT) implantation, CRT-battery replacement, revision or upgrade, and the number of previous procedures were independent predictors of CIED infections. The area under the curve (AUC) of SII to predict CIED infection was .733 (95% CI: .654-.811). A raised SII may be a useful predictor of CIED infection.

Background: Electrocardiographic left ventricular hypertrophy (ECG LVH) has a prognostic value for cardiovascular diseases. Pathological processes that cause development of left ventricular hypertrophy (LVH) also leads to remodeling and dysfunction of the left atrium (LA). Atrial functions can be evaluated by 2D speckle tracking echocardiography. In our study, we aimed to investigate whether the ECG LVH is associated with left atrial strain. Methods: Sixty two patients with LVH according to echocardiographic left ventricle mass index were included in the study. ECG LVH was defined according to: Sokolow- Lyon voltage S+R/R>35mm; Cornell voltage R+SV>28 mm (for men) >20mm (for women); or Cornell product (S+R+(for women 8 mm)) x QRS duration)>2440 mmxms criteria. Patients were categorised into two groups according to presence or absence of ECG LVH. Association between left atrial strain values and ECG findings were evaluated. Results: The mean age of the patients were 58.3±10.1 years; 40.3% were women; 91,9% had hypertension; 35.5% had diabetes. Nineteen patients (30.6%) had ECG LVH according to Sokolow-Lyon voltage, Cornell voltage or Cornell product. Left atrial reservoir, conduit and contraction strains were significantly lower in patients with ECG LVH (pConclusion: ECG LVH was associated with left atrial strain and therefore it can be a useful tool to predict left atrial dysfunction.

BACKGROUND To evaluate the role of the traditional risk scoring system (TRSS) in detecting subclinical atherosclerosis in HIV (+) patients. STUDY DESIGN Cohort study. PLACE AND DURATION OF STUDY Infectious Diseases Clinic, Izmir Katip Celebi University, Ataturk Training and Research Hospital, from March 2017 to January 2018. METHODOLOGY The patient group was formed with 52 HIV (+) patients, aged 18-60 years, and a control group was formed with 52 HIV (-) healthy volunteers. For all groups, there was no comorbid diseases or family history. Diabetes mellitus, hypertension, chronic kidney disease and cardiovascular disease were excluded from the two groups. Carotid intima-media thickness (CIMT) measurements were performed with high resolution B mode Doppler USG and patients with subclinical atherosclerosis were identified by the presence of atheroma plaque. RESULTS The median right CIMT measurement was 0.91 (0.73-0.97) mm and the median left CIMT was 0.90 (0.73-0.98) mm in HIV (+) patients. The median values of CIMT on right and left sides in the control group were 0.77 (0.67-0.81) mm and 0.76 (0.70-0.81) mm. Atheroma plaque was detected in 13.5% of the HIV (+) patients and in none of the control group. Subclinical atherosclerosis was found in 51.9% of HIV (+) patients and this rate was 7.7% in the HIV (-) group (p

Structurally complex and diverse polyamines and polyamine analogues are potential therapeutics and agrochemicals that can address grand societal challenges, for example, healthy ageing and sustainable food production. However, their structural complexity and low abundance in nature hampers either bulk chemical synthesis or extraction from natural resources. Here we reprogrammed the metabolism of baker’s yeast Saccharomyces cerevisiae and recruited nature’s diverse reservoir of biochemical tools to enable a complete biosynthesis of multiple polyamines and polyamine analogues. Specifically, we adopted a systematic engineering strategy to enable gram-per-litre-scale titres of spermidine, a central metabolite in polyamine metabolism. To demonstrate the potential of our polyamine platform, various polyamine synthases and ATP-dependent amide-bond-forming systems were introduced for the biosynthesis of natural and unnatural polyamine analogues. The yeast platform serves as a resource to accelerate the discovery and production of polyamines and polyamine analogues, and thereby unlocks this chemical space for further pharmacological and insecticidal studies. Structurally complex polyamines and polyamine analogues show potential as therapeutics and agrochemicals, but their production remains hampered. Here a polyamine yeast cell factory is developed that enables the gram-per-litre-scale titres of spermidine and the complete biosynthesis of a broad set of these compounds.

Bu çalışmanın amacı Milli Eğitim Bakanlığı, Talim Terbiye Kurulunun 2018 yılında yenilenen fen bilimleri öğretim programı doğrultusunda 2021-2022 eğitim öğretim yılında ortaokul ve imam hatip ortaokulu 5., 6., 7. ve 8 sınıf fen bilimleri dersinde okutulmasına onay verilen 8 tane Fen bilimleri ders kitabında bulunan bilim insanlarının analizinin yapılmasıdır. Araştırma ders kitaplarında üniteler ve konular içerisinde yer verilen bilim insanlarının isimlerini, veriliş şeklini (resim, yazı), cinsiyetlerini ve milliyetlerini belirlemeye yöneliktir. Nitel araştırma yöntemlerinden doküman analizi esas alınarak yapılmıştır. Araştırma sonucunda genellikle ders kitaplarında yer verilen bilim insanlarının isimlerinin gerek kitaplar arasında gerekse üniteler ve konular arasındaki dağılımının orantısız olduğu, bilim insanlarının cinsiyetlerinin genelde erkek olduğu, bilimi insanlarının ders kitaplarında veriliş biçiminin belirli bir düzen içerisinde bulunmadığı, milliyetlerinin yabancı kökenli oldukları tespit edilmiştir.

The objective of this study is to assess the prognostic effects of T ranscatheter aortic valve replacement (TAVR) on the patients with different degrees of left ventricular systolic (LVS) function and severe symptomatic aortic stenosis. Also examines the prognostic association of LV remodelling after TAVR.Patients stratified into four subgroups with respect to baseline LV ejection fraction (LVEF) (LVEF25%, LVEF 25%-40%, LVEF 41%-49% and LVEF ≥ 50%). We compared the baseline characteristics and temporal changes in echocardiographic parameters of the patients after TAVR, and determined all-cause mortality (ACM) in a follow-up period of mean 20.7 ± 15.8 months (up to 84). There were 495 patients at 8 centres. ACM was similar in all groups (28.1%, 29.5%, 22.5% and 24.1% respectively;This study shows that TAVR is beneficial in the whole range of LVS function, irrespective of the baseline EF. Early recovery in LVEF after TAVR is critical for survival, however, it seems to be more eye catching in the patients with advanced heart failure with reduced EF.

Background: Monitoring the longevity of immunoglobulin G (IgG) responses following severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infections is vital to understanding the role of antibodies in preventing infection. Aims: To determine the quantitative IgG responses specific to the Spike-S1 (S1) receptor-binding domain (S1/RBD) region of the virus in serum samples taken between 4 weeks and 7 months after polymerase chain reaction (PCR) positivity in patients who are diagnosed with coronavirus disease-2019 (COVID-19). Study design: A longitudinal study. Methods: This study included 113 patients with a clinical and molecular diagnosis of COVID-19. The first and second serum samples were taken 1 and 7 months, respectively, after the PCR positivity. S1/RBD-specific IgG antibody response was assayed using anti-SARS-CoV- 2 QuantiVac ELISA (IgG) kit (Euroimmun, Lübeck, Germany). The neutralizing antibodies were investigated in 57 patients whose IgG test results were above the cut-off value. Results: In 57 patients with SARS-CoV-2 IgG, the anti-SARS-CoV-2 IgG quantitative antibody levels significantly decreased after 7 months (Z = −2.197, p = 0.028). A correlation was detected between the anti-SARS-CoV-2 IgG and nAb percent inhibition (IH%) levels detected in 1 month (rs = 0.496, p < 0.001), but without significant correlation in serum samples taken on 7 months. The nAb IH% levels of the first and second were compared for COVID-19 severity and revealed no statistical difference (p = 0.256). In the second serum sample, the nAb IH%s of patients with moderate COVID-19 showed a statistically significant difference from patients with mild COVID-19 (p = 0.018), but without significant differences between severe and moderate or mild COVID-19. Conclusion: SARS-CoV-2 quantitative IgG antibody titers are significantly reduced at long-term follow-up (> 6 months). Due to the limited information on seroconversion, comprehensive studies should be conducted for long-term follow-up of the immune response against SARS-CoV-2.

The world population and consequently the global need for food continue to grow. At the same time, areas will be used to generate clean electricity to cope with climate change and global warming. The combination of crop production and solar photovoltaics in the form of ""agrivoltaic technology"" offers advantages for both sides that provide an adequate, resource-efficient solution to the persistent problem of competition for arable lands. The implementation of agrivoltaic systems has been exponentially increased in recent years and reached the global installed capacity of 2.8 GW in 2020 from the initial capacity of 5 MW in 2012. The agrivoltaic systems installed worldwide mostly employ conventional opaque photovoltaic (PV) modules, causing a change in the microclimate under the panels that become critical when shading ratios are high. Semi-transparent PV (STPV) modules have been recently employed to mitigate this issue which is profoundly studied in this research by considering the use of semi-transparent technologies based on crystalline silicon (c-Si), thin-film photovoltaics, organic PVs (OPVs), dye-sensitized solar cells (DSSCs), concentrating PVs (CPVs), and luminescent solar concentrators (LSCs) in open (arable farming lands) and closed (cultivation greenhouses) agrivoltaic systems. The results indicated that c-Si STPV modules have the highest share of employment in agrivoltaic systems due to their extreme benefits of low costs, high stability, and high efficiency in comparison with other technologies, while in contrast, the use of thin-film STPV modules have been rarely reported in the literature. Additionally, STPV modules using OPVs and DSSCs offer the capability to achieve wavelength-selective transparency, causing the photosynthetic active radiation to pass through while the remained spectrum is utilized to generate electricity. Other potential solutions come from CPVs and LSCs, in which, diffuse light is available for the growth of cultivated plants, while direct concentrated sunlight can generate electricity. Although STPV modules are proven as a feasible solution for use in agrivoltaic systems, still more developments are required in terms of the modules' efficiency enhancement and costs reduction, while more detailed research is required to observe the response of cultivated plants to make this technology a viable sustainable solution in the future.

Telif hakları ve bu hakların korunma seviyesi, ülkelerin gelişmişlik göstergeleri arasında yer almaktadır. Hukukumuzda, 5846 sayılı Fikir ve Sanat Eserleri Kanunu (FSEK)’nda, telif haklarının hukuki himayesinin yanı sıra cezai himayesi de öngörülmüştür. Öte yandan telif hakları, sahibine fikri çabalarının sonucu olarak ortaya çıkan çalışmaları için verilen bir ödüllendirme ve teşvik aracı olmanın yanı sıra toplumun da bu çalışmalardan fayda sağlamasına imkân veren, iki tarafın çıkarları arasında denge kurmayı amaçlayan bir sistem üzerine inşa edilmiştir. Dolayısıyla FSEK’te teklif haklarını sınırlayan çeşitli hükümlere de yer verilmiştir. Bunlardan biri FSEK’in 38’inci maddesinde düzenlenen ve hukuka uygunluk sebebi teşkil eden şahsen kullanmadır. Şahsen kullanma esasen eser sahibinin çoğaltma hakkının sınırlandırılmasına ilişkin olup mali haklara tecavüz suçu ve özelinde eseri çoğaltma hakkının cezai himayesi bakımından hususiyet arz etmektedir. Çalışmamızda öncelikle eseri çoğaltma hakkının cezai himayesi üzerinde durulacak olup ardından bir hukuka uygunluk sebebi olarak şahsen kullanma meselesi incelenecektir.

Considering the increasing use of the transcatheter aortic valve implantation (TAVI) procedure, the relationship of contrast-induced nephropathy (CIN) with post-TAVI mortality has become important. The Mehran score was developed to detect the risk of CIN development after cardiac intervention. We aimed to compare the role of the modified Mehran score, which can be calculated pre-procedure, in predicting CIN development and compare it with the original Mehran score. We retrospectively collected data from TAVI procedures at our institution between December 2016 and June 2021; of 171 patients, 44 (25.7%) had CIN. We found no association between contrast media volume and CIN (387 ± 120 vs 418 ± 139 mL, P = .303). High and very high modified Mehran score and preoperative C-reactive protein (CRP) level were independent risk factors for CIN development after TAVI procedure. The area under curve (AUC) was .686 with 95% CI: .591-.780 and P < .001, and also, with a cut-off point of >7.5 points, there was 79.5% sensitivity and 63.0% specificity; otherwise, with a cut-off point of >9.5 points, there was 54.5% sensitivity and 71.7% specificity, for the modified Mehran score. The modified Mehran score comes into prominence compared with the original Mehran score since it can be calculated pre-procedure.

Background: We aimed to establish an acute treatment protocol to increase serum vitamin D, evaluate the effectiveness of vitamin D3 supplementation, and reveal the potential mechanisms in COVID-19. Methods: We retrospectively analyzed the data of 867 COVID-19 cases. Then, a prospective study was conducted, including 23 healthy individuals and 210 cases. A total of 163 cases had vitamin D supplementation, and 95 were followed for 14 days. Clinical outcomes, routine blood biomarkers, serum levels of vitamin D metabolism, and action mechanism-related parameters were evaluated. Results: Our treatment protocol increased the serum 25OHD levels significantly to above 30 ng/mL within two weeks. COVID-19 cases (no comorbidities, no vitamin D treatment, 25OHD &lt, 30 ng/mL) had 1.9-fold increased risk of having hospitalization longer than 8 days compared with the cases with comorbidities and vitamin D treatment. Having vitamin D treatment decreased the mortality rate by 2.14 times. The correlation analysis of specific serum biomarkers with 25OHD indicated that the vitamin D action in COVID-19 might involve regulation of INOS1, IL1B, IFNg, cathelicidin-LL37, and ICAM1. Conclusions: Vitamin D treatment shortened hospital stay and decreased mortality in COVID-19 cases, even in the existence of comorbidities. Vitamin D supplementation is effective on various target parameters, therefore, it is essential for COVID-19 treatment.

OBJECTIVE: To evaluate whether there is any difference between radiographic axial spondyloarthritis (r-axSpA), also termed ankylosing spondylitis (AS), and non-radiographic (nr-) axSpA, with respect to subclinial myocardial dysfunction using speckle tracking echocardiography (STE). METHODS: This was a cross-sectional case control study. We included 72 patients with AS, 38 patients with nr-axSpA, and 56 age-matched healthy subjects. Patients with cardiac disease and cardiac risk factors affecting STE were excluded. The disease burden evaluated by the BASDAI, BASFI, BAS-G, and ASAS-HI scores were comparable in both the r- and nr-axSpA groups. A detailed echocardiographic examination including the M-mode, Doppler, and STE was applied to whole study population. RESULTS: Duration of the disease, the use of an anti-TNFα agent, and CRP levels were higher in patients with AS. Although the AS, nr-axSpA, and control groups had similar ejection fraction values (59±5.2, 60±4.6, 60±4.6, respectively, and p=0.499), the global longitudinal peak systolic strain (GLS) (20.5±3.3, 21.1±3.5, and 22.3±2.4, respectively, and p

Introduction: Atrial fibrillation (AF) is the most common arrhythmia with a prevalence that increases by aging. AF causes morbidity and mortality due to thromboembolic events. In developing countries, the use of new generation medications can be delayed. Objective: We evaluated nonvalvular AF patients without effective oral anticoagulation (OAC) when non- vitamin K antagonists (NOACs) were mostly unavailable in Turkey before 2012–2013. The results were compared with what would happen if NOAC was available in use. Patients and Methods: Two-hundred and five patients in AF with adequate information were detected 123 of these patients were nonvalvular AF, (92 patients in these 123 ones were not taking OAC or on ineffective INR range) were included in the study. Results: Thirty-one (25.2%) of these patients were already on effective warfarin therapy. Ninety-two (74.8%) patients were not on warfarin therapy or on out of effective therapeutic range. About 52.2% of participants were female. The mean age was 70.62 ± 11.8 years. Eighteen (19.5%) patients had a recurrent stroke. Conclusion: OACs are recommended for patients with high stroke risk according to CHA2DS2-VASc score. OAC therapy significantly decreases mortality, morbidity, and also especially stroke risk. The only OAC therapy was warfarin over the decades until NOACs have been found. In our study, if NOACs could be available before 2012 in Turkey, 74.8% of our cohort would be under the effective anticoagulation and 19.5% of patients may have avoided from stroke. This is important for patients' lives and also for their costs.

Severe aortic stenosis (SAS) is the most common valvular heart disease in elderly patients. Untreated SAS is known to have 50% mortality within 2 years of onset of symptoms. SAS with acute decompensated heart failure is fatal and requires immediate, appropriate treatment. Urgent transcatheter aortic valve implantation (TAVI) is acceptable with feasible outcomes for a selected group of patients with decompensated SAS. Herein, we present a case of a primary TAVI procedure with a good outcome for decompensated SAS. The patient was an 85-year female with SAS with peak/mean transvalvular gradients of 73/42 mmHg, and left ventricular ejection fraction (LVEF) of 60% on echocardiography. The TAVI procedure was confirmed with echocardiography and angiography. As there was no anatomic contraindication for TAVI, primary TAVI was selected for this patient with implantation of a No. 29 Portico™ TAVI valve (Abbott; St. Jude Medical Inc., St. Paul, MN, USA). To the best of the authors' knowledge, this case is the first to be reported as primary TAVI which was performed in 4 hours of emergency situation. A life-saving procedure was performed, which lasted 4 hours from door-tovalve placement.

Paraplegia after percutaneous iliac angioplasty is very rare, and is typically associated with spinal cord ischemia (SCI). Presently described is a case of SCI and paraplegia developing after bilateral iliac stenting. This complication may be caused by a change in spinal blood flow in patients with diffuse atherosclerosis, and should be kept in mind.

In the criminalproceeding which is started with the knowledge of the crime, under theprinciple of judgment without a filed lawsuit,it is claimed that an act constitutes a criminal offense and the actualperpetrator must be punished. Due to this principle, the Article 170 of theCriminal Procedure Code (CPC) contains that the public prosecutor has beencharged to file a public suit with the indictment of the public prosecutor.According to the Article 225 of the Criminal Procedure Code (CPC), the judgmenthave to only be represented about the conduct in relation with the elements ofthe offence and the perpetrator. However, the court is not bound by theprosecution and the defense. Therefore, the characterization of the act maychange during the trial. At the same time, it is also possible that thepenalties should be increased or that the provisions requiring theimplementation of security measures in addition to the punishment will occurfor the first time during the trial. With the Article 226 of CPC, in bothcases, the defendant has been granted additional defense rights and allowed tobe settled on the changing situation by the legislator. In this article,additional right of defense, requirements of giving additional right of defenseand what is the procedure of giving additional right of defense are examinedwithin Article 226 of CPC., Suç haberinin alınmasıyla başlayan ceza muhakemesinde, davasızyargılama olmaz ilkesi gereğince bir fiilin suç teşkil ettiğinin ve bu fiiliişleyen failin cezalandırılması gerektiğinin ileri sürülmesi gerekir. Builkenin de bir sonucu olarak Ceza Muhakemesi Kanunu’nun 170 inci maddesi,Cumhuriyet savcısına düzenleyeceği iddianame ile kamu davası açma görevinivermiştir. CMK’nın 225 inci maddesine göre ise mahkeme hükmünü sadeceiddianamede unsurları gösterilen suça ilişkin fiil ve fail hakkında kuracaktır.Ancak mahkeme fiilin nitelendirilmesinde iddia ve savunmalarla bağlı değildir.Dolayısıyla yargılama sırasında fiilin nitelendirmesinin değişmesi söz konusuolabilir. Bununla birlikte cezanın artırılmasını veya cezaya ek olarak güvenliktedbirlerinin uygulanmasını gerektirecek hâllerin ilk defa duruşma sırasındaortaya çıkması da mümkündür. Kanun koyucu CMK’nın 226 ncı maddesi ile her ikidurumda da sanığa ek savunma hakkı verilerek değişen durum üzerinden hükümkurulabilmesine imkân tanımıştır. Bu çalışmada CMK’nın 226 ncı maddesikapsamında ek savunma hakkı, ek savunma hakkı verilmesini gerektiren haller ileek savunma hakkı verilmesinde usulün nasıl olacağı incelenecektir.

\n Atriyal septal defekt(ASD) eriskinlerdeki defektlerin de % 30-33’unden sorumludur. Sekundum ASD tedavisinde transkateter tedavi birinci basamak tedavi olarak yer almaktadir. 36 yasinda sekundum ASD tanisi olan hastanin basarili transkateter kapatma islemi sonrasi ilk 24 saat icinde aortik arka embolize oldugunu fark ettik. Embolize olan cihazlarin snare ve biopsi kateteri ile alinmasi bilinmekle birlikte farkli olarak femoral artere baska bir ASD okluder cihaz ile cekilmesi sonrasi buradan cerrahi ile alinmasini iceren bir vaka sunduk. Farkli yontemler kullanilarak basari sansi yuksek olan embolize olan cihaz cikartilmasinda hibrit yaklasim her zaman akilda olmalidir.\n\n \n

Introduction: Allergic acute myocardial infarction with ST-segment elevation is rare, and vasoconstrictor mediators released from mast cells are responsible for its pathogenesis. Several medications have been reported to lead to acute myocardial infarction with ST-segment elevation, as a part of systemic allergic reactions and this entity is known as Kounis syndrome (KS). Case presentation: We presented a patient with recurrent KS who had no allergic reactions, except coronary spasm after parenteral diclofenac administration. First, she experienced anterior myocardial infarction with ST-segment elevation after administration of diclofenac 2 years ago. The second presentation was acute inferior-posterior myocardial infarction with ST-segment elevation with atrioventricular complete block leading to cardiogenic shock. She had no significant coronary stenosis responsible for each myocardial infarction with ST-segment elevation. However, she had a catheter-induced coronary spasm of non-dominant right coronary artery. She was considered to have a recurrent allergic myocardial infarction with ST-segment elevation due to parenteral diclofenac usage and treated with a calcium antagonist, statin, and dual antiplatelet agent. Discussion: KS can manifest as same as acute coronary syndrome. All drugs or any allergen can cause this event.KS had three variants but In all three conditions, treatment is antithrombotic or vasodilatator regime. Conclusion: As atherosclerosis events on coronary, allergic coronary events also may recurs. However, unlike the literature, our case is differentiated by recurrence of similar events in different coronary vessels.

In this study, the dependence of corrosion inhibition and microbial effects of four N-hydroxymethylated amino acids, on their molecular and electronic structure is analyzed using density functional theory calculations. Quantum chemical parameters such as highest occupied molecular orbital energy (EHOMO), lowest unoccupied molecular orbital energy (ELUMO), energy gap (ΔE) were calculated at the B3LYP/6-311G++(d,p) basis set. Although no simple relationship between the inhibition performance and the calculated data could be discerned, the comparison of inactivation rate constants with energetic parameters suggested that microbial effects of the compounds can be explained in terms of their side chain disparities.

Limited data exists to date on the predictors for the development of pneumonia in patients with mild and moderate coronavirus (COVID-19). In this study, it was aimed to evaluate the demographic characteristics and clinical findings of mild and moderate COVID-19 and to determine the risk factors for the development of COVID-19 pneumonia in patients admitted to the pandemic outpatient clinic of a university hospital. A total of 414 patients with laboratory confirmed COVID-19 were included. Of these, 220 (53.1%) were male, the mean age was 38.3 ± 12.7. Median duration of hospital admission from the onset of symptoms was three days (0-11). Of the confirmed COVID-19 cases, 154 (37.2%) had a history of family contact and the most common symptoms were weakness (68.4%), myalgia (61.8%), headache (56.5%), loss of smell (45.2%), loss of taste (43.2%) and anorexia (42.8%). Among females, weakness (p= 0.016), headache (p= 0.008), sore throat (p= 0.032), nausea (p= 0.003), anorexia (p= 0.045), loss of taste (p= 0.005) and loss of smell (p0.001) were more common. Loss of taste (47.6% vs. 25%, p0.001) and loss of smell (50% vs. 26.3%, p0.001) were more common in patients with under the age of 50 and cough (43.4% vs. 29.3%, p= 0.003) was more common in patients with above the age of 40. Among 46 (11.1%) patients with asymptomatic COVID-19, there was no significant difference (p= 0.500) between the genders. Pneumonia was detected in 150 (43.8%) of 339 patients who underwent thorax computed tomography. In the univariate analysis; advanced age (p0.001, odds ratio (OR)= 1.44), obesity (p0.001 OR= 2.5), not being actively smoking (p0.001, OR= 6.19), fever at first admission (p= 0.002, OR= 2.02), cough (p0.001, OR= 3.26), shortness of breath (p0.001, OR= 23.37), weakness (p= 0.042, OR= 1.63), anorexia (p= 0.009, OR= 1.79) and elevation of D-dimer (p= 0.014, OR= 1.92) were associated with the development of pneumonia. In multivariate analysis, obesity (p= 0.005, OR= 2.69), not being actively smoking (p0.001, OR= 5.43), cough at first admission p= 0.017, OR= 2.16) and shortness of breath (p= 0.008, OR= 16.22) was determined as an independent risk factor for the development of pneumonia. CRP (p0.001), D-dimer (p0.001), ferritin (p0.001) values among 108 (26.1%) patients with a body-mass index(BMI)30 were high, and 60.9% of the patients had pneumonia (p0.001) . CRP (p0.001), D-dimer (p= 0.010) values were low, lymphocyte count (p= 0.001) was high among 106 (25.6%) active smokers, and 15.6% of the patients had pneumonia (p0.001). Of the patients reported with persistent symptoms, 25.9% had loss of smell, 25% had weakness, and 23.1% had loss of taste on the seventh day; 21.1% had loss of smell, 21.1% had myalgia, and 19.7% had loss of taste on the 14th day. During their follow-up, the COVID-19 polymerase chain reaction (PCR) test was studied in 286 patients for control purposes. The median time of being negative for COVID-19 PCR test was eight days (3-56). In conclusion, symptoms may last longer than 14 days in 20- 30% of patients presenting with mild-moderate clinical findings. In addition, obesity should be considered as an important risk factor for COVID-19 pneumonia.