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Comorbidity is the coexistence of two or more diseases in a certain period. Severe COVID-19 can occur in healthy individuals of any age but predominantly in adults of advanced age or with underlying medical comorbidity. Comorbidities are identified as the main determinants of poor outcomes. This meta-analysis aims to examine the effect of comorbidity on mortality in patients with a diagnosis of COVID-19. Materials and Methods: The studies published between 2019-2020 from Google Scholar, Pub Med, Medline, Scopus, Science Direct, and Web of Science databases were scanned. Interrater agreement was calculated with Kappa statistics, effect size "Odds Ratio", heterogeneity between studies with Cochran's Q statistics. The study's effect size and publication bias included in the meta-analysis were calculated using the CMA 3 (Comprehensive Meta-Analysis) program. Results: A total of 24 studies were included in the study. According to the random-effects model, the overall effect size of comorbid factors on mortality development in patients diagnosed with COVID-19 was found to be statistically significant with a value of 2.537 (G.A; 2.078-2.098; p

The human appendix vermiformis is regarded as an evolutionarily vestigial organ, although it has presumptive immune system functions and appears to support beneficial bacterial gut flora, both of which could influence cancer progression. A review of the comparative anatomy of the mammalian appendix reveals a significantly longer appendix in herbivores than in carnivorous animals. The lengthier appendix vermiformis in herbivores has been associated with the presence of cellulose-digesting bacteria that colonize the structure. In light of recent studies that have reported the digestion of small amounts of cellulose in humans and the preventive effects of a vegetarian diet on colon cancer, we conducted a retrospective study of abdominal CT scans of 60 colon cancer patients and 60 healthy people to investigate a possible relationship between colon cancer and appendix vermiformis length. The mean length of the appendix in cancer patients [65.178 mm ± 13.46 (SD)] was shorter than that in the healthy control group [101.99 mm ± 16.58 (SD)] and the difference was statistically significant (P < 0.001). Statistical analysis demonstrated that the ages of the cancer patient group and the control group did not differ significantly (P = 0.534). The results of the present study indicate that the appendix is not merely a vestigial structure or regressed lymphoid tissue, but rather an organ that could be critical in the development of colon cancer, whether as a result of congenital or acquired appendicular factors. Copyright © 2014 Wiley Periodicals, Inc.

Katalepsi bir tek nedene bagh OW ortaya qllian bit durum degildir. Biyokimyasal ve norotransmitter sistemler agsmdan bu davran~gln sebebi, katalepsi olughYan qegitli maddeler iqin fad&&. Omegin noroleptiklerin kataleptojenik etkisi striatal dopamin reseptorlerinin blokaj~na bajjlanmqtx. Niirofizyolojik ve biyokimyasal veriler dopamine jik nigro-striatal sistemin duzenli $&$masmda gma-aminobutirik asid ve serotonin'e bagh olan bir mekanizmmn etkili oldugunu gostermigtir. Bir serotonin antagonisti olan siproheptadin'in ve Parkinson sendromunun tedavisinde hdlanllan amantadin'in; fenotiazin bilegigi olan trifluperazin ve noroIeptik olarak hullmlan ve etkili bir ih olan pimozid'in yaphklan katalepsiye etkilerini inceledik. Si- $anlara onceden siproheptadin verildiginde yukar~da belirtilen ila~lann neden oldugu katalepsinin giddetinin azal&@ goriildii. Diger yandan s~qanlara onceden amantadin verildigi zaman, ayni nijroleptik ilaglann ortaya @ar&gi katalepsinin de gec; ortaya qkhg~ gozlendi. Cahgmamum sonuqlan yukanda belirtilen noroleptik ilaqlann neden oldugu katalepside, serotonerjik ve dopaminerjik sistemlere etkili olan siproheptadin ve amantadinin de rolii oldu~mu gostermektedir., Catalepsy is not a unitary phenomenon. With respect to biochemical mechanisms and neurotransmitter sytems, the origin of this behavioural response varies according to different substances which cause catalepsy. For example, the catdeptogenic effect of neuroleptics has been related to the blockage of striatal doparnine receptors. Neurophysiological and biochemical data have shown that a mechanism caused by gama-aminobutyric acid and serotonin have been effective in the proper functioning of the dopaminergic nigrosbriatal tract. We have studied the effects of cyproheptadine, a serotonin antagonist, and of amantadin which is used in the treatment of Parkinson syndrome on the catalepsy induced by trifluoperazine, a phenothiazin compound, and pimozid, a drug used as a neuroleptic. It was observed that when rats were pretreated with cyproheptadine as well as amantadine, the catalepsy induced by the above neuroleptic drugs was attenuated. The results of our study show that substances which have an effect on the serotonergic and dopaminergic systems also play a role on cases of catalepsy induced by the neuroleptic drugs mentioned above.

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Purpose. The aim of this study was to compare the value of absolute and relative renal length (ARL and RRL, respectively) measurements in determining variations in normal kidney size related to sex, body height, and increasing age among patients older than 60 years.

Several factors play a role in the etiology of the degenerative spinal processes. This study examined the role of facet angle in the etiology of degenerative spondylolisthesis and lumbar spinal stenosis. In order to measure the facet angles, computerized tomographic scans of 18 patients with degenerative spondylolisthesis and 11 patients with lumbar spinal stenosis were reviewed and the results were compared with the results of the control group. A significantly more sagittal orientation was found in facet joint angles of the patients with degenerative spondylolisthesis and with lumbar spinal stenosis, when compared with the control group. It is concluded that more sagittal orientation of the facet joint angle may play a role in the pathogenesis and progression of the degenerative spondylolisthesis, and that this fact should be taken into consideration in cases which need extensive decompression for degenerative spondylolisthesis.

Discrete Mathematics & Theoretical Computer Science ; vol. 22 no. 1 ; Graph Theory ; 1365-8050, For positive integers $n,k$ and $t$, the uniform subset graph $G(n, k, t)$ has all $k$-subsets of $\{1,2,\ldots, n\}$ as vertices and two $k$-subsets are joined by an edge if they intersect at exactly $t$ elements. The Johnson graph $J(n,k)$ corresponds to $G(n,k,k-1)$, that is, two vertices of $J(n,k)$ are adjacent if the intersection of the corresponding $k$-subsets has size $k-1$. A super vertex-cut of a connected graph is a set of vertices whose removal disconnects the graph without isolating a vertex and the super-connectivity is the size of a minimum super vertex-cut. In this work, we fully determine the super-connectivity of the family of Johnson graphs $J(n,k)$ for $n\geq k\geq 1$.

Several factors play a role in the etiology of the degenerative spinal processes. This study examined the role of facet angle in the etiology of degenerative spondylolisthesis and lumbar spinal stenosis. In order to measure the facet angles, computerized tomographic scans of 18 patients with degenerative spondylolisthesis and 11 patients with lumbar spinal stenosis were reviewed and the results were compared with the results of the control group. A significantly more sagittal orientation was found in facet joint angles of the patients with degenerative spondylolisthesis and with lumbar spinal stenosis, when compared with the control group. It is concluded that more sagittal orientation of the facet joint angle may play a role in the pathogenesis and progression of the degenerative spondylolisthesis, and that this fact should be taken into consideration in cases which need extensive decompression for degenerative spondylolisthesis.

Megalencephalic leukoencephalopathy (MLC) with subcortical cysts, also known as Van der Knaap disease (MIM #604004) is an autosomal recessive neurological disorder characterized by early onset macrocephaly, epilepsy, neurological deterioration with cerebellar ataxia and spasticity. An 8-month-old boy was admitted to our pediatric neurology clinic with macrocephaly. His brain magnetic resonance imaging (MRI) revealed bilateral, diffuse, symmetric structural white matter abnormalities, relatively sparing the cerebellum and bilateral subcortical temporal cysts. The diagnosis of Van der Knaap disease was suspected based on the clinical features and imaging findings and the genetic analysis revealed a novel homozygous c.768+2T>C mutation of the MLC1 gene. For determination of the novel splice-site mutation’s effect, cDNA amplification was performed. cDNA analysis showed that the splice-site c.768+2T>C mutation gave rise to exon 9 skipping.

To investigate factors effecting the safety and recanalization efficacy of local intraarterial (IA) recombinant tissue plasminogen activator (r-tPA) delivery in patients with acute ischemic stroke. Eleven patients with anterior circulation acute ischemic stroke were treated. The neurological status of the patients were graded with the Glasgow Coma Scale (GCS) and National Institute of Health Stroke Scale (NIHSS). All patients underwent a computed tomography (CT) examination at admission. In addition four patients had diffusion-weighted and one patient had a perfusion magnetic resonance (MR) examinations. Patients were treated within six hours from stroke onset. Immediate, six hours, and 24 hours follow-up CT examinations were performed in order to evaluate the haemorrhagic complications and the extent of the ischemic area. The Rankin Scale (RS) was used as an outcome measure. Two of the 11 patients had carotid “T” occlusion (CTO), nine had middle cerebral artery (MCA) main trunk occlusion. Four patients had symptomatic haemorrhage with a large haematoma rupturing into the ventricles and subarachnoid space. Of these, three patients died within 24 hours. The remaining seven patients had asymptomatic haematomas that were smaller compared to symptomatic ones, and showed regression in size and density on follow-up CTs. At third month five patients had a good outcome and three patients had a poor outcome. In acute ischemic stroke, local IA thrombolysis is a feasible treatment when you select the right patient. Haemorrhage rate does not seem to exceed that occuring in the natural history of the disease and in other treatment modalities.

The syndrome of McCune-Albright syndrome (MAS) is clasically defined as a triad presentation with the findings of polyostotic fibrous dysplasia, cafe-au-lait spots, and sexual precocity. However, not all patients present with complete symptoms. A 52-year-old mail was diagnosed as having a variant of McCune-Albright syndrome with the following findings: polyostotic Fibrous dysplasia, acromegaly due to pituitary tumor and subclinical hyperthyroidism due to toxic multinodular goiter. Sexual precocity and cafe-au-lait spots were not noted. Acromegaly was confirmed by laboratory examination (IGF-1, glucose Suppression test and TRH stimulation test). Long acting somatostatin analogue was used as treatment. Although the pituitary tumor Could not be removed due to technical problems, mass lesions on the cranium were removed subtotally. Histopathological evaluation demonstrated that the lesion complied with fibrous dysplasia. Genomic DNAs were isolated from the craniofacial bones and peripheral leucocytes of the patient. After amplifying the related regions, Gs alpha (Gs alpha) gene was analysed by automatic DNA sequence analysis. Ail activating mutation of the Gs alpha gene (Arg 201 Cys) was found in the genomic DNA isolated from the bone tissue of the patient, but not in the genomic DNA isolated from the blood. We described a case of MAS associated with Gs alpha mutation in the bone tissue, presenting with polyostotic fibrous dysplasia, subclinical hyperthyroidism and acromegaly.

Amaç: Akut apandisit olgularında kontrastsız helikal BT'nin tanısal etkinliğini belirlemek. Gereç ve Yöntem: Acil servis tarafından akut apandisit ön tanısıyla servisimize gönderilen toplam 22 olguya helikal BT incelemesi yapıldı. Tarama alanı T12 vertebra korpusu düzeyi ile simfiz pubis arası ve kesit kalınlığı 5 mm olarak belirlendi. İnceleme sırasında oral ya da intravenöz kontrast madde kullanılmadı. Apendeks çapının 6 mm ve üzerinde olması ile apendeks lojunda yumuşak doku dansitesinde kitle varlığı, akut apandisit açısından pozitif bulgular olarak kabul edildi. İki ayrı radyolog tarafından değerlendirilen filmler cerrahi girişim veya 15 günlük klinik takip sonuçları ile karşılaştırıldı. Bulgular: Cerrahi girişim ve klinik takipler sonucunda 12 olguda akut apandisit saptandı. BT ile 1 hastada yanlış pozitif sonuç alındı. Elde edilen verilerin değerlendirilmesinde helikal BT'nin akut apandisit tanısında duyarlılığı % 100, özgüllüğü % 91, pozitif öngörü değeri % 92, negatif öngörü değeri % 100, doğruluk oranı % 96 olarak saptandı. Sonuç: Kontrastsız helikal BT incelemesi akut apandisit şüphesi olan olguların değerlendirilmesinde güvenilir bir yöntemdir. Purpose: To determine the value of non-contrast helical CT in the evaluation of patients with suspected acute appendicitis. Material and Method: Helical CT was performed in 22 cases with suspected acute appendicitis referred by the emergency service. Scanning area was between T12 vertebra corpus and symphisis pubis, and 5 mm collimation was used. No oral or intravenous contrast media was used. Findings that correlated with acute appendicitis were determined as appendix lumen diameter greater than or equal to 6 mm and mass lesion with soft tissue density in the appendix area. The examinations were separately assessed by two radiologists and correlation was made with surgical and clinical follow-up findings. Results: 12 cases were diagnosed to have acute appendicitis with surgical and clinical follow-up findings. One patient was false positively diagnosed as acute appendicitis with helical CT. Helical CT was found to have a sensitivity of 100%, specificity of 91%, positive predictive value of 92%, negative predictive value of 100%, and overall accuracy of 96% in the diagnosis of acute appendicitis. Conclusion: Unenhanced helical CT examination is an effective method in the evaluation of patients with suspected acute appendicitis.

Amac: Kolesistektomi amellyati olmu§olgularda uzun dOnemde koiedok kanali capindakive ameliyat Oncesi ve sonrasi semptomlardaki degi§ikliklerin saptanmasi, koledok kanali cap! ile semptomatik iyile§me arasindaki ili§kinin ara§tirilmasi. Durum degerlendirilmesi: Daha Once yapilan call§malar kolesistektomi sonrasi erken dOnemde koledok kanali capinda anlamli bir art oldugunu gOstermektedir. Ancak uzun dOnemde yapilan cali§malarda bOyle birarh§saptanmami§tinSemptomatik iyile§me Ile cap deg§iklikleri arasindaki ill§kinin ise halen bilinmemektedir. Yontem: Elektif §artlarda semptomatik safra kesesi tai nedeni ile acik veya laparoskopik yOntemle kolesistektomi yapilmi olan ve preoperatif donem koledok kanali cap bilinen 28 olgu de 'Oerlendirmeye aiindi. Postoperatif donemde en az dortyilini dolduran olgularin koledok kanali cap ultrasonografi ile olcOlerek preoperatif OlcOmler ile kar ila tinldi. Ayrica hazirlanan anket formu ile olgulann ameliyat Oncesi varolan yakinmalannin ameliyatsonrasindaki durumu sorgulandi. pkanmlar: Olgular medyan 98.5 ay (53 -135 ay) takip ediidi. Postoperatif ultrasonografi incelemelerinde %29 olguda koledok kanali gape 7 mm`nin Ozerinde olguldu. Preoperatif clOnemde bu oranin%43 oldugu saptandi. Preoperatif ye postoperatif Olciamler arasinda istatistiksel olarak anlamli fork bulunmadi. Olgulann tOmOnde anneliyat Oncesinde var olan koliktarzda kann agrisi yakinmasinin ameliyattan sonra ortadan kalktigi saptandi. Ameliyatsonrasinda hastalann medikal tedavi gerektirmeyen yakinmalannin ise koiedok kanali capindaki degi§iklikler lie iii kisi olmadigi gbrOld0. Sonuclar: Kolesistektomi sonrasi uzun donem sonunda yapilan incelemelerde hastalann koledok kanali cap OlcCimlerInde aniamli bir degi§iklik saptanmadi. Postkolesistektomi yakinmalannin derecesi Ile koledok kanali cap' arasinda ili§ki saptanmadi. Olgularda elde edilmi§ klinik ba§annin uygun hasta segimine bagli oldugu dO§C.InUld6. The effect of cholecystectomy on common bile duct diameter remains controvertial. It has been shown thatthe diameter of common bile duct increases significantly in the early postoperative period, but in the long term studies such an evidence has not been shown. This study investigates the long term changes in the diameter of common bile duct and its relationship with symptomatic relief following cholecystectomy. Twenty eight patients undergoing elective open or laparoscopic cholecystectomy due to symptomatic gall bladderstone were studied. The common bile duct diameter of these patients were measured by ultrasonography and compared with the preoperative values. Meanwhile the degree of symptomatic improvement was determined by a questionnaire to compare the preopera¬tive and postoperative symptoms. The median follow-up period was 98.5 (53 - 135) months. In the postoperative measurements, the diameter of common bile duct was found to be more than 7 mm in 29% of the patients (mean 6.1 mm) where as the corresponding figure was 43%, preoperatively (mean 7.4 mm). There was no statistically significant difference in measurements between two periods. Following cholecystectomy, 79% of patients had complete symptomatic relief. All patients were satisfied with the operation in various degrees. As the conclusion, cholecystectomy has no effect on changes of common bile duct diameter and clinical success as well as patient satisfaction can be achieved when patients with appropriate indication are chosen for surgery.