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WOS: 000468584300005, PubMed ID: 30930455, Objective: Heart failure (HF) has a high prevalence and mortality rate in elderly patients; however, there are few studies that have focused on patients older than 80 years. The aim of this study is to describe and compare the age-specific demographics and clinical features of Turkish elderly patients with HF who were admitted to cardiology clinics. Methods: The Epidemiology of Cardiovascular Disease in Elderly Turkish population (ELDER-TURK) study was conducted in 73 centers in Turkey, and it recruited a total of 5694 patients aged 65 years or older. In this study, the clinical profile of the patients who were aged 80 years or older and those between 65 and 79 years with HF were described and compared based on the ejection fraction (EF)-related classification: HFrEF and HFpEF (is considered as EF: >= 50%). Results: A total of 1098 patients (male, 47.5%; mean age, 83.5 +/- 3.1 years) aged 80 years and 4596 patients (male, 50.2 %; mean age, 71.1 +/- 4.31 years) aged 65-79 years were enrolled in this study. The prevalence of HF was 39.8% for patients who were >= 80 years and 27.1% for patients 65-79 years old. For patients aged >= 80 years with HF, the prevalence rate was 67% for hypertension (HT), 25.6% for diabetes mellitus (DM), 54.3% for coronary artery disease (CAD), and 42.3% for atrial fibrilation. Female proportion was lower in the HFrEF group (p=0.019). The prevalence of HT and DM was higher in the HFpEF group (p= 80 years with HFrEF (p, Turkish Society of Cardiology, This study was supported by Turkish Society of Cardiology.

WOS: 000468584300005, PubMed: 30930455, Objective: Heart failure (HF) has a high prevalence and mortality rate in elderly patients; however, there are few studies that have focused on patients older than 80 years. The aim of this study is to describe and compare the age-specific demographics and clinical features of Turkish elderly patients with HF who were admitted to cardiology clinics. Methods: The Epidemiology of Cardiovascular Disease in Elderly Turkish population (ELDER-TURK) study was conducted in 73 centers in Turkey, and it recruited a total of 5694 patients aged 65 years or older. In this study, the clinical profile of the patients who were aged 80 years or older and those between 65 and 79 years with HF were described and compared based on the ejection fraction (EF)-related classification: HFrEF and HFpEF (is considered as EF: >= 50%). Results: A total of 1098 patients (male, 47.5%; mean age, 83.5 +/- 3.1 years) aged 80 years and 4596 patients (male, 50.2 %; mean age, 71.1 +/- 4.31 years) aged 65-79 years were enrolled in this study. The prevalence of HF was 39.8% for patients who were >= 80 years and 27.1% for patients 65-79 years old. For patients aged >= 80 years with HF, the prevalence rate was 67% for hypertension (HT), 25.6% for diabetes mellitus (DM), 54.3% for coronary artery disease (CAD), and 42.3% for atrial fibrilation. Female proportion was lower in the HFrEF group (p=0.019). The prevalence of HT and DM was higher in the HFpEF group (p= 80 years with HFrEF (p, Turkish Society of Cardiology, This study was supported by Turkish Society of Cardiology.

OBJECTIVE The aim of this study was to determine the baseline clinical characteristics and the cardiovascular drug usage of patients aged ≥80 years who were admitted to cardiology clinics and to compare the cardiovascular disease and risk factors with patients aged 65-79 years who participated in the Epidemiology of Cardiovascular Disease in Elderly Turkish Population (ELDER-TURK) study. METHODS The ELDER-TURK study included 5694 patients aged over 65 years who were followed up at cardiology clinics between March 2015 and December 2015. The prevalence of cardiovascular diseases and the risk factors of 1098 patients aged ≥80 years (Group II) were compared with 4596 patients aged 65-79 years (Group I). RESULTS The mean age of Group I was 71.1±4.31 years (male: 50.2%) and the mean age of Group II was 83.5±3.12 years (male: 47.5%). The prevalence rate was 71.3% for hypertension, 24.6% for diabetes mellitus (DM), 44.7% for coronary artery disease (CAD), 35.9% for atrial fibrillation (AF), and 15.5% for renal failure. A statistical difference in the prevalence of comorbid conditions and cardiovascular disease risk factors, such as DM, CAD, renal failure, and AF was seen in the very elderly group (p

Bu tezde jack-up tipi açık deniz petrol platform temellerinin (spudcan) üniform killi deniz tabanına penetrasyonu 3 boyutlu sonlu elemanlar modeli (Abaqus 6.14) ile Bağlı Euler – Lagranj Metodu kullanılarak çalışılmıştır. Kılavuzlarda bazı analitik metodlar yer alsa da, bu temellerin taşıma kapasiteleri, metodların kullandığı bazı basitleştirmeler nedeniyle sık sık olduğundan az ya da çok tahmin edilmektedir. Bu çalışmada kullanılan spudcan geometrisi ve zemin özellikleri için, 3 boyutlu sonlu elemanlar metodu analiz sonuçları göz önüne alındığında, hedeflenen taşıma kapasiteleri için gerekli olan penetrasyon derinlikleri 2 ile 4 metre aralığında azaltılabilinir. Ayrıca 3 boyutlu sonlu elemanlar metodu analizlerinde penetrasyon derinliğine bağlı spudcan taşıma kapasitesi artış oranı, InSafeJIP metodlarına oranla daha fazladır ve bu da önemli tasarruflar ile sonuçlanabilir, fakat bu sonuç yalnızca bu çalışmadaki spudcan geometrisi ve zemin özellikleri için geçerlidir. Spudcan penetrasyon direncini etkileyen faktörler için sistematik parametrik çalışmalar yapılmıştır. Bu parametreler temelin çapı (7.5 ile 15 m arası), temel koniklik açısı (90 ile 150 derece arası), spudcan yüzey pürüzlülük katsayısı (0 ile 1. arası), kilin drenajsız kesme dayanımı (20 ile 80 kPa arası), spudcan penetrasyon derinliği (3 ile 20 m arası), ve iki komşu spudcan arasındaki uzaklıktır (uzaklık/çap oranı 1.5 ile 3.0 arası). Bu sonuçlara bağlı olarak, temel büyüklükleri, koniklik açıları gibi parametreler farklı durumlar için gerekli penetrasyon direncini sağlamak ve derinliğini azaltmak için seçilebilir. Bu çalışma ile yukarıda bahsedilen faktörler ve penetrasyon direnci arasındaki ilişkiyi anlamak, bu tip temellerin güvenli ve ekonomik dizayn ve başarılı uygulama süreçlerini arttırma konusunda önemli bir adım olabilir. Ancak, unutulmamalıdır ki, kilit nokta zemin profili ve malzeme özellikleri hakkında kapsamlı ve doğru bilgiye sahip olmaktır. The penetration of the foundation for `jack-up rig` type offshore oil platform (spudcan) into a uniform clayey seabed is studied with three dimensional finite element modeling (Abaqus 6.14) using Coupled Eulerian Lagrangian method. Although there exists some analytical methods (InSafeJIP etc.) for the calculation of the spudcan bearing capacity, they frequently underestimate or overestimate the bearing capacity due to simplifications involved. For the spudcan geometry and soil properties used in this study, based on the 3D FEM analyses, the required penetration depth for a target bearing capacity of spudcans can be reduced by 2 to 4 m. Rate of increase of the bearing capacity with depth is larger in 3D FEM analyses as compared to InSafeJIP method, which may also result in significant savings, however this finding is limited for the spudcan geometry and soil properties used in this study. A systematic parametric study is conducted for the variables that affect the spudcan penetration resistance. These parameters were spudcan diameter (7.5 to 15 m), spudcan cone angle (90 to 150 degrees), roughness of spudcan surface (roughness coefficient of 0 to 1.0), undrained shear strength of clay (20 to 80 kPa), spudcan penetration depths (3 to 20 m), and the spacing between two adjacent spudcans (spacing/diameter ratio of 1.5 to 3.0). Based on these results, spudcan size, cone tip angle etc. can be selected, for each case, to provide required penetration resistance and/or to reduce the required penetration depth.Understanding the relations between the factors and penetration resistance based on this study, may provide a significant step in enhancing the safe and economical design and successful penetration operation of spudcans. However, it should not be forgotten that, the key is to have extensive and correct information and interpretation about the subsoil profile and material properties. 124

Transcatheter aortic valve implantation is becoming increasingly popular as an alternative treatment technique for symptomatic patients with severe aortic stenosis, who are at high risk for surgery. However, with this revolutionary treatment modality, some fatal complications have also emerged. One of these fatal complications is the occlusion of the left main coronary artery at the time of procedure. In this case report, we presented a case of a transcatheter aortic valve implantation complicated by acute left main trunk subtotal oc-clusion and hemodynamic collapse, which was successfully resolved by balloon angioplasty and stent implantation.

Trombolitik ajanlardaki son gelişmelere rağmen reperfüzyon kriterlerini sağlayan hastaların bir kısmında halen infarkt ilişkili damar İİD açıklığı sağlanamamaktadır. Hastaneye başvurudaki hematolojik parametrelerin trombolitik tedavi başarısı ile ilişkisi net değildir. Çalışmamızda akut ST elevasyonlu miyokard infarktüsü STEMİ hastalarında hastaneye başvuru hematolojik parametreleri ile trombolitik tedavi başarısı arasındaki ilişkinin incelenmesi amaçlanmıştır. Akut STEMİ hastalarında, hastaneye başvuru esnasında saptanan yüksek OPH ve nötrofil sayısı anlamlı olarak başarısız tromboliz ile ilişkili bulunmuştur, Despite recent advances in thrombolytic agents, a significant number of patients fulfilling the reperfusion criteria still fail to accomplish complete patency of infarct related artery IRA . Therelationshipof hospital admission hematological parameters with thrombolytic outcome is not clear. We aimed to evaluate the relationship of hospital admission hematological parameters with thrombolytic outcome in acute ST elevation myocardial infarction STEMI patients

Objective: the evolution of non-vitamin K antagonist anticoagulants (NOACs) has changed the horizon of stroke prevention in atrial fibrillation (SPAF). All 4 NOACs have been tested against dose-adjusted warfarin in well-designed, pivotal, phase III, randomized, controlled trials (RCTs) and were approved by regulatory authorities for an SPAF indication. However, as traditional RCTs, these trials have important weaknesses, largely related to their complex structure and patient participation, which was limited by strict inclusion and extensive exclusion criteria. in the real world, however, clinicians are often faced with complex, multimorbid patients who are underrepresented in these RCTs. This article is based on a meeting report authored by 12 scientists studying atrial f ibrillation (AF) in diverse ways who discussed the management of challenging AF cases that are underrepresented in pivotal NOAC trials. Methods: An advisory board panel was convened to confer on management strategies for challenging AF cases. the article is derived from a summary of case presentations and the collaborative discussions at the meeting. Conclusion: This expert consensus of cardiologists aimed to def ine management strategies for challenging cases with patients who underrepresented in pivotal trials using case examples from their routine practice. Although strong evidence is lacking, exploratory subgroup analysis of phase III pivotal trials partially informs the management of these patients. Clinical trials with higher external validity are needed to clarify areas of uncertainty. the lack of clear evidence about complex AF cases has pushed clinicians to manage patients based on clinical experience, including rare situations of off-label prescriptions., Amaç: Non-Vitamin K antagonisti oral antikoagülanların (NOAK) geliştirilmesi ve yaygın klinik kullanıma girmesi ile Atriyal fibrilasyonda (AF) inmeden korunmanın ufku değişmiştir. Her ne kadar dört NOAK, büyük çaplı Faz 3 klinik denemeler ile düzenleyici otoritelerden alarak pazar erişim sürecini tamamlasa da Faz 3 denemelerin eksternal validasyonuna ilişkin geleneksel zorluklar günlük pratikte klinisyenleri zorlu olgu ve klinik senaryolar ile karşı karşıya bırakmaktadır. Günlük pratiklerinde klinisyenler, sıklıkla söz konusu Faz 3 denemelerde yeterince temsil edilmemiş ve yeterli kanıtın bulunmadığı hasta grupları ile yüz yüze kalmaktadır. Bu yazıda, pivot NOAK denemelerinde yeterince temsil edilmeyen ancak günlük pratikte sıklıkla karşılaşılan AF olgularının yönetimi ile ilgili olarak, günlük pratikte bu AF olgularının takip ve tedavisini sürdüren 12 kardiyoloji akademisyeninin katıldığı toplantı raporu sunulmaktadır. Yöntemler: Zorlu AF olgularının yönetim stratejilerini tartışmak için bir danışma kurulu paneli toplanmıştır. Mevcut makale bu toplantıdaki olgu sunumları ve tartışmaların özeti olarak derlenmiştir. Sonuç: Kardiyologların bu uzman fikir birliği, rutin uygulamalarından olgu örnekleri kullanarak, önemli çalışmalarda yeterince temsil edilmeyen zorlu olguların yönetim stratejilerini tanımlamayı amaçlamıştır. Güçlü kanıtlar eksik olmakla birlikte, faz çalışmaların alt grup analizleri, bu hastaların yönetimini hakkında kısmen bilgi vermektedir. Bununla birlikte alt grup analizlerinin hipotez kanıtlayıcı değil hipotez oluşturucu doğası unutulmamalı, ihtiyaç duyulan kanıtların elde edilmesine yönelik uygun tasarlanmış deneme/çalışmaların gerçekleştirilmesi gerekliliği göz önünde bulundurulmalıdır. Bu süreç, klinisyenlerin NOAK’ları yalnızca klinik deneyimlerine dayanarak “off label” kullanmasının da önüne geçecektir.

WOS: 000457932600012, PubMed ID: 30311891, Objective: Patients with iliac vein compression syndrome (IVCS) usually present to the hospital with left-sided leg edema. We looked for an answer to the question: "Can iliac vein compression syndrome (IVCS) be predicted with a reliable physical examination test in the differential diagnosis?'' Methods: We tested a new physical examination on patients with only left-sided lower extremity edema. In this physical examination the widest area of the calf point (just below tuberosity of the tibia) and medial malleolus was measured in both legs on the Trendelenburg position at 30 degrees and repeated in standing position. Then the iliac venography was performed. Results: The test was performed on 32 (N = 32) patients with left extremity edema. IVCS was observed on 18 (n = 18) (56%) patients. The test was found to have 88% sensitivity and 92% specificity in IVCS. Conclusion: This new physical examination finding, which may be valuable in diagnosing IVCS, is proposed for use in patients with unilateral left-sided edema to preclude unnecessary use of expensive diagnostic imaging methods.