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Aim: Chronic venous insufficiency (CVI) is a condition that results from obstruction, valve insufficiency, dysfunction of calf muscle pump, or their combinations. This study analyzed the risk factors and demographic characteristics of CVI in nurses in Turkiye. Additionally, it seeks to identify the total number of patients treated at medical centers in 2022 and assess the prevalence of CVI. Material and Methods: This multicenter, descriptive, and cross-sectional study was conducted with the participation of nurses working in 18 centers. Nurses completed a questionnaire that included their demographic information and venous insufficiency risk factors, and the Venous Insufficiency Epidemiological and Economic Study-Quality of Life Questionnaire. Researchers also completed the Standard CEAP Form Section C. The cases were divided into 2 groups: CVI (-) group (n=776, 43.5%) and CVI (+) group (n=1010, 56.5%). Results: A total of 1786 nurses participated in this study. Older age (>30-39 years), female gender, ≥2 pregnancies, ≥2 childbirths, years in the profession (>5-15 years), family history, and night cramps were identified as risk factors for CVI (p0.05). Hypertension, diabetes, and a history of deep vein thrombosis were the most common coexisting diseases. With a one-unit increase in age, risk of CVI increased 1.1-fold, family history of VV increased CVI risk 1.9-fold and presence of nocturnal night cramps increased risk of CVI 2.6-fold. The prevalence of CVI in 2022 was found to be 22.66% in this study. Conclusion: Older age, female gender, ≥2 pregnancies, ≥2 childbirths, years in the profession, family history, and night cramps are identified as risk factors for CVI in nurses. Common comorbid diseases include hypertension, diabetes, and a history of DVT. Pregnancy, particularly with multiple occurrences, stands out as a critical period for CVI. Reported symptoms in CVI (+) nurses include leg pain, swelling, heaviness, restless legs, and throbbing. Nurses demonstrate a higher incidence of CVI compared to other professions, highlighting an occupational risk. These findings stress the importance of preventive measures for nurses. [Turk J Vasc Surg 2024; 33(1.000): 1-9]

Rekabetin her geçen gün daha yoğun yaşandığı günümüz kapitalizminde, performans ile onun unsurları olan etkinlik ve verimlilik artan önemini korumaktadır. Üretim sisteminde yüksek bir performans gerçekleştirmek için tüm süreçte optimal kaynak kullanımının sağlanması, maliyetlerin düşürülmesi gerekmektedir. Malzeme arzı, malzeme tedariki ve lojistik süreci boyunca tüm aşama optimum uyum içinde gerçekleştirilmelidir. Dolayısıyla performans artışında, lojistik sektörlerinin etkinliğinin ve verimliliğinin sağlanması önem kazanmaktadır. Bu çalışmada, Avrupa Geçiş Ekonomisi Ülkeleri içinde geçişi tamamlamış olan 11 ülkenin etkinlik ve verimlilik analizi, Lojistik Performans Endeksi alt boyutlarına ait veriler kullanılarak Girdi Odaklı Ölçeğe Göre Sabit Getiri (CCR) ve Girdi Odaklı Ölçeğe Göre Değişken Getiri (BCC) Modellerine göre yapılmıştır. Lojistik Performans Endeksinin altı alt boyutundan üçü (gümrük, altyapı ve lojistik kalite) girdi olarak kullanılırken, diğer üçü ise (uluslararası gönderiler, izleme-takip ve zamanında teslimat) çıktı olarak ele alınmıştır. Veri Zarflama Analizi ile yapılan çalışmada “EMS Paket Programı” kullanılarak etkinlik değerlendirilmesi yapılmıştır. Analiz bulgularından elde edilen sonuçlara göre etkin ve verimli olan ülkeler bulunmuştur. Aynı zamanda etkinsiz ve verimsiz olan ülkeler de bulunarak, etkin olmayan ülkelerin ideal etkinlik düzeyine çıkabilmesi için girdi değişkenlerin iyileştirme oranları hesaplanmıştır.

Abstract Introduction: Rhythm problems are the most observed complications following coronary artery bypass grafting (CABG), the most common being postoperative atrial fibrillation (PoAF), with an incidence reaching 50% of the patients. In this study, we aimed to investigate the predictive importance of prognostic nutritional index (PNI) and visceral adiposity index (VAI) in predicting PoAF, which occurs after CABG accompanied by cardiopulmonary bypass. Methods: Patients who underwent isolated CABG with cardiopulmonary bypass between June 15 and October 15, 2019, were prospectively included in the study. Patients who did not develop in-hospital PoAF were identified as Group 1, and those who did constituted Group 2. Results: PoAF developed in 55 (27.6%) patients (Group 2). The mean age of the 144 patients included in Group 1 and 55 patients in Group 2 were 56.9±8.7 and 64.3±10.2 years, respectively (P

Öğrenme sürecini olumlu ya da olumsuz yönde şekillendirebilecek birçok etken vardır. Sürecin sağlıklı işleyebilmesi ve öğretim programlarının hedeflediği kazanımların öğrencilere kazandırılması noktasında dersin öğretmeni, ders kitapları ve öğrenme ortamının şartları büyük önem taşımaktadır. Dersin öğretmenlerinin hedef dile ve kültüre yönelik donanımlarının yanı sıra ders materyallerinin niteliği yurt dışında yaşayan Türklerin ana dillerinden ve milli kültürlerinden oluşan zihin haritalarının sınırlarını çizmesi açısından özenle üzerinde durulması gereken konulardandır. Yapılan araştırma yurt dışında yaşayan, ana dilini ve milli kültürünü içinde yaşadığı coğrafyada öğrenmeye çalışan Türk çocukları için 2019 yılında yayımlanan 1-4 ve 5-8. seviye Türkçe ve Türk Kültürü Ders Kitapları'nda yer alan etkinliklerin, 2018 yılında hazırlanan Yurt Dışındaki Türk Çocukları İçin Türkçe ve Türk Kültürü Dersi Öğretim Programındaki kazanımları karşılama durumunu değerlendirmek amacıyla gerçekleştirilmiştir. Çalışma kapsamında Milli Eğitim Bakanlığının söz konusu ders kitapları doküman incelemesi yoluyla incelenerek içerik analizi yöntemiyle çözümlenmiştir. Nitel hüviyetteki araştırmanın sonucuna göre ders kitapları ve bu kitaplarda bulunan etkinliklerin kazanımlarla uyumu konusuna ilişkin belirleyici sonuçlara ve çözüm önerilerine yer verilmiştir.

In recent years, human beings and our planet have suffered great losses in the frequent disasters. Effective and timely intervention is of utmost importance in all large-scale disasters, whether natural or man-made. In this article, a study has been conducted on a model in which the location selection criteria of the management and support centers, where the coordination works as well as the management and administration are carried out in disaster areas, are evaluated by the Multi-Criteria Decision Making (MCDM) method. For this, an in-depth literature analysis was carried out at the first stage, and then all the findings obtained as a result of the literature research were presented to the professionals related to the subject, and expert opinion was sought. In the light of expert opinion, the location selection criteria for the coordination management center and logistic support units in disaster areas were determined, and a model proposal was made, in which the importance values ​​were weighted by using one of the MCDM methods, The Analytic Hierarchy Process (AHP), which is widely used.

Aim: Our aim was to evaluate the two-year results of radiofrequency ablation (RFA) in the treatment of great saphenous vein (GSV) insufficiency. Methods: A total number of 217 patients who underwent RFA (52.5 % male, mean age 42.7±11.4) were included in the study. RFA was performed in patients with great saphenous vein valvular incompetence and saphenofemoral junction incompetence. Occlusion status was recorded by ultrasonography. Venous clinical severity score (VCSS) was calculated pre- and post-intervention. Results: The mean follow-up period of the patients was 22.2 ± 5.1 months. Cumulative survival rate (Kaplan–Meier) of 24-month follow-up was 84.3%. Complete occlusion rate for GSV was 100%, 98.6% ,97.6%, 97.6% and 97.6% for 1, 6, 12, 18 and 24 months follow up, respectively. VCSS was significantly different before RFA and 4 weeks after RFA (p < 0.001). No major complications were observed in the study. Conclusion: In the treatment of GSV insufficiency, RFA is a safely applied method with high occlusion rates and obvious VCSS score decrease.

Abstract Objective: Del Nido cardioplegia (DNC) has been used in pediatric cardiac surgery for many years with a single dose application and its usage in adult cardiac surgery has been increasing in recent years, with results being published. In this study, we aimed to investigate the effect of DNC on the development of postoperative atrial fibrillation (PoAF). Methods: In this retrospective observational comparative study, 255 patients who underwent isolated on-pump coronary artery bypass grafting, between January 2019 and November 2019, were enrolled. The patients were divided into two groups: DNC (n=132) and blood cardioplegia (BC) (n=123). Intraoperative and postoperative data were evaluated and compared in terms of the development of PoAF. Results: We found that the development of PoAF and the length of hospital stay remain significantly higher in the BC group (P=0.044, P

Abstract Ventricular free wall rupture is a fatal mechanical complication of acute myocardial infarction. In some cases it can be represented as subacute clinic and may not cause death in a few minutes. Acute pseudo-aneurysms are extremely unstable and bound to fatal rupture. Herein we report a male patient who suffered dyspnea and mild chest pain, 4 weeks after acute ST-segment elevation myocardial infarction.

Bu çalışmanın amacı, B2 (Orta) seviyesinde Türkçe öğrenen yabancı öğrencilerin yazılı anlatım becerilerini “yanlış çözümleme yaklaşımına” göre değerlendirmektir. Araştırmanın verileri, Gaziantep Üniversitesi TÖMER’de öğrenim görmekte olan B seviyesindeki 42 öğrenciye yazdırılan kompozisyonlar ile toplanmıştır. Toplanan veriler, dil bilgisi yanlışları, söz dizimsel yanlışlar, sözcük seçiminden kaynaklanan yanlışlar ve yazım-noktalama yanlışları olarak sınıflandırılmıştır. Belirlenen bu yanlışlar, yanlış çözümleme yaklaşımına göre değerlendirilmiştir. Yanlışların değerlendirilmesi, “dil içi gelişimsel yanlışlar” ile sınırlandırılmıştır. Değerlendirme sonucunda; toplam 1282 yanlış belirlenmiştir. Yapılan bu yanlışların % 31’i dil bilgisel % 9,9’u söz dizimsel, % 44,46’sı yazım-noktalama ve % 14,4’ü de sözcük seçiminden kaynaklanan yanlışlardır. Elde edilen bu sonuçlar doğrultusunda yabancı dil olarak Türkçe öğrenenlerin yazılı anlatım becerilerinin geliştirilmesine dönük çözüm önerilerinde bulunulmuştur.

Abstract Objective: To investigate the effect of continuous lung ventilation with low tidal volume on oxidation parameters, such as thiol/disulphide homeostasis and albumin-adjusted ischemia-modified albumin (AAIMA), during cardiopulmonary bypass (CBP) in coronary artery bypass grafting (CABG). Methods: Seventy-four patients who underwent elective CABG with CPB were included in the study. Blood samples were taken in the preoperative period, 10 minutes after CPB, and six and 24 hours postoperatively. Patients were assigned to the continuous ventilation group (Group 1, n=37) and the non-ventilated group (Group 2, n=37). The clinical characteristics, thiol/disulphide homeostasis, ischemia-modified albumin (IMA), and AAIMA levels of the patients were compared. Results: A significant difference was found between the groups regarding native thiol, total thiol, and IMA levels at the postoperative 24th hour (P=0.030, P=0.031, and P=0.004, respectively). There was no difference between the groups in terms of AAIMA. AAIMA levels returned to preoperative levels in Groups 1 and 2, at the 6th and 24th postoperative hours, respectively. Length of hospital stay was significantly shorter in Group 1 (P

Abstract Objective: Postoperative atrial fibrillation (PoAF) is a common complication after coronary artery bypass grafting (CABG). The aim of the present study was to evaluate the association between development of PoAF and vitamin D levels in patients undergoing isolated CABG. Methods: This prospective randomized clinical trial was conducted on the patients with isolated CABG. The study was terminated when 50 patients in both PoAF(+) group and PoAF(-) group were reached. Development of AF until discharge period was assessed. Vitamin D level was measured immediately after AF; it was measured on the discharge day for the patients without PoAF. Predictive values of the independent variables were measured for the development of PoAF. Results: The groups were separated as PoAF(-) group (66% male, mean age 58.18±10.98 years) and PoAF(+) group (74% male, mean age 61.94±10.88 years). 25(OH) vitamin D level (OR=0.855, 95% CI: 0.780-0.938, P=0.001) and > 65 years (OR=3.525, 95% CI: 1.310-9.483, P=0.013) were identified as an independent predictor of postoperative AF after CABG surgery in multivariate analysis. The cut-off level for 25(OH) vitamin D level in receiver-operating characteristic curve analysis was determined as 7.65 with sensitivity of 60% and specificity of 64% for predicting PoAF (area under the curve: 0.679, P=0.002). Conclusion: Vitamin D level is considered an independent predictor for development of PoAF. Lower vitamin D levels may be one of the reasons for PoAF.

Rationale and Objectives: Gliomatous tumors are known to affect neural fiber integrity, either by displacement or destruction. The aim of this study is to investigate the integrity and distribution of the white matter tracts within and around the glioma regions using probabilistic fiber tracking., Material and Methods: Forty-two glioma patients were subjected to MRI using a standard tumor protocol with diffusion tensor imaging (DTI). The tumor and peritumor regions were delineated using snake model with reference to structural and diffusion MRI. A preprocessing pipeline of the structural MRI image, DTI data, and tumor regions was implemented. Tractography was performed to delineate the white matter (WM) tracts in the selected tumor regions via probabilistic fiber tracking. DTI indices were investigated through comparative mapping of WM tracts and tumor regions in low-grade gliomas (LGG) and high-grade gliomas (HGG)., Results: Significant differences were seen in the planar tensor (C p ) in peritumor regions; mean diffusivity, axial diffusivity and pure isotropic diffusion in solid-enhancing tumor regions; and fractional anisotropy, axial diffusivity, pure anisotropic diffusion (q), total magnitude of diffusion tensor (L), relative anisotropy, C p and spherical tensor (C s ) in solid nonenhancing tumor regions for affected WM tracts. In most cases of HGG, the WM tracts were not completely destroyed, but found intact inside the tumor., Discussion: Probabilistic fiber tracking revealed the existence and distribution of WM tracts inside tumor core for both LGG and HGG groups. There were more DTI indices in the solid nonenhancing tumor region, which showed significant differences between LGG and HGG., (Copyright © 2020. Published by Elsevier Inc.)

Background Context: Biopsy is important to obtain microbiological and histopathological diagnosis in spine infections and tumors. To date, there have been no prospective randomized trials comparing fluoroscopic guided and computed tomography (CT) transpedicular biopsy techniques. The goal of this study was to evaluate the accuracy, safety, and diagnostic outcome of these two diagnostic techniques., Purpose: To evaluate the accuracy, safety, and diagnostic outcome of fluoroscopic guided and CT transpedicular biopsy techniques., Study Design: Prospective randomized trial., Patient Sample: Sixty consecutive patients with clinical symptoms and radiological features suggestive of spinal infection or malignancy were recruited and randomized into fluoroscopic or CT guided spinal biopsy groups. Both groups were similar in terms of patient demographics, distribution of spinal infections and malignancy cases, and the level of biopsies., Outcome Measures: The primary outcome measure was diagnostic accuracy of both methods, determined based on true positive, true negative, false positive, and false negative biopsy findings. Secondary outcome measures included radiation exposure to patients and doctors, complications, and postbiopsy pain score., Methods: A transpedicular approach was performed with an 8G core biopsy needle. Specimens were sent for histopathological and microbiological examinations. Diagnosis was made based on biopsy results, clinical criteria and monitoring of disease progression during a 6-month follow up duration. Clinical criteria included presence of risk factors, level of inflammatory markers and magnetic resonance imaging findings. Radiation exposure to patients and doctors was measured with dosimeters., Results: There was no significant difference between the diagnostic accuracy of fluoroscopic and CT guided spinal biopsy (p=0.67) or between the diagnostic accuracy of spinal infection and spinal tumor in both groups (p=0.402 for fluoroscopy group and p=0.223 for CT group). Radiation exposure to patients was approximately 26 times higher in the CT group. Radiation exposure to doctors in the CT group was approximately 2 times higher compared to the fluoroscopic group if a lead shield was not used. Lead shields significantly reduced radiation exposure to doctors anywhere from 2 to 8 times. No complications were observed for either group and the differences in postbiopsy pain scores were not significant., Conclusions: The accuracy, procedure time, complication rate and pain score for both groups were similar. However, radiation exposure to patients and doctors were significantly higher in the CT group without lead protection. With lead protection, radiation to doctors reduced significantly., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Tuberculous meningitis (TBM) causes significant morbidity and mortality. The primary objective was to re-examine the concept of "TB zone" and "ischaemic zone" in cerebral infarction in patients with tuberculous meningitis. The secondary objective was to evaluate cerebral infarction, vasculitis and vasospasm in tuberculous meningitis infections. Between 2009 and 2014, TBM patients were recruited. Neuroimaging was performed and findings of cerebral infarction, vasculitis and vasospasm were recorded. Infarcts were classified based on arterial supply and Hsieh's classification. Fifty-one TBM patients were recruited of whom 34 patients (67%) had cerebral infarction. Based on Hsieh's classification, 20 patients (59%) had infarcts in both "TB zone" and "ischaemic zones". 12 patients (35%) had infarcts in "ischaemic zone" and two (6%) patients had infarcts in "TB zone". In terms of vascular supply, almost all patients (35/36) had infarcts involving perforators and cortical branches. 25 patients (73%) and 14 patients (41%) had infarcts supplied by lateral lenticulostriate and medial lenticulostriate arteries respectively. 15 patients (37%) had vasculitis. Vasospasm was present in six patients (15%). 29 patients (85%) with cerebral infarction also had leptomeningeal enhancement (p = 0.002). In summary, infarcts involved mainly perforators and cortical branches, rather than "TB zone" versus "ischaemic zone".

Paradoxical manifestation is worsening of pre-existing tuberculous lesion or appearance of new lesions in patients whose condition initially improved with antituberculous treatment. Our hypothesis was that paradoxical manifestation in non-HIV tuberculous meningitis (TBM) patients was underestimated and this could contribute to patients' prognosis. This was the first systemic study of paradoxical manifestation in HIV-negative TBM patients. Between 2009 and 2014, TBM patients were studied prospectively in 2 hospitals. Clinical features, cerebrospinal fluid, and radiological findings were monitored. Paradoxical manifestation was divided into definite (4 weeks or more) and probable (between 14 and 27 d) after commencement of antituberculous treatment. Forty-one non-HIV TBM patients were recruited. Definite paradoxical manifestation occurred in 23/41 (56%) of the patients. Time to onset of paradoxical manifestation was between 28 days and 9 months, and majority was between 28 and 50 days. Neuroimaging manifestation in the brain (22/41 patients, 54%) and clinical manifestation (22/41 patients, 54%) were most commonly seen, followed by cerebrospinal fluid manifestation (7/41 patients, 17%). Neuroimaging changes most commonly seen were worsening of leptomeningeal enhancement, new infarcts, new tuberculomas, and enlargement of tuberculoma. Initial Computed Tomography Angiography/magnetic resonance angiography brain showed vasculitis in 14 patients, with 2 (12.5%) showing paradoxical vasculitis during follow-up. Recurrence of the paradoxical manifestation was seen in 7/23 (30%) of the patients. More than half (14/23, 61%) of the patients improved, 6 (26%) patients died, and 3 (13%) patients had persistent neurological deficit. Paradoxical manifestation was very common in non-HIV TBM patients. Neuroimaging paradoxical manifestation of 2-4 weeks may not be paradoxical manifestation but could be delayed treatment response.