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Aim: COVID-19 is an epidemic communicable disease that has been declared as a pandemic caused by severe acute respiratory syndrome coronavirus 2. Clinical studies have demonstrated that advanced age and comorbid conditions enhance the severity of the infection. The objective of this study was to examine the of effects of blood group types on risk of infection, disease severity, and mortality in COVID-19 patients. Material and Method: Included in this study were 1618 patients who had been diagnosed with PCR confirmed COVID-19 infection. The age, gender, blood type, disease severity, need for intensive care, and deaths of the patients were analyzed retrospectively. For the distribution of the blood types in a healthy population, statistics for the blood types of individuals in Ankara for 2020 were obtained from the Republic of Turkey Red Crescent Blood Services and used as a healthy control group for comparison with the data of the patients included in the study. Results: Among the COVID-19 patients, blood type A was the most common type at a rate of 46.2%. This was followed by blood type O at a rate of 28.4%. The least common blood type was found to be type AB at a rate of 9%. When compared to the healthy population, blood type A was determined to be statistically significantly more common in COVID-19 infection (p=0.07,). In contrast, blood type O was determined to be less common when compared to the healthy population (p

Aim: We planned this study to examine whether the measures taken against COVID-19 infection during the pandemic and COVID-19 vaccination process raise awareness about influenza and pneumococcal vaccines for patients in the risk group. Material and Method: Patients over the age of 18 who were in the risk group according to CDC and had chronic diseases requiring influenza and pneumococcal vaccination were included in the study. A questionnaire consisting of seven questions was applied to all volunteers, showing their clinical demographic findings, their vaccination history, and whether the pandemic and COVID-19 vaccination processes contributed to the vaccination processes. Results: It was found that 42.5% of the entire population had had a preventive vaccine before. With the COVID-19 pandemic, it was determined by the survey that 74.7% of the people would get their preventive vaccinations regularly from now on. After that, it was determined that the pandemic and COVID-19 vaccination processes were effective at a rate of 57.9% in the formation of this idea in the group that wanted to get a preventive vaccine. Conclusion: As a result, the idea of having a preventive vaccination compared to the period before the pandemic increased during the pandemic period in relation to the events experienced in the pandemic. In this, it was determined that catching COVID-19 infection, hospitalization and intensive care unit admission and COVID-19 vaccination campaigns were effective in the cases in the risk group.

Bu çalışmada inceleme konusu edilen Eldar Guliyev'in Küresel Gıda Güvenliği (Gerçekler-Çağrılar-Perspektifler) isimli kitabı temel olarak gıda güvenliği konusunda yapılabilecek çalışmalar hakkında çözüm önerileri sunmaktadır. İlk 3 bölümde gıda güvenliği konusunun ekonomik, küresel, sosyal yönleriyle incelendiği kitapta, 4’üncü bölümde gıda güvenliğinin sağlanabilmesinin çeşitli yönleri, 5’inci bölüm olan sonuç ve önerilerde ise gıda erişilebilirliği konusunda neler yapılabileceği açıklanmıştır. Kitabın 2017 yılında Roma’da ingilizce yapılan tanıtımına, önemli ülkelerin ünlü bilim ve eğitim kurumları, akademik çevreler, Roma’daki uluslararası örgütler, aynı zamanda Birleşmiş Milletler Gıda ve Tarım Örgütü (FAO) temsilcileri ile birlikte Azerbaycan’ın İtalya’daki Büyük Elçilik temsilcileri katılmış, kitabın yazarı Prof. Eldar Guliyev’e, BM Kamu Hizmetler Ödülü Konseyinin uluslararası yılın Kitabı ödülü takdim edilmiştir. Bu tanıtımda, Profesör Eldar Guliyev`e Vatikan Bonifesiana Akademisinin gerçek üyelik (akademik) diploması da takdim edilirken, kitap da BM İsviçre`deki Merkezi Kütüphane Fonuna alınmıştır. Ayişe Nebi tarafından Azerbaycan Türkçesinden Türkiye Türkçesine aktarılan kitap, Türk Dünyası Araştırmaları Uluslararası İlimler Adademisi’nin bilimsel Kurul üyelerinin 24 Mayıs 2019 tarihli, 5 nolu kararına istinaden 1000 adet olarak, Eylül 2019’da yayımlanmıştır. Bölüm sonlarında gıda güvenliği boyutuyla ele alınan her bir konuda gerçekçi bakış açıları sunması, çözüm önerisi konusunda etkili tavsiye vermesi ve yetkililere çözüm konusunda çağrıda bulunması bakımından nitelikli bir eser olan bu kitap, küresel gıda güvenliğinin anlaşılabilmesi bakımından temel bilgilerin toplandığı kapsamlı bir çalışma ve akademik arkaplanın yanında insanların gıda güvenliğinin önemini anlayabilmesi için önemli bir kaynaktır.

In this study, we aim to evaluate the presence of endothelial dysfunction in Gilbert syndrome patients with left ventricular mass index (LVMI) and endocan levels. The study included 60 patients who diagnosed with Gilbert syndrome and 60 healthy controls who did not have any known diseases. Human endocan levels were measured using a sandwich ELISA method. The endocan and LVMI levels were lower in the Gilbert syndrome group than in the healthy controls. In the Gilbert syndrome group, total bilirubin level was negatively correlated with LVMI (r = −0246; P = .007) and endocan levels (r = −.270; P = .046). In the Gilbert syndrome group, increasing age (β ± SE = 20.78 ± 7.47; P = .006), was a positive independent predictor of LVMI, and increasing high-density lipoprotein cholesterol (HDL-C) (β ± SE = −.27 ± .09; P = .007), and total bilirubin levels (β ± SE = −6.09 ± 3.02; P = .046) were found to be a negative independent predictor. These results support that endothelial dysfunction is decreased in Gilbert Syndrome patients with mild hyperbilirubinemia compared with the healthy control group.

Introduction: There is insufficient data on the role of the medium cutoff (MCO) membranes in the clearance of pro-inflammatory cytokines and oxidant radicals in patients with sepsis requiring hemodialysis. Methods: The study consisted of 38 septic patients who developed acute kidney injury (AKI) and who were scheduled to undergo 2 sessions of hemodialysis. Nineteen patients underwent their first dialysis session with the MCO membrane and 19 patients with the high-flux (HF) membrane. In the second session, the membranes were switched. Pro-inflammatory cytokine and oxidative marker levels were measured in blood samples obtained before and after both dialysis sessions. Reduction ratios were compared for the 2 types of hemodialysis membranes. Results: After the first session, there was a greater reduction in tumor necrosis factor (TNF)-α with the MCO membrane (28.2 ± 21.1 vs. 8.0 ± 6.6, p = 0.001). After the second session, there was a greater reduction in interleukin (IL)-6 (27.8 ± 26.5 vs. 5.9 ± 13.3, p = 0.003) and IL-1β (20.5 ± 21.1 vs. 4.0 ± 6.5, p = 0.004) with the MCO membrane. When the first and second sessions of all 38 patients were compared, the reductions in TNF-α, IL-6, and IL-1β were consistently greater for MCO than HF (p = 0.001, p = 0.006, p < 0.001, respectively). The reductions in total antioxidant status, total oxidant status, and myeloperoxidase were not statistically different for the 2 types of dialysis membranes. Conclusions: MCO membrane was superior to HF membrane in the removal of cytokines in septic patients with AKI. However, a similar effect was not observed for oxidative stress markers.

Background: This study aimed to reveal whether there is any difference in clinical outcome between the octogenarian (>80 years old) and non-octogenarian patients in the geriatric patient group (>65 years old) with acute upper gastrointestinal bleeding. Methods: Patients aged 65 and over who were admitted with non-variceal upper gastrointestinal system bleeding included in the study. Patients in the study were divided into 2 groups, those aged 65-80 years and those over 80 years of age. Groups were compared in terms of laboratory findings, endoscopy findings, and serious clinical outcome. Results: The number of patients included in the study was 263 and their mean age was 78.25 ± 8.20 years. Comorbidity was present in 97.4% of the patients and in both groups the most common comorbid disease was hypertension. 28.5% of the patients were taking anticoagulants, 39.9% were taking antiplatelet drugs, and 18.6% were taking non-steroidal anti-inflammatory drugs. The median hospital stay of the patients was 5 days. In-hospital mortality was 5 (4.4%) and 6 (4.0%) and rebleeding was seen in 10 (8.8%) and 13 (8.7%) patients in the octogenarian and non-octogenarian groups, respectively. The frequency of patients who stayed in the hospital longer than 21 days was significantly higher in the octogenarian group compared to the other group (p=0.011). Conclusion: There was no significant difference in terms of in-hospital mortality, re-bleeding, need for intensive care, need for endoscopic intervention or hospital stay, but the frequency of prolonged hospital stay was significantly higher in the octogenarian group.

This research was conducted to determine the effect of Coenzyme Q10 (CoQ10) on blood glucose, total protein, triglyceride, and total cholesterol levels in rats for that experimental hypothyroidism was induced. A total of 32 healthy adult male Wistar Albino rats were used as a material in the research. After the adaptation period of animals for ten days, the main research period was conducted for a total of three weeks. The rats housed as four rats in each cage during the research were divided into four experimental groups as control (K), CoQ10 (C), Hypothyroid (H), and CoQ10+Hypothyroid (CH). CoQ10 was administered intraperitoneally every day to the group C animals. In addition, propylthiouracil (PTU) was added daily to the water of rats in group H to induce experimental hypothyroidism. Both CoQ10 and PTU administration was performed on the animals in the group HC. At the end of the trial period, blood was drawn from the hearts of rats in all groups. Glucose, total protein, triglyceride, and total cholesterol levels were determined in plasma samples obtained from blood samples. It was observed in the research that hypothyroidism administration (group H) decreased plasma glucose and triglyceride values (p

Aim: The issue of which scoring system is appropriate in older adults patients with acute biliary pancreatitis is an ongoing debate. We aimed to compare the efficiency of four existing scoring systems in predicting clinical outcomes in the elderly with acute biliary pancreatitis. Material and Method: The study included patients aged 60 years and older with a diagnosis of acute biliary pancreatitis. Clinical findings, routine laboratory examinations, and imaging findings were retrospectively accessed through the hospital information system and reviewed. Then, the efficacy of Ranson, Bedside Index of Severity in Acute Pancreatitis (BISAP), Glasgow-Imrie, and Acute Physiology and Chronic Health Evaluation (APACHE) II scoring systems in predicting mortality, severity, organ failure, complications, intensive care unit (ICU) admission, and prolonged hospital stay (PHS) were compared. Results: The Ranson score was compared with three other existing scoring systems in primary and secondary outcomes in 364 eligible patients. The area under the curve (AUC) values of the Ranson, BISAP, Glasgow, and APACHE II scores were 0.787 (95% CI: 0.649-0.925), 0.856 (95% CI: 0.784-0.929), 0.908 (95% CI: 0.854-0.961), and 0.836 (95% CI: 0.702-0.971) for mortality. Although the AUC of the Ranson score for mortality was lower than that of the other scores, no significant difference was found in pairwise comparisons with the other three scores (p>0.05 for all). Conclusion: The Ranson scoring system was the weakest among the assessed scoring systems in predicting clinical outcomes in older adults with biliary pancreatitis.

Turkey is one of the countries that is the gene center and the homeland of walnuts. The purpose of the study was to determine the energy uses of walnut production in Turkey. In the study, the energy efficiency of walnut production, net energy, energy productivity, and specific energy were examined. In addition, the benefit-cost ratio, the use of direct and indirect energy, renewable and non-renewable energy were determined. Data was obtained from walnut producers in the Istanbul province of Turkey by using a survey. Surveys were performed with 48 walnut producers. Total energy input and total energy output of the surveyed orchards were calculated as 12,605 MJ ha−1 and 23,300 MJ ha−1 respectively. The energy use efficiency was calculated as 1.85 for the walnut production. While specific energy was calculated as 5.95 MJ kg−1 energy productivity was calculated 0.17 kg MJ−1 in the study. According to economic analysis, it was determined that the walnut producers had 4850 US$ ha−1 net return per year. The benefit-cost ratio was calculated as 1.51. As a result of the study, it was determined that the walnut production was preferable in the region.

Objective The aim of the study was to evaluate proline metabolism in patients affected by COVID-19. Materials and Methods This case-control study consisted of 116 patients with COVID-19 and 46 healthy individuals. Tests related to proline metabolism (prolidase, proline, hydroxyproline, glutamic acid, manganese) and copper and zinc tests were analyzed. Results The levels of proline and hydroxyproline amino acids and the prolidase enzyme were found to be lower and glutamic acid was found to be higher in the COVID-19 group compared to the healthy group (P = .012, P < .001, P < .001, and P < .001, respectively). The copper/zinc ratio was higher in patients with COVID-19 than in healthy individuals (P < .001). Significant correlations were found between proline metabolism tests and inflammatory and hemostatic markers commonly used in COVID-19. Conclusion The proline metabolic pathway was affected in COVID-19. Relationships between proline pathway–related tests and inflammatory/hemostatic markers supported the roles of proline metabolism in proinflammatory and immune response processes.

Amaç: Korona virüs hastalığı (COVID 19) 4,5 milyondan fazla insanın ölümüne sebep olmuş küresel bir halk sağlığı sorunudur. Bu çalışmada, yataklı servis ve yoğun bakım ünitesinde tedavi alan COVID-19 hastalarının tiyol ve iskemi modifiye albumin (İMA) düzeylerinin, hastaların mevcut klinik durumu ve hastalığın seyri ile olan ilişkisinin değerlendirilmesi amaçlanmıştır.Materyal ve metod: Bu çalışmaya, PCR testi ile pozitif olduğu doğrulanmış, COVID-19 enfeksiyonu tanısı alan 300 hasta dahil edilmiştir. Hastalar tedavi edildiği birim esas alınarak iki gruba ayrılmıştır. Bu hastaların 160’ı serviste (grup 1), 140’ı yoğun bakım birimlerinde (grup 2) tedavi edilmiştir. Hastaların numunelerinde tiyol, İMA, CRP, ferritin ve lenfosit düzeylerinin ölçümü gerçekleştirilmiştir.Bulgular: Gruplar karşılaştırıldığında grup 2’nin tiyol düzeyleri önemli derecede düşük bulunmuştur (p, Background: Corona virus disease (COVID 19) is a global public health problem that has killed more than 4.5 million people. In this study, it was aimed to evaluate the relationship between the thiol and ischemia modified albumin (İMA) levels of COVID-19 patients treated in the inpatient and intensive care unit with their current clinical status and the course of the disease.Materials and Methods: In this study, 300 patients who were confirmed to be positive by PCR test and diagnosed with COVID-19 infection were included. The patients were divided into two groups based on the unit they were treated. 160 of these patients were treated in the inpatient service (group 1) and 140 in the intensive care units (group 2). Thiol, İMA, CRP and ferritin levels were measured from the serum samples of the patients.Results: When the groups were compared, the thiol levels of group 2 were found to be significantly lower (p

In this study, we aimed to compare differences in disease course, etiology of acute pancreatitis admission to the intensive care unit, in-hospital mortality, disease severity, and local and systemic complications between patients aged ≥ 80 years (octogenarians) and patients aged between 65 and 79 years (non-octogenarians), all of whom were being followed with the diagnosis of acute pancreatitis.Patients aged 65 years and older with a diagnosis of acute biliary pancreatitis were included in the study. Clinical findings, routine laboratory test results, and imaging findings of all patients were reviewed retrospectively via the hospital's records system.Of a total of 402 enrolled patients, 238 (59.2%) were female. Mean age was 77.1 ± 7.37 years. Pancreatitis after endoscopic retrograde cholangiopancreatography was detected more frequently among octogenarians than non-octogenarians (12.9% versus 5.3%, respectively; p = 0.007). Levels of blood urea nitrogen, creatinine, and total bilirubin were higher among octogenarians, while lymphocyte, calcium, and albumin levels were lower. The frequency of patients without local complications was higher among octogenarians than non-octogenarians (75.5% versus 63.6%, respectively; p = 0.013). Necrosis was less frequent in the octogenarian group than the non-octogenarian group (2.6% versus 8.9%, respectively; p = 0.012). Mild acute pancreatitis was higher in the octogenarian group, while moderate acute pancreatitis was higher in the non-octogenarian group (p = 0.028 and p = 0.012, respectively).The frequencies of prolonged hospitalization, intensive care unit admission, and in-hospital mortality were similar in the octogenarian and non-octogenarian groups. In terms of disease severity, mild acute pancreatitis was higher in the octogenarian group, while moderate acute pancreatitis was higher in the non-octogenarian group.

Günümüzde gıdaya olan talebin giderek artmasıyla önemli oranda bir kesimin yeterli ve dengeli beslenemediği görülmektedir. Gelir dağılımındaki eşitsizlik ve satın alma gücündeki düşüklük ile gıdaya ulaşmada zorluklar yaşayan kesim hesap edildiğinde adil gıda paylaşımı konusu gözden geçirilmelidir. Gıda hakkı, gıda güvencesi, gıda paylaşımı gibi kavramlar ve bu kavramlarla beraber anılan mevcudiyet, erişilebilirlik, süreklilik vb. konular son yıllarda çokça tartışılmaktadır. Özellikle Covid-19 pandemisi sonrası ülkelerin gıda temininde yaşanan zorluklar, bazı ülkelerin diğer ülkelere gıda satışını sınırlandırma veya durdurma kararları zaman zaman gıdaya ulaşmada zorluklar oluşturmuş, gıda fiyatlarını arttırmıştır. Vatandaşların gıda harcamalarının artması, özellikle düşük gelirli kesimin gıda satın almakta zorlanması gıda politikaları için başarılı ve kalıcı çözümler alınması gerektiğini göstermiştir. ‘Gıda herkes içindir’ düşüncesi için en büyük engel ekonomi olarak hesap edilmektedir. Gıdanın ekonomik maliyetlerini düşüren, her kesimin gıdaya kavuşmasını sağlayan kalıcı bir çözüme yönelik politikalar oluşturulmalıdır. Uzun vadede sorunu kalıcı yapan ekonomik sistemin getirdiği yapısal bozuklukların çözümlerine odaklanılmalıdır. Kısa ve orta vadede ise kişileri güvenilir gıdaya ulaştıracak sosyal politikalar, tarım politikaları ve gıda politikaları birlikte yürütülmelidir. Bu araştırmada, Türkiye’deki gıda politikalarının mevcut gelişimi değerlendirilmiş, mevcut tarımsal desteklemelerden bahsedilmiş, vatandaşların gıda satın alma güçlerine ilişkin inceleme yapılmış, gıda fiyatlarını arttıran unsurlar açıklanarak tartışılmış ve sorunlar incelenerek çözüm önerileri ortaya konulmuştur.

Studies regarding effectiveness of anakinra and tocilizumab treatments in coronavirus disease 2019 (COVID-19) have contradictory results. Furthermore, there is scarce comparative data regarding superiority of any agent. To further elucidate any superiority between these two agents, we retrospectively investigated and compared outcomes in hospitalized COVID-19 patients of our inpatient cohort who received anakinra or tocilizumab.This study was designed as a single-center, retrospective, cross-sectional cohort study. Hospitalized patients with confirmed diagnosis of COVID-19 who had Brescia-COVID respiratory severity scale score ≥3 and hyperinflammation (defined as elevation of C reactive protein ≥50 g/L or ferritin ≥700 ng/mL) and received anakinra or tocilizumab in addition to standard care were enrolled in the study. Length of hospital stay after initiation of antiinflammatory treatment, need for mechanical ventilation, need for intensive care unit admission, mortality were set as primary outcomes and compared between tocilizumab and anakinra recipients after propensity score matching.One hundred and six patients were placed in each group after propensity score matching. In the anakinra group, relative risk reduction for intensive care unit admission was 50% when compared to the tocilizumab group and the number needed to treat to avert an intensive care unit admission was 3 (95% CI, 2-5). In terms of mortality, a 52% relative risk reduction was observed with anakinra treatment and the number needed to treat to avert an intensive care unit admission was 8 (95% CI, 4-50). Significantly more patients were observed to receive glucocorticoids in the anakinra group.Anakinra administration in severe COVID-19 patients was significantly associated with better survival and greater clinical improvement compared to the tocilizumab administration in our study. Increased rate of glucocorticoid use in the anakinra group might have contributed to better outcomes.

In this study, we aimed to investigate whether degree of pneumonia and COVID-19 prognosis are associated with serum endocan levels at the early stage, when vascular damage has started. Patients between the ages of 18–85 years who were hospitalized and followed up with a diagnosis of COVID-19 were included in the study. A total of 80 patients were divided into 2 groups as mild/moderate pneumonia and severe pneumonia. Serum endocan levels were measured on the 8th day from the onset of symptoms in all patients. Of the 80 patients included in the study, 56.3% were female and 43.8% were male. There was no significant relationship between serum endocan levels and degree of pneumonia ( P = .220) and prognosis of the disease ( P = .761). The correlation analysis indicated a weak positive correlation between serum endocan levels and lactate level in venous blood gas (r = .270; P = .037). During the 28-day follow-up, the mortality rate was 3.75%. It was determined that the serum endocan levels was not associated with the degree of pneumonia and was not an early prognostic marker for COVID-19.

Rural development policies aim to raise the people living in rural areas to the level of the cities in agricultural, economic, social and cultural issues and to increase their living standards. Rural areas in Turkey are areas where a significant portion of the population is engaged in agriculture. Improving the infrastructure of agricultural enterprises will increase the living standards of the people living in rural areas. Turkey should support its rural infrastructure in order to be competitive in rural development. In this sense, with the order of the Ministry of Agriculture and Forestry of the Republic of Turkey, the first 50% grant support, and the Rural Development Investments Support Program started to be implemented in the whole country with the decision of the Council of Ministers in 2011. In 2021, the support continued in two different parts under the name of agricultural-based economic investments and supporting rural economic infrastructure investments. In the study, Kastamonu province, which has an important potential, was examined in terms of rural development. The contribution of the supports provided with the program "Supporting Economic Investments Based on Agriculture within the Scope of Rural Development Supports" implemented in the province in 2021 has been evaluated. There have been 18 project applications for agricultural-based economic investments in Kastamonu province for 2021. Their total project cost is 12.8 million TL. 279 project applications were made to support rural economic infrastructure investments. The total project cost of these was 30.8 million TL.

Introduction: Colchicine is an ancient agent with well-known anti-inflammatory effects and commonly used in treatment of hyperinflammatory conditions. It has been argued that colchicine could be an appropriate treatment option in COVID-19 to control hyperinflammatory response. Here in this study, we aimed to investigate the impact of colchicine on outcomes of COVID-19 in our inpatient cohort. Methodology: In this retrospective cohort study, hospitalized COVID-19 patients were investigated. Demographics, comorbidities, COVID-19 symptoms, laboratory findings on admission and discharge, baseline and seventh day oxygenation status, rates of mortality, intensive care unit admission, administration of other anti-inflammatory treatments and length of hospital stay were compared between patients who received standard of care medications and who received colchicine additionally. Results: Three hundred and thirty-six patients were included in the study (171 standard of care, 165 standard of care plus colchicine). The median length of hospital stay in colchicine group was significantly shorter. Rates of admission to intensive care unit, anti-inflammatory treatment administration and mortality did not differentiate between standard of care and colchicine groups. However, reduced rates of mortality and ICU admission were observed in patients who received colchicine with a dose of 1 mg/day when compared to patients who received 0.5 mg/day. Conclusions: Our study demonstrated that COVID-19 patients who received colchicine in addition to standard of care had shorter hospital stay. Our results further support the use of colchicine in treatment of COVID-19, particularly with a dose of 1 mg/day.

Rural development is the development of agriculture and non-agricultural employment in rural areas, increasing and differentiating incomes, taking measures to increase the education and entrepreneurship level of women and young people. The state, on the other hand, makes arrangements for rural development programs, projects and activities to achieve this and takes measures to ensure coordination between public institutions. In order to better manage rural areas and not to cause confusion in practice by the services brought by the institutions, the distinction of rural areas and the powers in these areas should be well defined. For this purpose; it is important to make the definition of rural areas effective in a way that does not cause problems in practice. The Law No. 6360 dated 12.11.2012 on the Establishment of the Metropolitan Municipality and Twenty-Seven Districts in Fourteen Provinces and the Amendment of Certain Laws and Statutory Decrees has been prepared by foreseeing that it will bring significant changes in rural area administrations. While the confusion about delivering services to rural areas in metropolitan municipalities continued after the local elections on 30.03.2014; tax, fee, drinking, wastewater use and obligations on some issues were put into effect after 5 years. On 16.10.2020, the regulation introduced by the Law No. 7254 on the Amendment of the Law on Public Finance Management and Control and Certain Laws could not fully clarify the issues such as rural neighborhood and rural residential area. And Then, In the Official Gazette dated 15.04.2021 and numbered 31455, it was thought that the Regulation on Rural Neighborhood and Rural Residential Area would solve the problems in practice. In this study, the issues of confusing rural area definitions, service delivery to rural areas and rural area regulations have been examined and suggestions have been put forward.

Aim: The aim of this study is to develop and explain an easy-to-use severity score calculation tool to predict severe COVID-19 cases that would need intensive care unit (ICU) follow-up.Material method: The study was carried out in patients with laboratory-confirmed COVID-19 hospitalized in Ankara City Hospital between March 15, 2020, and June 15, 2020. The outcome was severe illness that required ICU follow-up. Univariate and binary logistic regression were used to create a prediction model by using potential predictive parameters obtained on the day of hospitalization. Youden’s J index was calculated with receiver-operator characteristic curves analysis in order to evaluate cut-off points, and predicted probability was calculated. The accuracy of the prediction model was tested by calculating the area under curve (AUC). Results: Of the total of 1022 patients, 152 had a severe illness and required ICU follow-up. Among 68 variables, 20 parameters met the potential predictive factor condition for severe illness and were included in the development process for ANKARA CITY HOSPITAL COVID-19 SEVERITY SCORE (ACCSES). The ACCSES calculation tool was created by the final 9 parameters (sex, oxygen saturation, hemoglobin, platelet count, glomerular filtration rate, aspartate transaminase, procalcitonin, ferritin, and D-dimer). AUC was 0.96 (95% CI, 0.95-0.98).Conclusion: We developed a simple, accessible, easy to use calculation tool, ACCSES, with good distinctive power for a severe illness that required ICU follow-up. The clinician can easily predict the course of COVID-19 and decide the procedure and facility of further follow-up simply using available clinical and laboratory values of patients upon admission.

Background Early identification of severe COVID-19 patients who will need intensive care unit (ICU) follow-up and providing rapid, aggressive supportive care may reduce mortality and provide optimal use of medical resources. We aimed to develop and validate a nomogram to predict severe COVID-19 cases that would need ICU follow-up based on available and accessible patient values. Methods Patients hospitalized with laboratory-confirmed COVID-19 between March 15, 2020, and June 15, 2020, were enrolled in this retrospective study with 35 variables obtained upon admission considered. Univariate and multivariable logistic regression models were constructed to select potential predictive parameters using 1000 bootstrap samples. Afterward, a nomogram was developed with 5 variables selected from multivariable analysis. The nomogram model was evaluated by Area Under the Curve (AUC) and bias-corrected Harrell's C-index with 95% confidence interval, Hosmer–Lemeshow Goodness-of-fit test, and calibration curve analysis. Results Out of a total of 1022 patients, 686 cases without missing data were used to construct the nomogram. Of the 686, 104 needed ICU follow-up. The final model includes oxygen saturation, CRP, PCT, LDH, troponin as independent factors for the prediction of need for ICU admission. The model has good predictive power with an AUC of 0.93 (0.902–0.950) and a bias-corrected Harrell's C-index of 0.91 (0.899–0.947). Hosmer–Lemeshow test p-value was 0.826 and the model is well-calibrated (p = 0.1703). Conclusion We developed a simple, accessible, easy-to-use nomogram with good distinctive power for severe illness requiring ICU follow-up. Clinicians can easily predict the course of COVID-19 and decide the procedure and facility of further follow-up by using clinical and laboratory values of patients available upon admission.

BACKGROUND/AIM: Coronavirus 2019 disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a pandemic infectious disease that causes morbidity and mortality. As a result of high mortality rate among the severe COVID-19 patients, the early detection of the disease stage and early effective interventions are very important in reducing mortality. Hence, it is important to differentiate severe and non-severe cases from each other. To date, there are no proven diagnostic or prognostic parameters that can be used in this manner. Due to the expensive and not easily accessible tests that are performed for COVID-19, researchers are investigating some parameters that can be easily used. In some recent studies, hematological parameters have been evaluated to see if they can be used as predictive parameters. MATERIALS AND METHODS: In the current study, almost all hematological parameters were used, including the neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio, monocyte/lymphocyte ratio, mean platelet volume to lymphocyte ratio, mean platelet volume to platelet ratio, plateletcrit, and D-dimer/fibrinogen ratio (DFR), neutrophil/lymphocyte/platelet scoring system, and systemic immune-inflammation index. A total of 750 patients, who were admitted to Ankara City Hospital due to COVID-19, were evaluated in this study. The patients were classified into 2 groups according to their diagnosis (confirmed or probable) and into 2 groups according to the stage of the disease (non-severe or severe). RESULTS: The values of the combinations of inflammatory markers and other hematological parameters in all of the patients with severe COVID-19 were calculated, and the predicted values of these parameters were compared. According to results of the study, nearly all of the hematological parameters could be used as potential diagnostic biomarkers for subsequent analysis, because the area under the curve (AUC) was higher than 0.50, especially for the DFR and NLR, which had the highest AUC among the parameters. CONCLUSION: Our findings indicate that, the parameters those enhanced from complete blood count, which is a simple laboratory test, can help to identify and classify COVID-19 patients into non-severe to severe groups.

Rural development; It is one of the most fundamental elements of countries' having a strong economy and developing. The most important activity area in rural development is rural tourism. Natural wealth, historical memories, local values, etc. recognition and promotion will bring social and cultural development together. In other words, “rural tourism” will be the most important door in the development of domestic and foreign tourism in Turkey and opening up to the world. In the process of European Union accession process, the ARDSI, which is established by aiming to make the modern enterprises sustainable by increasing the welfare and livelihood of the citizens living in the countryside with the competitiveness at the international level, making stronger investments in domestic and foreign marketing, and increasing the welfare and livelihood level of our citizens living in the country, is the relevant institution of the Ministry of Agriculture and Forestry. Since 2011, ARDSI has invested approximately 3.8 billion TL in our country's economy. Within the scope of these investments, approximately 60 000 people were employed, 14 441 of whom were directly employed. In Kastamonu, ARDSI has signed an investment agreement with 11 investors to date, exceeding 11.5 million TL. For that reason, Kastamonu has become a model city for our country in the tourism area of the rural development movement. In this study, general information about the rural tourism potential in Kastamonu and ARDSI was given first and rural tourism applications in Kastamonu province were examined.

Endocan, a cysteine-rich dermatan sulfate proteoglycan expressed by endothelial cells, is seemed to be a new biomarker for endothelial dysfunction. Pre-eclampsia (PE) is characterized by the new onset of hypertension, proteinuria after 20 weeks of gestation, placental vascular remodeling, systemic vascular inflammation and endothelial dysfunction. The aim of this study was to investigate the relationship of PE and its severity with serum endocan levels.A cross-sectional study was performed. Serum was collected from women with PE and normotensive controls. Serum endocan and tumor necrosis factor alpha (TNF-α) concentrations were measured by a specific enzyme linked immunosorbent assay.Patients with PE had significantly higher median (interquartile range) endocan and mean TNF-α concentrations than controls [20.04 (12.26) ng/mL vs 15.55 (6.19) ng/mL, p 0.001 for endocan; 26.49 ± 12.14 pg/mL vs 14.62 ± 5.61 pg/mL, p 0.001 for TNF-α; respectively]. Serum endocan concentrations were positively correlated with systolic blood pressure (r = 0.618, p 0.001), diastolic blood pressure (r = 0.608, p 0.001), the amount of 24-h proteinuria (r = 0.786, p 0.001) and TNF-α (r = 0.474, p 0.001) in women with PE. In subgroup analysis, patients with severe PE had significantly higher endocan concentrations than those with mild PE. Receiver operating characteristic analysis of endocan was used to identify the patients with PE and also discriminating between mild and severe PE.Serum endocan concentrations were significantly elevated in women with PE versus normotensive controls, and concentrations seem to be associated with the severity of the disease.

Functional iron deficiency (FID) incidence is gradually increasing in hemodialysis (HD) patients. Recently, high levels of GDF-15 supressed the iron regulatory protein hepcidin and GDF-15 expression increased in iron-deficient patients. The relationship between FID, GDF-15, and hepcidin is currently unknown. The present study aimed to evaluate the association between GDF-15, hepcidin, and FID in chronic HD patients. Serum GDF-15 and hepcidin concentrations were measured in 105 HD patients and 40 controls. FID is defined as serum ferritin >800 ng/mL, TSAT

OBJECTIVE Recent studies revealed that inflammation plays a critical role in bone remodeling and the pathogenesis of postmenopausal osteoporosis, a major health concern. Neutrophil-lymphocyte ratio (NLR) is a cost-effective marker of inflammation that has been linked with several diseases. This study aimed to compare NLR and C-reactive protein (CRP) levels in osteopenic, osteoporotic, and control subjects and to assess the correlation between NLR levels, CRP, and bone mineral density (BMD) in postmenopausal women. METHODS In this cross-sectional study, the relationship between NLR, CRP, and BMD in 438 women was investigated using uni- and multivariate analyses. BMD (g/cm²) was measured by dual-energy X-ray absorptiometry (DEXA) at the lumbar spine and femur. Complete blood count (CBC), CRP, glucose/lipid metabolism, and established risk factors were determined. RESULTS In the osteoporotic group, NLR and CRP levels were found to be elevated as compared to the osteopenic and control groups (NLR: 4.68 ± 0.72, 3.17 ± 0.43, 2.01 ± 0.54; CRP: 12.3 ± 4.1, 4.1 ± 2.7, 3.2 ± 2.1, respectively). A negative correlation was present between NLR and the lumbar spine (L2-L4) and femoral neck BMD after adjusting other risk factors. There was no correlation between CRP levels and BMD after adjusting other risk factors. NLR was significantly associated with L2-L4 BMD (s = -0.653, p

When we think of human nature, and of her organized unity, society, we realize that these structures entail a certain social order and that its main lines of development are shaped within such an order. The nature of the social order reveals, indirectly, essential characteristics of a human and society. Thus, the present thesis attempts at constructing an axis that could help us to deal with the generality of these issues of nature and social order. First moment in this attempt is to understand, philosophically, how the fiction for an idealized order can be constructed. Our first moment in this journey is to deal with the issue of constructing the philosophically idealized social order, on the basis of Plato’s and Aristotle’s writings. According to these two eminent philosophers, wisdom and well-being (“the good life”) form the main axis of such an order. In the next step, we are to be witnessed the intersection of this idealized fiction with the political reality itself, Spinoza being the specific example this time. Idealization and rationality escape, however brief, from the glamour of transcendental vis a vis passion and desire. Our inquiry of the social order proceeds, then, towards the issue of power through the writings of two monumental figures, Machiavelli and Hobbes, who present us the reality of the order directly and in its whole nakedness. Locke is our next step for the very reason that he was the one who reveals the essence of this reality quite explicitly through his emphasis on private property as the foundation of the social order. Construction of the social order encounters some, albeit partial, not essential, criticisms with the arguments of Rousseau’s. Rousseau represents, all the same, longing of the past, embarrassment of the present, and the opacity of the future. At the end, we will see that philosophical and political language in the attempt at constructing the social order will yield its prominence to the economic language devised by Adam Smith, who places the individual guided by her self-interest at the very center of the construction of the social order, with his notion of the “Invisible Hand”. In other words, our journey of constructing the social order that started with the constitutive power of the wise man ends with the actions of the individual whose conduct rests on the simplest and the most concrete motive of self-interest. This, in the end, completes our attempt at constructing the main axis of the social order from Plato to Smith. Keywords Social order, human nature, society, law, power, interest, private property, wealth. İÇİNDEKİLER KABUL VE ONAY…………………………………………………………………….. i BİLDİRİM…………………………………………………………………………….. ii YAYIMLAMA VE FİKRİ MÜLKİYET HAKLARI BEYANI…………………… iii ETİK BEYAN………………………………………………………………………… iv TEŞEKKÜR…………………………………………………………………………... vi ÖZET…………………………………………………………………………………... x ABSTRACT…………………………………………………………………………... xi İÇİNDEKİLER……………………………………………………………………… xiii BİR BAŞLANGIÇ 1 BÖLÜM 1 İDEAL UYUM EVRENİ………………………………………………...10 1. 1. Bir Bilgelik Filozofu: Platon……………………………………………… 10 1. 2. Bir İyi Yaşam Filozofu: Aristoteles………………………………………. 23 BÖLÜM 2 İDEALE MESAFE ALIŞ; TOPLUMSAL, İNSANSAL GERÇEKLİĞE DOKUNUŞ…………………………………………………………………………… 36 2. 1. Bir Zorunluluk ve Olanak Filozofu: Benedictus Spinoza………………. 36 BÖLÜM 3 İDEAL OLANDAN SAPMA; DOĞRUDAN SOSYAL GERÇEKLİK................................................................................................................ 54 3. 1. Machiavelli’nin Büyüsü 54 3. 2. Bir İtaat Filozofu: Thomas Hobbes 60 3.3. İnterlüd. Bir Mülkiyet Filozofu: John Locke 71 BÖLÜM 4 SOSYAL GERÇEKLİĞİN İÇERİSİNDE İDEALİN YENİDEN KEŞFİ, ONA DUYULAN ÖZLEM 75 4. 1. Bir Pastoral Senfoni: Jean-Jacques Rousseau 75 BÖLÜM 5 YENİDEN AMA ÇOK DAHA KUVVETLİ, BASİT, SAF SOSYAL GERÇEKLİK 96 5. 1. Bir Sempati ve Zenginlik Filozofu: Adam Smith 96 YENİ BİR BAŞLANGIÇ İÇİN SON 122 KAYNAKÇA 135 EK 1. Etik Kurul İzni Muafiyet Formu…………………………………………….152 EK 2. Orijinallik Raporu……………………………………………………………153 İnsanın, onun örgütlü bir bütünlüğü olan toplumun doğası üzerine düşündüğümüzde, bu yapıların belirli bir sosyal düzeni içerdiğini, gelişiminin ana hatlarının bu düzen altında şekillendiğine tanık oluruz. Sosyal düzenin nasıllığı bize dolaylı olarak insanın, toplumun neliğini açık ediyor. Nasıllık ve nelik tartışmasının genelliği karşısında bir ana eksen belirleme çabası bu metnin özünü oluşturuyor. Felsefi, ideal bir düzen inşası kurgusu ilk uğrak. Platon ve Aristoteles özelinde, bilgelik ve iyi olmaklık ekseninde düzen örülmeye çalışılıyor. Bir adım sonrasında, Spinoza özelinde, ideal kurgunun siyasi gerçeklikle kesişimine tanık oluyoruz. İdeallik ve akılsallık; tutkunun, arzunun karşısında aşkın büyüsünden biraz biraz sıyrılıyor. Siyaset alanın, o muazzam güç, iktidar zemininin iki anıtsal figürü ile düzen soruşturması ilerliyor. Machiavelli ve Hobbes, bize düzen gerçekliğini tüm çıplaklığıyla, doğrudanlığıyla sunuyor. Bu gerçekliğin üzerine titrediği özü en yalın biçimiyle açık eden Locke, tam da bu yalınlığı özelinde, metnin harcına ekleniyor ilerleyen sayfalarda. Düzen inşası, Rousseau’nun argümanları üzerinden kısmı bir eleştiriyle yüz yüze kalıyor. Geçmiş zaman özlemi, şimdiki zaman sıkıntısı, gelecek zaman bulanıklılığı ve Rousseau. Felsefi, siyasi dil son sözü iktisadi dile bırakıyor ve Smith, kişisel çıkar temelinde durumunu iyileştirmeye çalışan insanı, “Görünmez El” dolayımı ekseninde düzen inşasında en başa yerleştiriyor. Böylelikle bilge kimsenin kurucu gücüyle başlayan düzen inşası serüveni, en basit, somut güdüyle iş gören, kişisel çıkarını izleyen insanın eyleyişinde düğümleniyor. Platon’dan Smith’e sosyal düzenin inşası bu eksende tamamlanıyor.

Increased arterial stiffness is strongly associated with cardiovascular diseases, while thrombotic events are more common than hemorrhagic events in hypertensive patients. Markers of a hypercoagulable state may also predict future cardiovascular events in hypertensive patients. Here, we speculated that increased arterial stiffness might lead to the development of a hypercoagulable state that can play a role in the thrombotic complications of hypertension. Soluble endothelial protein C receptor (sEPCR) is one such marker of hypercoagulation. The ambulatory arterial stiffness index (AASI) could be accepted as a non-invasive measure of arterial stiffness. The aim of this study was to investigate association of AASI with levels of sEPCR in newly diagnosed hypertensive patients.The study included 263 newly diagnosed essential hypertensive patients and 55 healthy normotensive controls. All subjects underwent 24 h ambulatory blood pressure monitoring (ABPM); the AASI was derived from ABPM tracings. Plasma sEPCR was measured by ELISA.Hypertensive patients (n = 263) had higher AASI, C-reactive protein (CRP) and sEPCR versus the normotensive healthy group (n = 55). Univariate analysis showed that AASI was positively associated with age (r = 0.212, p 0.001) body mass index (r = 0.412, p 0.001), pulse pressure (r = 0.350, p 0.001), plasma sEPCR (r = 0.894, p 0.001), 24-h heart rate (r = 0.176, p = 0.001) and inversely related to high-density lipoprotein (HDL) (r = -0.293, p 0.001). Multivariate analyses revealed that sEPCR and HDL are independently correlated to AASI.We suggest that increased AASI is associated with elevated sEPCR. It might be responsible for subsequent thrombotic events in newly diagnosed hypertensive patients.

Non-alcoholic fatty liver disease (NAFLD) is a major cause of chronic liver disease worldwide. The aims of this study were to assess Neutrophil-Lymphocyte Ratio (NLR) and C-reactive protein (CRP), and their association with liver histology in patients with non-alcoholic steatohepatitis (NASH), chronic hepatitis B (HBV), and hepatitis C (HCV).We studied 38 consecutive patients with biopsy-proven NASH, 19 patients with HCV, 45 patients with HBV, and 35 healthy controls who were similar for age and gender. The stage of fibrosis was measured using a 6-point scale.NLR was significantly higher in NASH patients compared to controls, HBV, and HCV patients (p0.001, p0.001, and p0.001, respectively). NLR was positively associated with NAFLD activity scores (r=0.861, p0.001). NLR was associated with hepatocyte ballooning degeneration (r=0.426, p=0.024), lobular inflammation(r=0.694, p0.001), steatosis(r=0.498, p=0.007), and fibrosis stage(r=0.892, p0.001) in NASH patients. Univariate and multivariate analyses showed that NLR was significantly associated with liver fibrosis and NAS (β=0.631, p0.001 for liver fibrosis; β=0.753, p0.001 for NAS in the multivariate model); however, CRP had no association with liver fibrosis and NAS CONCLUSION: NLR is a promising and inexpensive inflammation marker that correlates with histological grade and fibrosis stage in NASH patients.

Objective. Subclinical hypothyroidism and vitamin D defi ciency are common. Th e diastolic function of patients with both subclinical hypothyroidism and vitamin D defi ciency remains unknown. Th is study aimed to investigate diastolic dysfunctio n in patients with both subclinical hypothyroidism and vitamin D defi ciency. Subjects and Methods. Th is study included 254 patients. All patients underwent standard Doppler echocardiography. Patients who had risk factors for diastolic dysfunction or had used L-thyroxine and vitamin D within the previous 3 months were excluded. Vitamin D defi ciency was defi ned as a 25-OH-vitamin D level lower than 20 ng/ml, and vitamin D suffi ciency was defi ned as a 25-OHvitamin D level ≥30 ng/ml. Subclinical hypothyroidism was defi ned as a TSH level of 4.5-10 mU/l when the free T4 concentration was normal. Results. Th e patients were divided into 4 groups. Group 1 (n=71) included patients with subclinical hypothyroidism and vitamin D defi ciency; Group 2 (n=66) included patients with subclinical hypothyroidism and vitamin D suffi ciency; Group 3 (n=65) included euthyroid patients with vitamin D defi ciency; and Group 4 (n=52) included euthyroid patients with vitamin D suffi ciency. LAVI (31.3±3.2, 28.7±3.0, 28.4±3.4, and 27.9±3.9; p

Galectin-3 (Gal-3) is a marker of cardiac fibrosis and predicts incident heart failure. Gal-3-deficient mice are resistant to multiple low-dose streptozotocin-induced diabetes. Recent experimental studies suggested an important role for Gal-3 in the regulation of adiposity, metaflammation and type 2 diabetes. This study aimed to examine the relationship between Gal-3 and newly diagnosed prediabetes and diabetes. Gal-3 concentrations were measured in 118 participants and 56 age- and sex-matched healthy controls. All subjects underwent a 75-g oral glucose tolerance test and were stratified into normal, prediabetic, and diabetes mellitus subgroups. DM was defined as a plasma glucose level ≥126 mg/dL in the fasting state or ≥200 mg/dL in the second hour after glucose loading. Impaired fasting glucose was defined as an FPG level of 100–125 mg/dL, and impaired glucose tolerance was defined as a 2-h plasma glucose level of 140–199 mg/dL. Sixty-one patients had prediabetes (Group 1), 57 had diabetes (Group 2), and 56 had neither diabetes nor prediabetes (Group 3). Gal-3 levels correlated with FPG (r = 0.787, P

Bu çalışmanın amacı, özellikle günümüzde daha da belirgin biçimde kendini duyuran kriz olgusunu, kapitalist örgütlenmenin ve sermaye birikiminin doğalarından türeyen çelişkiler ekseninde tartışmaya çalışmaktır. Tartışmanın kapsamı geniş bir alana işaret ediyor olsa da belirli bir sınırlama yaklaşımıyla inceleme içeriğinin ürünleri özellikle, Karl Marx'ın kapitalist üretim biçiminin yapısını kriz olgusuyla da bütünler görünen düşünsel malzemeleridir. Sonrasında Marx'ın düşüncesini belirli ölçüde güncelleme amacıyla, Marx'ın yapıtlarından hareketle sistemin doğasını kavramaya çalışan M. Tugan-Baranovsky, Rudolf Hilferding, Rosa Luxemburg, Paul Sweezy ve Ernest Mandel'in daha çok kriz eksenli tartışmaları incelemeye konu edilmektedir. İnceleme süresince gözetilen yöntem Marx'ın yaklaşımına yakın durmaktadır. Öyle ki, kapitalist üretim örgütlenmesini tarihsel bir biçimde ele almak ve bu örgütlenmeyle ilişkili olan kriz oluşumunu dışsal bir nedenle açıklamayıp sisteme özgü gelişim dinamiklerinden türeyen nedenler kümesiyle açıklamak yöntemi belirlemektedir. Her ne kadar Marx'ın çalışmaları özelleşmiş bir kriz oluşumuna tam olarak yakın durmuyorsa da Marx'ın kapitalist üretim biçimini çözümleme uğraşının doğrudan ya da dolaylı olarak kriz olgusunu kavramaya katkı sunduğu varılan bir sonuç olarak tanımlanabilir. Kriz olgusunu kavramada kâr oranının azalma eğilimi, orantısızlık ve eksik-tüketim olguları araç görünümündedir. Marx, daha çok kâr oranının azalma eğilimi ile sistemin ve krizin doğasına açıklık getiriyor olsa da krizin kavranılmasında tek nedenli bir açıklamadan öte çok nedenli bir açıklamayı yeğliyor görünmektedir. Diğer düşünürler açısından; Baranovsky ve Hilferding orantısızlık yaklaşımı ile, Luxemburg ise kâr oranının azalma eğilimini görmezden gelmeksizin artı-değerin gerçekleşme sorunu ile kriz oluşumunu ilişkilendirmektedir. Sweezy daha çok eksik-tüketim olgusunu krizin nedeni biçiminde yorumlarken Mandel ise kâr oranının azalma eğilimine temel bir önem yüklemekle beraber çoklu nedenlerden hareketle krizi anlamlandırır. Sonuç olarak Marx sonrası düşünürlerin sistemi ve krizi çözümlemeleri büyük ölçüde Marx'ın kurgusunun içinde yer almakta ve bu nedenle Marx, düşüncesinin geçerli güncelliğini kendi kendisine sağlıyor görünmektedir. En temel yargı; kapitalist örgütlenmenin ve krizin birbirinden ayrı düşünülmeyeceğinin yanı sıra sistemin işleyişi görünür biçimde krizle kesintiye uğramasa dahi sistemin varoluşunun yapısal bir kriz biçiminde görülmesi gerektiği yönündedir.Anahtar Sözcüklerkriz, kapitalizm, sermaye, sermaye birikimi, artı-değer, artı-değer oranı, kâr oranının azalma eğilimi, orantısızlık, eksik-tüketim. The purpose of this study is to try to argue on the concept of crisis which has been fully developed within the axis of capitalist organization, and of the dilemmas created within the natural growth of the accumulation of capital. Although the field of the study points at the general field, the approach of analysis is narrowed specially to all of Karl Marx?s intellectual provisions including the crisis concept with the construction of capitalist output. Thereafter, with the purpose of updating Marx?s ideas to certain extent, crisis centered arguments of M. Tugan-Baranovsky, Rudolf Hilferding, Rosa Luxemburg, Paul Sweezy and Ernest Mandel, all of whom try to grasp the systems nature from the view point of Marx, will be taken in to analysis. The method employed throughout stands within the circle of Marxists approach, such that, what defies the approach is taking the capitalist production organizations into consideration from a historical perspective, and instead of explaining the formation of crisis, which is linked to the organization, with on the surface reasons, the approach is laid out with the gathering of causes which is unique to the systems? developing dynamics. Even though, Marxist studies do not exactly relate to a specialized crises formation, Marx? s occupation with solving the capitalist production methods can be taken as a direct or indirect way of contributing to the crisis concept with can be a result that is agreed upon. While grasping the concept of crisis the tendency of the rate of profit to fall, disproportionality, and underconsumption phenomenon are seen as devices. Although Marx for the most part brings clarity to the system? s and crisis? nature with tendency of the rate of profit to fall, it seems that he is preferring a multi reasoned explanation instead of a single one while explaining crisis. From the perspective of other intellectuals it can be seem that Baranovsky and Hilferding employs the idea of disproportionality while Luxemburg, without ignoring the tendency of the rate of profit to fall, applies the surplus value to the materialization problem; however, both link their view points to the formation of crisis. While Sweezy interprets the underconsumption phenomenon as a cause for crisis, Mandel chooses to give meaning to crisis by providing many reasons although he does give most emphasis to the tendency of the rate of profit to fall. As a result, it is observed that the post-Marxists? intellectuals system and crisis resolution are built upon Marx?s constructions, and for this reason Marx seems to be updating the validity of his views by himself. The fundamental judgment is that capitalist organization and crisis cannot be thought of separately along with the fact that although the systems workings are not interfered by crisis, the existence of the system must be seen as a structural crisis itself.Key Wordscrisis, capitalism, capital, accumulation of capital, surplus value, rate of surplus value, tendency of the rate of profit to fall, disproportionality, underconsumption. 95