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Yakup Altas, Ali Veysel Ulugg Department of Cardiology, Diyarbakir Gazi Yasargil Education and Research Hospital, Diyarbakir, Turkey Abstract: ST segment elevation is the most common electrocardiographic finding in acute myocardial infarction. ST elevation in chest leads generally represents left anterior descending artery occlusion, while elevation in DII and III, and aVF represents right coronary and circumflex artery occlusion. A female patient aged 66 years was admitted to our emergency service with ST elevation in leads DIII and aVF. A diagnosis of acute inferior myocardial infarction was made. The patient’s history included coronary artery bypass graft involving the left internal mammary artery to the left anterior descending coronary artery and aorta to the right coronary artery. The patient was taken to the cardiac catheterization laboratory for primary percutaneous coronary intervention and a lesion in the left anterior descending artery was identified. Additionally, the left subclavian artery was totally occluded. Following intervention to the lesion, the patient was discharged on day 4 of admission. Keywords: electrocardiography, myocardial infarction, coronary circulation

Indoor radon concentration levels at three sites in Turkey were measured using CR-39 solid state nuclear track detectors. The annual mean of radon concentration was estimated on the basis of four quarter measurements at specific locations in Turkey. The measuring sites are on the active faults. The results of radon measurements are based on 280 measurements in doors. The annual arithmetic means of radon concentrations at three sites (Isparta Egirdir, and Yalvac) were found to be 164 Bqm–3, 124 Bqm–3, and 112 Bqm–3 respectively, ranging from 78 Bqm–3 to 279 Bqm–3. The in door radon concentrations were investigated with respect to the ventilation conditions and the age of buildings. The ventilation conditions were determined to be the main factor affecting the in door radon concentrations. The in door radon concentrations in the new buildings were higher than ones found in the old buildings.

Objectives To determine the effects of hyperandrogenemia and other phenotypic parameters on endometrial vitamin D receptor (VDR-X2 and VDR-X4) expression in women with polycystic ovary syndrome (PCOS) undergoing ovarian stimulation and total embryo freezing.Methods Forty-four PCOS patients were divided into four phenotypes according to the criteria for hyperandrogenemia (HA), ovulatory dysfunction (OD), and polycystic ovary morphology (PCOM): phenotype A (HA+OD+PCOM), phenotype B (HA+OD), phenotype C (HA+PCOM), and phenotype D (OD+PCOM). Endometrial VDR expression was determined by real-time PCR and immunohistochemistry. Twenty age- and body mass index (BMI)-matched couples with male infertility were included as controls.Results VDR-X2 and VDR-X4 expression levels were significantly lower in the PCOS group than in the control group. A significant downregulation was detected in the relative VDR-X2 and X4 expression in phenotypes A, B, and C compared to the control group. VDR-X2 and X4 expression in phenotype D was significantly higher than in phenotypes A and B. A significant negative correlation was detected among VDR-X2, VDR-X4, serum testosterone (T), androstenedione (A), DHEAS, and insulin resistance (IR). Multivariate analysis revealed that serum T, A, DHEAS, and IR levels were independently associated with both VDR-X2 and VDR X4 relative gene expression after adjusting for age and BMI. The VDR mRNA and immunoreactivity of each phenotype overlapped. The clinical pregnancy rates for each phenotype were similar.Conclusion VDR expression in the endometria of patients with PCOS was defective. Hyperandrogenemia and insulin resistance are the key drivers of defective VDR expression in the endometrium of patients with PCOS.

Introduction Comorbidities in addiction: It is a rule rather than an exception. The story starts in childhood; even before, in infancy, may be in utero. The dimensional traits have been already there, existing obviously far before any DSM-5 diagnosis. Developmental qualities of stress sensitivity, impulsivity and emotion dysregulation are the leading ones. Besides, comorbidity research (NESARC being one of the prominents) (Hasin and Grant. Soc Psychiatry Psychiatr Epidem, 2015;50 (11): 1609-1640) addressed childhood abuse, neglect or other childhood adverse experiences as a definite risk factor for adolescence and adult mental disorders, particularly substance use disorders. Developmental and environmental adversities in a mutually amplifying pattern make a vicious cycle in which the individual finally finds an illusionary exit, a pathway to addiction. Objectives This presentation aims to discuss the complexities and challenges for the diagnosis and treatment of a patient with a twenty five year follow-up, a survival period for the patient herself as well as for the therapeutic alliance (Ulug, Arch Neuropsychiatr, 2015;52: 213-215). Methods Case study: The history and the life chart of her, diagnosed as having at least seven DSM diagnoses, indicate the depth of pyschopathology and the intensity of interventions, most of which failed due to the lack of a transdiagnostic and holistic perspective. A specific focus of the case study will be on the problematic use of Borderline Personality Disorder formulation/diagnosis and its negative, somehow short-coming, impact on the treatment, course and recovery. Results The challenges brought by comorbid transdiagnostic cases, similar to the subject of this presentation, have become a common practice for addiction professionals. While big data or empirical large datasets can have their own limitations to help the practitioner for overcoming such challenges, as stated in Stein’s article “it is important to recognize the value of a wide range of complementary research designs including the age-old single-case study, which may sometimes provide clinical insights that outweigh those from big data analyses.” (Stein et al. World Pychiatry, 2022; 21(3): 393-414). Conclusions The case study indicates the necessity for transdiagnostic and holistic approach in the management and long term treatment of such difficult-to-diagnose and difficult-to-treat patients. Disclosure of Interest None Declared

In December 2019, cases of pneumonia of unknown origin were detected in Wuhan, Hubei Province, China. It was later determined that the pathogen SARS-CoV, which causes these cases of pneumonia, has been identified as the new enveloped RNA Betacoronavirus 2, now called severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2). In Turkey, the first case was detected on March 10, 2020. This study aimed to evaluate the factors that will enable rapid diagnosis of the disease through comparison of COVID-19 RT PCR results, thorax computed tomography (CT) findings, and laboratory results of patients suspected with COVID-19 who visited Başkent University Ankara Hospital Emergency Medicine Clinic. In our sample of 515 patients (280 female and 235 male patients), infiltration was detected in 113 patients (21.9%) The ratio of females to males increased with age. When the sex distribution of the thoracic CT findings was examined, the incidence of infiltration was higher in male patients. Conversely, no statistically significant dependence was found between the two categories using the chi-squared test. Shortness of breath was observed in 32.7% of patients with positive thoracic CT findings. Other common complaints were chest pain, 12.4%; fever, 10.6%; and weakness, 9.7%, respectively. The other category, which covered unclassified arrival complaints, had the highest percentage in the entire sample. When the thoracic CT distribution of comorbidities was examined (hypertension, 29.2% and diabetes, 25.2%) were more common than the other comorbidities in terms of the presence of infiltration. Thoracic CT results with RT-PCR, which were analyzed using the chi-square test, showed a statistically significant dependence between them. Conversely, COVID-compatible thorax CT findings were detected in 80 of 260 patients who tested negative in the PCR test. No complaints of fever, cough, weakness, shortness of breath, or chest pain associated with COVID were found in 48.6% of patients who were thoracic CT positive. PCR showed a low sensitivity rate. Therefore, thoracic CT is a better choice than PCR for the detection of asymptomatic cases in emergency patients. Because its selectivity rate is high, using PCR as a diagnostic test is more significant. [Med-Science 2023; 12(3.000): 741-5]

Background This study examines spinal muscular atrophy (SMA), a neuromuscular disease associated with malnutrition. Our goals are to assess how effectively screening tools can detect malnutrition and evaluate the impact of nutritional interventions on neurological outcomes, particularly motor functions. Methods Thirty-seven genetically diagnosed SMA patients (types 1, 2, and 3) under nusinersen therapy were included in the study. The nutritional status of these patients was assessed by using anthropometric measurements, including height for age (HFA), weight for height (WFH), and body mass index (BMI) before and after the study. Additionally, the risk of malnutrition was determined using screening tools, namely the Pediatric Yorkhill Malnutrition Score (PYMS) and the Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP). Nutritional counseling followed the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) guidelines and considered the patients’ dietary history, including content and administration method. Motor functions were assessed by validated tests: the Children’s Hospital of Philadelphia Infant Test of Neuromuscular Disorders (CHOP-INTEND) and the Hammersmith Functional Motor Scale—Expanded (HFMSE). Result The study showed an improvement in HFA, by a change from −0.95 to −0.65 (p = 0.015). Conversely, BMI scores decreased from 0.08 to −0.54 (p = 0.015), while WFH and MUAC showed no significant alterations (p = 0.135, p = 0.307). Following nutritional interventions, HFMSE demonstrated a median increase from 29.5 to 30.5 (p = 0.023). Patients identified as being at high risk for malnutrition based on PYMS and STAMP belonged to the moderate-to-severe malnutrition group (BMI Z-score ≤ −2, p = 0.001). Conclusions Use of screening tools in SMA patients is highly beneficial for the early detection of malnutrition. Future research should highlight the importance of combining nutritional management with nusinersen therapy to potentially alter the disease trajectory, especially in motor and neurological functions.

Author(s): Özden Melis Ulug [sup.1] [sup.2] , Nevin Solak [sup.3] , Betül Kanik [sup.4] Author Affiliations: (1) grid.254277.1, 0000 0004 0486 8069, Department of Psychology, Clark University, , 950 Main [...], The coronavirus pandemic has caused unemployment to skyrocket, exposed the longstanding inequalities in health care services and working conditions, and mainly affected the poor in different parts of the world. In the current study, we focus on social identity and social class-related factors that are critical during the pandemic to gain insights into what predicts support for policies favoring economic equality in the post-pandemic period. We argue that to the extent that individuals 1) identify with all humanity during the pandemic, 2) are aware of their socio-economic status-based privilege, 3) do not hold classist attitudes, they would support policies favoring economic equality. In Study 1, survey data from 1212 participants in Turkey were analyzed by means of hierarchical linear regression analysis. The findings showed that stronger identification with all humanity, higher awareness of socio-economic status-based privilege, and less endorsement of classist attitudes predict more support for socio-economic equality policies in the post-pandemic period, after controlling for socio-demographic and socio-political characteristics of participants. Study 2 (N = 212) replicated the findings in a different context, namely the U.S. Our findings extend previous studies by showing the importance of a global identity, such as shared human identity, in the ongoing and potentially in the aftermath of the pandemic. In addition, our findings highlight the joint contributions of socio-economic factors such as classist attitudes and awareness of class-based privilege to the support for socio-economic policies.

Background: Injury patterns in hypoxic-ischaemic brain injury (HIBI) are well recognised but there are few studies evaluating cerebral injury using neuroquantification models. Objectives: Quantification of brain volumes in a group of patients with clinically determined cerebral palsy. Method: In this retrospective study, 297 children with cerebral palsy were imaged for suspected HIBI with analysis of various cerebral substrates. Of these, 96 children over the age of 3 years with a clinical diagnosis of cerebral palsy and abnormal MRI findings underwent volumetric analyses using the NeuroQuant® software solution. The spectrum of volumetric changes and the differences between the various subtypes (and individual subgroups) of HIBI were compared. Results: Compared with the available normative NeuroQuant® database, the average intracranial volume was reduced to the 1st percentile in all patient groups (p 0.001). Statistically significant differences were observed among the types and subgroups of HIBI. Further substrate volume reductions were identified and described involving the thalami, brainstem, hippocampi, putamina and amygdala. The combined volumes of five regions of interest (frontal pole, putamen, hippocampus, brainstem and paracentral lobule) were consistently reduced in the Rolandic basal ganglia-thalamus (RBGT) subtype. Conclusion: This study determined a quantifiable reduction of intracranial volume in all subtypes of HIBI and predictable selective cerebral substrate volume reduction in subtypes and subgroups. In the RBGT subtype, a key combination of five substrate injuries was consistently noted, and thalamic, occipital lobe and brainstem volume reduction was also significant when compared to the watershed subtype. Contribution: This study demonstrates the value of integrating an artificial intelligence programme into the radiologists’ armamentarium serving to quantify brain injuries more accurately in HIBI. Going forward this will be an inevitable evolution of daily radiology practice in many fields of medicine, and it would be beneficial for radiologists to embrace these technological innovations.

See the retraction notice E3S Web of Conferences 538, 00001 (2024), https://doi.org/10.1051/e3sconf/202453800001