Search

OBJECTIVE: The Pleth Variability Index (PVI) can guide the approach to hypovolemia, which is sometimes the cause and sometimes the result of major diseases; further studies are needed on this index. Therefore, in the present study, we aimed to evaluate the prognostic value of PVI and its relationship with 28-day mortality. PATIENTS AND METHODS: A total of 158 patients were included. Patients were divided into two groups according to 28-day mortality. Patients who died within 28 days were assigned to Group M (Mortal), while those who survived were included in Group S (Survive). Patients' demographics, definitive diagnosis, arterial blood pressure, fingertip oxygen saturation, PVI, fingertip blood glucose, fever, pulse, shock index, and serum lactate level were recorded. RESULTS: Regarding demographics, no statistically significant difference was found between the two groups in terms of age, gender, and Body Mass Index (BMI) (p=0.356, p=0.966, and p=0.977, respectively). The rate of intubation, the use of vasopressors, Acute Physiology and Chronic Health Evaluation (APACHE) II score, shock index, and PVI values were statistically significantly higher in Group M compared to Group S (for all, p<0.001). Glasgow Coma Score (GCS), Perfusion Index (PI), and length of stay were statistically significantly lower in Group M than in Group S (p<0.001, p<0.001, and p=0.025, respectively). PVI predicted 28-day mortality with 83.8% sensitivity and 97.9% specificity. CONCLUSIONS: PVI, serum lactate level, PI, APACHE II, GCS, and need for vasopressors were independent risk factors for 28-day mortality in the Intensive Care Unit (ICU). PVI and serum lactate have a prognostic value in predicting mortality. [ABSTRACT FROM AUTHOR]

Objective: Childhood drowning is a common environmental emergency worldwide. In this study, we examined drowning and non-fatal drowning (NFD) cases and tried to determine which parameters could predict prognosis during follow-up. Methods: This study was conducted in a tertiary pediatric emergency room. The study population comprised cases of drowning/NFD between 2008 and 2021. Age, gender, and drowning mechanisms. Laboratory examinations, and the outcomes of these cases were analyzed. The data were obtained from the hospital automation system. The Szpilman score (SC) of each patient was calculated. Results: A total of 150 cases were included in the study. The ages of the cases were 5.2±3.8. The mean Glasgow Coma Scale (GCS) score was found to be 12.2±3.8. Cardiopulmonary resuscitation (CPR) was performed in 75 cases (50%), and 30 cases (20%) patients were intubated. Cases were divided into two groups: those in the intensive care unit and those followed in the emergency department. The mean SC of the follow-up group was 1.4±0.6, and the mean SC of the intensive care group was 4.6±1.4 (p

This study aims to examine how the subcomponents and overall measurement of ecological footprint, as well as the use of information and communication technologies, affect health expenditures. For this study, the sample group consisted of the top 25 countries with the highest ecological footprint for the period 2000 to 2021. System GMM estimation results demonstrate that economic growth and ecological footprint have a positive impact on health expenditures. Covid-19 dummy variables, have a statistically significant and positive effect on health expenditures. On the other hand, information and communication technologies has a statistically significant but negative effect on health expenditures. The estimation results show that the Covid-19 pandemic increased health expenditures. Looking at the effect of subcomponents of environmental degradation on health expenditures, all subcomponents have a statistically significant and positive effect on health expenditures. It is seen that the most effective variable is forest products. The variable that has almost the same impact as the footprint of forest products is the carbon footprint. Carbon footprint has significant and positive impact on health expenditures, followed by fishing grounds cropland, grazing land, built-up land. The results of the study indicate which forms of pollution should be given priority by policymakers in order to prevent an increase in health expenditure resulting from environmental degradation.

Among head and neck cancers, adenoid cystic carcinoma (ACC) has a separate place compared to other histological types. Our case report is about the follow-up of a patient with ACC originating from the left parotid gland, who applied to our clinic for about 10 years, after different treatments were applied in different centers.

In this study, the relationship between economic growth and financial development was analyzed for emerging markets and middle-income economies. The effect of financial development on growth, whether there is institutional quality or not, has also been investigated. In addition, which financial development indicator is more effective for growth has been examined. Six institutional quality indicators and seven financial development indicators were used. According to the Dumitrescu–Hurlin causality test results, there is a causality relationship between all financial development indicators and growth. According to the estimation results, financial development indicators have a positive effect on growth in the presence of institutional quality. However, if institutionalization is not included in the model, the effect of financial development indicators on economic growth is statistically insignificant.

In the past decade, the importance of the smart city applications has gained popularity by the city governments to use their resources in an efficient and effective way, present better services and quality of life for their residents, make their cities more competitive, provide better disaster management. As the world has experienced crisis such as energy and grain in the recent past due to the COVID-19 pandemic and the war between Russia and Ukraine, the management of the resources has become more important for the countries and local governments, as well. In this study national government plans of Turkiye, such as Eleventh Development Plan and 2020–2023 National Strategy and Action Plan for Smart Cities, have been addressed as reference documents and the actions of some city governments, including the most populous city, Istanbul and the capital, Ankara, have been examined with the purpose of determining the level of smart city willingness. This study peruses the degree of enthusiasm of the local governments to become smart and maintain sustainable city services considering the main smart city characteristics. Based on the information gathered concerning the selected cities, it has been observed that the cities having populations quite lower than the great metropolitans such as Istanbul and Ankara are more enthusiastic and successful to provide services for their citizens that can be associated with the smart city concept.

PURPOSETo evaluate the frequency of abdominal computed tomography (CT) findings in patients with coronavirus disease-2019 (COVID-19) and interrogate the relationship between abdominal CT findings and patient demographic features, clinical findings, and laboratory test results as well as the CT atherosclerosis score in the abdominal aorta.METHODSThis study was designed as a multicenter retrospective study. The abdominal CT findings of 1.181 patients with positive abdominal symptoms from 26 tertiary medical centers with a positive polymerase chain-reaction test for severe acute respiratory syndrome coronavirus 2 were reviewed. The frequency of ischemic and non-ischemic CT findings as well as the association between CT findings, clinical features, and abdominal aortic calcific atherosclerosis score (AA-CAS) were recorded.RESULTSIschemic and non-ischemic abdominal CT findings were detected in 240 (20.3%) and 328 (27.7%) patients, respectively. In 147 patients (12.4%), intra-abdominal malignancy was present. The most frequent ischemic abdominal CT findings were bowel wall thickening (n = 120; 10.2%) and perivascular infiltration (n = 40; 3.4%). As for non-ischemic findings, colitis (n = 91; 7.7%) and small bowel inflammation (n = 73; 6.2%) constituted the most frequent disease processes. The duration of hospital stay was found to be higher in patients with abdominal CT findings than in patients without any positive findings (13.8 ± 13 vs. 10.4 ± 12.8 days, P < 0.001). The frequency of abdominal CT findings was significantly higher in patients who did not survive the infection than in patients who were discharged after recovery (41.7% vs. 27.4%, P < 0.001). Increased AA-CAS was found to be associated with a higher risk of ischemic conditions in abdominal CT examinations.CONCLUSIONAbdominal symptoms in patients with COVID-19 are usually associated with positive CT findings. The presence of ischemic findings on CT correlates with poor COVID-19 outcomes. A high AA-CAS is associated with abdominal ischemic findings in patients with COVID-19.