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13 result(s) for "Yerlikaya, Gokhan"
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The relationship between advanced lung cancer inflammation index and high SYNTAX score in patients with non-ST-elevation myocardial infarction
The advanced lung cancer inflammation index (ALI) is an independent prognostic biomarker of inflammation and nutrition in various types of cancer, acute heart failure and acute coronary syndrome. The SYNTAX (Synergy between Percutaneous Coronary Intervention with TAXUS and Cardiac Surgery) score (SXscore) is an angiographic scoring tool used to determine the extent and severity of coronary artery disease. To investigate the relationship between ALI and coronary artery lesion complexity assessed using the SXscore in patients with non-ST-segment elevation myocardial infarction (NSTEMI). Between February and November 2020, a total of 284 patients with NSTEMI were included consecutively. ALI was calculated with the formula body mass index (BMI) × serum albumin concentration/neutrophil-to-lymphocyte ratio (NLR). SXscore was calculated using the online calculator and divided into two groups - low (< 32) and high (≥ 33) - and then analyzed. Patients with a high SXscore had lower ALI (22.4 ±7.3 vs. 58.5 ±44.3, = 0.016). In the univariable analysis, age ( = 0.046), BMI ( = 0.021), C-reactive protein ( = 0.002), peak troponin I ( = 0.009), NLR ( = 0.025), serum albumin ( = 0.003) and ALI ( < 0.001) were significantly associated with a high SXscore. ALI emerged as an independent predictor of a high SXscore in multivariable analysis (95% CI: 0.931-0.984, = 0.002). The ALI may be useful as a simple tool for predicting high SXscore in patients with NSTEMI. To our knowledge, this is the first study to examine the relationship between ALI and severity of CAD.
Clinical outcomes of the Myval transcatheter heart valve system in patients with severe aortic valve stenosis: a two-year follow-up observational study
Limited data exist on long-term follow-up of severe aortic stenosis (SAS) patients who have undergone transcatheter aortic valve implantation (TAVI) with a new generation, balloon expandable Myval transcatheter heart valve (THV). Thus, we sought to investigate the performance and 2-year clinical outcome of the Myval THV system based on Valve Academic Research Consortium-3 (VARC-3) criteria. A multi-centre, registry-based, observational study was conducted, which included 207 consecutive degenerative SAS patients, from Turkey ( = 128), Italy ( = 58), and Greece ( = 21) (mean [standard deviation] 81 (7) years, 94 [45%] men; 73% NYHA III or IV; EuroSCORE II 5.2% [2.4%]); all patients underwent TAVI with Myval. Patients were followed up at 1 year and 2 years after implantation. Clinical and procedural outcomes were defined according to VARC-3 criteria. Technical success was observed in 204 (99%), device success was observed in 189 (91%), early safety was observed in 161 (78%), and clinical efficacy was observed in 163 (79%) patients. The 30-day death rate was 7.7%; of these, 3.4% were due to cardiovascular reasons. All-cause and cardiovascular mortality rates were 9.7% and 4.3% at 1-year follow-up, and 17.4% and 9.7% at 2-year follow-up, respectively. Incidence of ≥ moderate paravalvular leak (PVL) at 30 days, 1 year and 2 years of follow-up were 3.4%, 4.3% and 4.8%. A total of 11.1% of patients required a permanent pacemaker implantation (PPI) at 30 days after implantation, while the cumulative rate of PPI at 2 years was 12.1%. In this cohort of patients with SAS, the Myval was found to be safe and effective in up to 2 years of follow-up.
Efficacy and safety of combination therapy with statin and ezetimibe in patients failing to achieve target LDL levels at cardiology outpatient clinics in Turkey (COM-TR-OLDL): a real-world observational study
Background Achieving target low-density lipoprotein cholesterol (LDL-C) levels in patients with atherosclerotic cardiovascular disease (ASCVD) frequently requires combination lipid-lowering therapy. Single-pill combination (SPC) regimens may improve adherence compared with free-dose combinations (FDC) in real-world clinical practice. Methods This retrospective observational study included 450 ASCVD patients with baseline LDL-C levels of 70–189 mg/dL who were followed in cardiology outpatient clinics between January 2023 and December 2024. Patients received atorvastatin–ezetimibe either as a single-pill combination (SPC, n  = 392) or as a free-dose combination (FDC, n  = 58). Primary endpoints were LDL-C reduction and treatment adherence (≥ 80% of prescribed doses). Secondary endpoints included LDL-C target attainment and adverse events. Non-parametric tests and chi-square/Fisher’s exact tests were used for statistical analysis. Results At 1 month, LDL-C levels were significantly lower in the SPC group compared with the FDC group (90.6 vs. 119 mg/dL; p  = 0.005), and adherence was higher (89.8% vs. 70.7%; p  < 0.001). At 4 months, LDL-C levels were comparable between groups, while continuous adherence remained significantly higher in the SPC group (86% vs. 69%; p  = 0.001). A higher proportion of SPC-treated patients achieved LDL-C < 100 mg/dL at 1 month (81.9% vs. 67.2%; p  = 0.009). Conclusions In this real-world ASCVD cohort, SPC therapy with atorvastatin and ezetimibe was associated with superior adherence and comparable lipid-lowering efficacy despite lower statin doses. Fixed-dose combination strategies may represent an effective approach to optimize adherence and cardiovascular risk management.
The use of intravascular ultrasound during percutaneous coronary intervention does not reduce all cause in-hospital mortality but doubles the cost, with higher utilization in privately insured patients
The effect of using intravascular ultrasound (IVUS) during percutaneous coronary intervention (PCI) on short-term mortality is not well established. To evaluate any association between the use of IVUS vs. no IVUS during PCI and mortality in a large inpatient database. We used the National Inpatient Sample (NIS) database for available ICD-10 codes from 2016-2020 for IVUS and PCIs. A total of 10,059,56 PCIs were performed. In 206,910, IVUS-guided PCI was performed vs. 9,852,359 without IVUS. Mortality did not differ between the two groups, with 2.52% mortality in the IVUS arm vs. 2.59% in no IVUS cohort, = 0.4. The mean age of patients with IVUS use was 65.5 vs. 70.1 years without IVUS, < 0.001. Total in-hospital cost in the IVUS group was double that without IVUS ($141,920 vs. $71,568, < 0.001). Furthermore, IVUS utilization was significantly higher in patients with private health insurance (28.3% vs. 17.2%, p < 0.001). In-patient all-cause mortality using IVUS during PCI was similar to that in patients without IVUS utilization, but the cost was doubled, with higher utilization in privately insured patients.
Yap- işlet- Devret Modeli ve Vergilendirilmesi
Türkiye Cumhuriyeti'nin kuruluşundan bu yana bakıldığında, Osmanlı Devletinden devreden borçların ödenmesi, kuruluş döneminin zorlukları, alt yapı, bilgi ve sermaye yetersizliği gibi esaslı unsurların yanısıra 1929 Büyük krizinin başgöstermesi ve bütün dünyayı etkisi altına alması o günkü yöneticileri haklı olarak Keynesyen bir çizgide \"karma ekonomi\" dedikleri devletçi ekonomiye yönlendirmiştir! . Şüphesiz yine o dönemlerde işsizlik ve gelir dağılımının bozuk olması, sosyalist, totaliter ve devletçi eğilimlerin güçlü olması ve korporatist üretim sisteminin dünyada güçlü bir blok olarak belirmesi gibi unsurlar da bu eğilimin gelişmesinde önemli olmuştur?. Ekonomide Keynesçi? bir anlayış uzantısında devlet payının yüksek olması, toplumsal mal ve hizmetlerin bütününe yakınının devlet tarafından? üretilmesi özel sektörün gelişimine imkan vermemiştir.Bu yapılanma hem bir devlet politikası olarak, hem sosyal ve siyasal bir mutabakat? olarak ve hem de ve daha önemlisi bir üretim sistemi olarak 1970'li yıllara kadar devam ede gelmiştir.Söylenebilecek olan şudur ki, 1929 yılı büyük buhrandan başlayıp 1970'lere kadar süregelen büyük bolluk ve refah sağladığı düşünülen Keynesyen dönem, yine 1970'lerde başgösteren işsizlik, enflasyon ve stagflasyon krizinde Keynesçi çözümlerin yetersiz kalması hatta bu krizin sebebinin Keynesçi Politikalara dayandırılması kamu ekonomisinin yetersizliğinin kabul edilmesine© ve Keynesyen dönemin kapanmasına sebep olmuştur”. Bu gelişmelere tepki olarak 1970'li yılların sonundanitibaren bilhassa İngiltere ve Amerika Birleşik Devletleri'nde başlayan ve dünyayı saran ve Neo-Liberal karakterli bir \"Arz Yönlü İktisat©\" anlayışının yayılmaya başlandığı söylenebilir. Bu anlayış, devletin konumunu, gelirlerini, müdahaleciliğini, ekonomide ki payını v.s. sonuçta yapısal bir değişimi öngörerek sorunların çözümünü farklı düzlemlerde aramayı önermektedir. Batı dünyasında sosyal devlet, refah devleti anlayışı hızla eleştrilip terkedilmekte ve buna örnekler olarak ta Rusya ve Çin'de komünist ekonomilerin çökmesi, Batı Avrupa'da (İsveç'te) ve Amerika'da refah devleti anlayışının değişime uğraması ve karma ekonomilerde özelleştirme akımı verilmektedir?, Nitekim dünyada ekonomik ve siyasal anlamda başgösteren Liberal esintiler Türkiye'de de etkili olmaya başlamıştır. Türkiye'de de devletin ekonomiiçerisindeki payı tartışılmaya ve ekonomide devletin küçültülmesi için özelleştirme girişimlerine başlanmıştır.Bu yüzden 1980'li yıllar, düzenlenme ve icraat bakımından önceki dönemlerden köklü bir ayrılışı temsil etmektedir. 1980'li yıllardan sonra uygulanan iktisadi ve mali politikalar uluslararası ekonomik entegrasyona bir uyum sürecinin başlangıcı olarak betimlenebilir.. Bu dönemin önde gelen göstergelerini! 0; mali sektörün serbestleştirilmesi (bu suretle piyasada kredi faizleri serbestçe belirlenmesine yol verilmiştir), diş ticaret ve kambiyo rejiminin serbestleştirilmesi (bu dönemde 1984'ten itibaren kaynağı sorulmadan döviz tevdiat hesaplarına yol verilmiş ve dövize endeksli borçlanmaaraçlarının ihracı ve sermaye hareketlerinin serbestlik kazanması sağlanmış, TL'nin yabancı paralar karşısında değeri sürekli olarak düşük tutulmuş ve ihracatın arttırılması amaçlanmış), Finans piyasalarının gelişmesi ve yeni finansal araçların gelişmesi, KİT'lerin bu dönemin ruhuna uygun olarak özelleştirme programlarına tabi tutulması, vergi gelirlerinin artması bakımından KDV'nin bu dönemdebir vergi reformu olarak uygulamaya girmesi ve yine ödeme kaydedici cihazlarında bu sisteminişlerliğini istikrarlı bir biçimde sağlaması v.s. Bu örnekleri daha da çoğaltmak mümkündür. Böyle bakıldığında, Türkiye'de Liberal bir anlayışa sahip ve hukuka bağlı bir çerçeve içerisinde serbestiye ve rekabete dayalı bir üretim ekonomisinin gelişmesi ve bunun paralelinde devletin küçültülmesi gibi arayışlar önemli bir kalkınma (take off) ivmesi sağlamıştır. Bunun yanısıra idarede \"hukuksal rasyonelliğin\" yerini \"işletmeci rasyonelliğin\" kavramının ağırlık kazanması anlayışına da kapı açmıştır!Yap-İşlet-Devret Modeli 1980'li yıllardan sonra Türkiye gündemine dönemin başbakanı Özal!2 tarafından getirilmiş ve hukuki altyapısı düzenlenmeden uygulamaya geçirilmiş ve yabancı liteatürde de Özal ismiyle anılan bir model halini almıştır Gelişmekte olan ülkeler kategorisinde değerlendirilen Türkiye için bu model henüz hukuki altyapısı oluşturulmadan hayata geçirilmeye çalışılmış ve yine o dönemin özelleştirme akımının mütemmim cüzü olması bakımından bir anlam taşımış ve halen de taşımaktadır.
Vergi hatalarında düzeltme Ve yargı Yoluna başvuru
Vergiler, çağımızdaki modem devlet gelirlerinin önemli bir kısmını teşkil etmektedir. Ekonomik olarak kalkınmış devletlerin gelirlerinde dolaylı ve dolaysız olarak alınan vergilerin payı büyüktür. Bupayın büyüklüğü bize iktisaden kalkınmışlıkla vergi gelirlerinin yüksekliği arasında anlaşılır bir bağın ipuçlarını vermektedir Örneğin \"Amerika Birleşik Devletlerinde federal devlet gelirlerinin V 75S'inden fazlası, İngiltere'de merkezi devlet gelirlerinin 4 60'ına yakını, Fransa ve BatıAlmanye' da merkezi ve federal devlet gelirlerinin650-60'ı dolaysız vergilerden gelirken!\" bu oranın Türkiye'de, çok daha düşük seviyelerde yani 9X6 35 ile VW 41,5' larda (1992 tahmini) seyrettiği tahmin ediliyor?. Bütçenin Vergi Gelirleri giderlerin çok gerisinde kalmaktadır. 1992 bütçesinde bütçe vergi gelirlerinin giderleri karşılama oranının Ye 67 olduğunu, ve daha önce yapılan araştırmalara göre de bu-oranın Yo 85'lerin altına düşmesinin riskli olduğu- vurgulanmıştır?. Türkiye'de durumun böyleolması yani- toplam kamu gelirleri içerisinde vergi gelirlerinin payının küçük olmasının ekonomik yapıdan kaynaklananbir çok sebepleri olması yanı sıra, Türkiye'de yürütülen vergi sisteminin etkinsizliği, kayıt dışı ekonominin büyüklüğü”, vergi kaçırma ve vergiden kaçınma güdüsünün fazlalığı ve konumuzu yakından ilgilendiren; vergi yargısına intikal eden ve bir türlü kısa zamanda çözüm bulamayan çeşitli vergi davaları sayılabilir5. Bunlardan bir kısmını teşkil eden vergi hataları ile ilgili davalar da, vergi haftaları mükellefin aleyhine olduğu gibi vergi idaresi aleyhine de olabilmektedir. Ancak inceleme konumuzu; vergi mükelleflerinin aleyhine olan vergi hataları ve bu hataların düzeltim süreçleri ilgilendirmektedir. Ancak 213 Sayılı VUK, 6183 Sayılı AATUHK, 193Sayılı GVK, 5422 Sayılı KVK ve 3065 Sayılı KDVK'larında değişiklik yapılmasını öngören 25.05.1995 tarihli ve 4108 Sayılı Kanun Hükümleri vergi ile yapılan düzenlemelerde geçmişe etkili ve bir defaya mahsus bir uygulama getirdiği için konumuzu ilgilendiren kısımları incelememizin dışında bırakılmasıtercih edilmiştir. Ayrıca konu incelenirken vergi hatalarıileilgilidüzelme. taleplerinin anayasal kökleri ve çağdaşdevlet ilkeleri ile ilişkileri de mümkün -mertebe ayrıştırılmaya çalışılmıştır.
A Multidirectional Perspective for Novel Functional Products: In vitro Pharmacological Activities and In silico Studies on Ononis natrix subsp. hispanica
The genus has important value as traditional drugs and foods. In the present work, we aimed to assess the chemical profiles and biological effects of subsp. extracts (ethyl acetate, methanol, and water). For chemical profile, total and individual phenolic components were detected. For biological effects, antioxidant (DPPH, ABTS, CUPRAC, FRAP, phosphomolybdenum, and metal chelating assays), enzyme inhibitory (against cholinesterase, tyrosinase, α-amylase and α-glucosidase), antimicrobial, DNA protection and cytotoxic abilities were tested. The predominant phenolics were apigenin, luteolin, and quercetin in the tested extracts. Generally, the ethyl acetate and methanol extracts were noted as the most active in the antioxidant and enzyme inhibitory assays. Water extract with different concentrations indicated high level of DNA protection activity. Methanol and ethyl acetate extracts showed antibacterial effect against to and strains. The cytotoxic effects of subsp. extracts on the survival of HeLa and PC3 cells were determined by MTT cell viability assay. Water and methanol extracts caused initiation of apoptosis for PC3 cell line. Furthermore, molecular docking was performed to better understand interactions between dominant phenolic compounds and selected enzymes. Our results clearly indicate that subsp. could be considered a potential candidate for designing novel pharmaceuticals, cosmeceuticals and nutraceuticals.
Exploring the Nutraceutical Potential of Dried Pepper Capsicum annuum L. on Market from Altino in Abruzzo Region
Sweet pepper is a typical type of Capsicum annuum from Abruzzo region, recognized as a traditional and local product, traditionally cultivated in the town of Altino (Abruzzo region, Italy). The aim of this study is to compare the sweet type of peppers from Altino with the hot pepper cultivated in the same area, in order to delineate their different phytochemical and biological profiles in vitro and in vivo. In this study, we elucidated their phytochemical composition, fatty acids composition and phenolic/flavonoid contents in extracts. Then antioxidant and enzyme inhibition assays were performed to evaluate their biological properties, together with in vitro cell assay and in vivo anti-inflammatory activity. Microwave (1000 mg/mL) extract of hot pepper showed the best inhibition value on in vitro cell growth assay; in fact, the number of survived cells was about 20% and 40% for microwave and Soxhlet extracts, respectively. In vivo anti-inflammatory assay revealed good activity for both species, which, when associated with in vitro cell inhibition results, could explain the protective effect on human prostatic hyperplasia.
Genome-wide analysis of DUF221 domain-containing gene family in common bean and identification of its role on abiotic and phytohormone stress response
The domain of unknown function (DUF221 domain-containing) proteins regulates various aspects of plant growth, development, responses to abiotic stresses, and hormone transduction pathways. A comprehensive genome-wide analysis was performed in its genome to understand the role of DDP genes (DUF221) in the common bean ( Phaseolus vulgaris L.). A total of 12 DDP genes were identified and distributed in 8 chromosomes in the common bean genome. The physical and biochemical characteristics of amino acids, motif and intron–exon structure, and cis-regulatory elements of DDP members were determined. Phylogenetically all PvDDPs were clustered into nine clades, subsequently supported by their gene structure and conserved motifs distribution. The PvDDPs contained various cis-acting elements involved in plant responses to abiotic and various phytohormones stresses. A total of 45 different cis-regulatory elements in the putative promoter regions of the PvDDPs were identified. ERE and ABRE were discovered to be present in all PvDDPs , indicating that they may be regulated by ethylene and ABA, both of which are strongly associated with biotic stress response in plant species. Additionally, PvDDPs were targeted by multiple miRNA gene families as well. In this context, the most targeted DDP family members are PvDD10 and PvDDP11 . The miRNA target analysis showed that Pvu-miR2594, Pvu-miR169, Pvu-miR2584, Pvu-miR530, Pvu-miR156, and Pvu-miR2592 target these genes. There is a strong correlation between abiotic stress and PvDDPs expression in both leaf and root tissues. PvDDP11 is the unique and highest upregulated gene with hormone treatment and abiotic stress among all the members. Expression of the PvDDP11 gene indicated a strong correlation with drought and salt stress in the common bean roots and leaves, respectively. In conclusion , this study predicted that the putative DDP genes might help improve abiotic and phytohormone tolerance in common bean.
Change in species distribution and antifungal susceptibility of candidemias in an intensive care unit of a university hospital (10-year experience)
Candidemia is a nosocomial infection mostly found in critically ill patients. Our objectives were to evaluate the change in distribution and resistance profile of Candida spp. isolated from candidemic patients in our intensive care unit over two 5-year periods spanning 15 years and to evaluate the risk factors. Records from the microbiology laboratory were obtained, from January 2004 to December 2008 and from January 2013 to December 2017, retrospectively. Antifungal susceptibility was performed by E-test and evaluated according to EUCAST breakpoints. A total of 210 candidemia cases occurred; 238 Candida spp. were isolated in 197 patients (58.8% male; mean age, 59.2 ± 19.6 years). The most predominant risk factor was central venous catheter use. Species distribution rates were 32%, 28%, 17%, and 11% for C. albicans (n = 76), C. parapsilosis (n = 67), C. glabrata (n = 40), and C. tropicalis (n = 27), respectively. Resistance rate to anidulafungin was high in C. parapsilosis over both periods and increased to 73% in the second period. Fluconazole showed a remarkable decrease for susceptibility in C. parapsilosis (94 to 49%). The prevalence of MDR C. parapsilosis (6%/33%) and C. glabrata (0%/44%) increased in the second period. We observed a predominance of non-albicans Candida spp., with C. parapsilosis being the most frequent and C. glabrata infections presenting with the highest mortality. High level of echinocandin resistance in C. parapsilosis and increasing prevalences of MDR C. parapsilosis and C. glabrata seem emerging challenges in our institution.