Toplu ulaşımda bekleme süresi, yolcuların algıladığı hizmet seviyesinin en önemli boyutlarından biridir. Özellikle trafik koşullarının etkisi altında işletilen kent içi otobüs taşımacılığında aşırı bekleme süresi, yolcuların tür ve güzergâh seçimini değiştirebilecek bir fayda fonksiyonu bileşenine dönüşebilmektedir. Bu çalışmada, kent içi otobüs taşımacılığında karşılaşılan bekleme süresi, hat ve durağa ait fiziksel koşulların yanı sıra, güvenilirlik ve yolcu bilgilendirme sistemlerinin etkisi de dikkate alınarak modellenmiştir. Oluşturulan doğrusal modeller sonucunda bilgilendirme sistemi varlığının bekleme süresini ortalama 2 dakika, güvenilirliğin ise ortalama 1,3 dakika kısaltıcı etkisi olduğu görülmüştür. Ayrıca yolcu bilgilendirme sistemlerinin, kent merkezinden gelen hatlar tarafından kullanılan ve geometrisine uygun kullanılan duraklarda uygulanmasının daha verimli olacağı sonucuna varılmıştır.
In this study, we present a case of bilateral optic neuropathy and macular ischemia in the right eye associated with neurosarcoidosis. A 26-year-old woman presented to our clinic with complaints of bilateral blurred vision. Bilateral granulomatous anterior uveitis, vitritis, optic neuropathy, and macular ischemia were detected in the right eye in slit-lamp examination. She also reported complaints of fever, weakness, sweating, arthralgia, and headache for 2 months. She was referred to the pulmonary diseases unit of our hospital due to hilar lymphadenopathy seen in her chest x-ray, and biopsies were taken for diagnostic purposes. Histological analysis of the mediastinal lymph node biopsies revealed chronic, non-caseating, granulomatous inflammation. Furthermore, the patient was referred to a neurologist due to concomitant complaint of intense headaches. She was diagnosed with neurosarcoidosis supported by findings on cranial magnetic resonance imaging and lumbar puncture. She received a 3-day course of high-dose (1 g/day) intravenous steroid treatment (methylprednisolone) followed by a tapering dose of oral prednisone. The patient began receiving oral methotrexate 15 mg/week as a steroid-sparing agent. Significant improvement in neurological and ophthalmological symptoms occurred in the first week of treatment. In this case report, we emphasized that neurosarcoidosis should be included in the differential diagnosis of patients with both bilateral optic neuropathy and macular ischemia. Furthermore, early diagnosis and timely treatment of neurosarcoidosis are important for favorable visual outcomes.
This multi-center point prevalence study evaluated children who were diagnosed as having coronavirus disease 2019 (COVID-19). On February 2nd, 2022, inpatients and outpatients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were included in the study from 12 cities and 24 centers in Turkey. Of 8605 patients on February 2nd, 2022, in participating centers, 706 (8.2%) had COVID-19. The median age of the 706 patients was 92.50 months, 53.4% were female, and 76.7% were inpatients. The three most common symptoms of the patients with COVID-19 were fever (56.6%), cough (41.3%), and fatigue (27.5%). The three most common underlying chronic diseases (UCDs) were asthma (3.4%), neurologic disorders (3.3%), and obesity (2.6%). The SARS-CoV-2-related pneumoniae rate was 10.7%. The COVID-19 vaccination rate was 12.5% in all patients. Among patients aged over 12 years with access to the vaccine given by the Republic of Turkey Ministry of Health, the vaccination rate was 38.7%. Patients with UCDs presented with dyspnea and pneumoniae more frequently than those without UCDs ( p < 0.001 for both). The rates of fever, diarrhea, and pneumoniae were higher in patients without COVID-19 vaccinations ( p = 0.001, p = 0.012, and p = 0.027). Conclusion : To lessen the effects of the disease, all eligible children should receive the COVID-19 vaccine. The illness may specifically endanger children with UCDs. What is Known: • Children with COVID-19 mainly present with fever and cough, as in adults. • COVID-19 may specifically threaten children with underlying chronic diseases. What is New: • Children with obesity have a higher vaccination rate against COVID-19 than children without obesity. • Among unvaccinated children, fever and pneumoniae might be seen at a higher ratio than among vaccinated children.
Hemolacria is known as bloody tears and described as blood coming from the eyes. Eye infections, trauma, bleeding disorders, eye and lacrimal canal malignancies, hypertension, hyperthyroidism, retrograde epistaxis and endometriosis have been reported among the causes of hemolacria. When no underlying cause can be found, this condition is defined as idiopathic hemolacri and is knokn as a benign and self-limiting condition. In this case report we present a 15-year-old an adolescent boy with bloody tears. He had pain around the right eye and headache on the right side of head. He had no other findings as discharge in the eyes, redness, blurred vision, or bleeding in the nose. On physical examination; we observed red fluid starting from the right punctum. Visual examination revealed complete visual capacity, natural bilateral anterior segments, clear fundus, natural and soft retina, and no foreign body or infection findings. Etiological factor was not found in the diagnostic investigations of the patient. The patient was followed with the diagnosis of idiopathic unilateral hemolacria. The hemolacria occurred twice a week and limited itself within several days. Hemolacria is a rare condition and should be evaluated together with pediatricians and ophthalmologists within a multidisciplinary approach.
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