Tıp Fakültesi / Faculty of Medicine

Permanent URI for this collectionhttps://hdl.handle.net/11727/1403

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Abdominal Compartment Syndrome
(2015) Zeyneloglu, Pinar
Intraabdominal hypertension and Abdominal compartment syndrome are causes of morbidity and mortality in critical care patients. Timely diagnosis and treatment may improve organ functions. Intra- abdominal pressure monitoring is vital during evaluation of the patients and in the management algorithms. The incidence, definition and risk factors, clinical presentation, diagnosis and management of intraabdominal hypertension and Abdominal compartment syndrome were reviewed here.
ACUTE NECROTIZING PANCREATITIS AFTER TRANSARTERIAL CHEMOEMBOLIZATION IN A PATIENT WITH HEPATOCELLULAR CANCER: CASE REPORT AND REVIEW OF THE LITERATURE
(2019) Ocal, Serkan; Suna, Nuretdin; Etik, Digdem Ozer; Bovyat, Fatih; Selcuk, Haldun; 31574073
Antifungal Stewardship
(2019) Kurt-Azap, Ozlem
Invasive fungal infections are commonly detected because of increasing number of immunocompromised patients. Emerging antifungal resistance in addition to high mortality and costs are the triggers for the implementation of antifungal stewardship (AFS) programmes. The aim of stewardship programmes is the quality improvement in health care and better outcomes for the patients rather than the costs. Optimizing the use of antifungal drugs to achieve the best outcomes while minimizing adverse events and the emergence of resistance are the accompanying goals. AFS is less established than antibacterial stewardship because of a narrower and more complex evidence base along with only a few number of available drugs. Rapid diagnostic tools and therapeutic drug monitoring are the key components of the AFS programmes. Available data show that AFS programmes are feasible, sustainable and well accepted and favor the implementation of AFS programmes in routine care.
Approach to cardiovascular disease in women
(2018) Gulmez, Oyku; Acar, Rezzan Deniz; Aktoz, Meryem; Atamer, Oya; Aytekin, Saide; Polat, Evin Bozcali; Celik, Hulya Gamze; Celik, Omer; Elcioglu, Betul Cengiz; Dincer, İrem; Gazi, Emine; Kayikcioglu, Meral; Keser, Nurgul; Ozer, Necla; Yasar, Ayse Saatci; Sahinarslan, Asife; Kurklu, Turkan Seda Tan; Tokgozoglu, Lale; Yamac, Aylin Hatice; Yildirimturk, Ozlem; Yilmaz, Dilek Cicek; Yilmaz, Neslihan
Cardiovascular disease (CVD) in women is still not completely understood by either patients or physicians. It is perceived as a health problem that becomes manifest only after menopause; however, it is the most frequent cause of mortality in women and is often seen at an earlier age in the presence of risk factors. Moreover, the symptoms, course, and prognosis are quite different from those seen in men, and both physicians and patients remain inadequately aware of the character of the disease. In the approach to female patients, some risk factors inherent to women should be considered in addition to the classic factors. In this review article, aspects of CVD that are different in women, etiological factors, risk factors specific to women, and particular points to be taken into consideration in the treatment and diagnosis are illustrated in the form of questions and responses from experts.
The Assessment of Efficiency of Traditional and Complementary Medicine Practices in Neurology
(2018) Kibaroglu, Seda; Caglayan, Hale Zeynep Batur; Ataoglu, Esra Erkoc
Traditional, complementary, and alternative medicine practices are used in the prevention, diagnosis, and treatment of a wide variety of diseases in the world. Such practices in Turkey are regulated by the "Regulation of Traditional and Complementary Medicine Practice" issued by the Ministry of Health in the Official Gazette of the Republic of Turkey (Issue: 29158, 27th October 2014). The appendix of this regulation defines 15 practices that can be applied in units and practice centers. These applications include; 1. Acupuncture, 2. Apitherapy, 3. Phytotherapy, 4. Hypnosis, 5. Leech therapy (Hirudotherapy), 6. Homeopathy, 7. Chiropractic, 8. Cupping, 9. Maggot therapy, 10. Mesotherapy, 11. Prolotherapy, 12. Osteopathy, 13. Ozone therapy, 14. Reflexology, and 15. Music therapy. In this review, the indications of these 15 applications in the field of neurology are examined and current opinions of the evidence-based medical data are summarized.
Bariatric Surgery and Urinary Stone Disease
(2016) Ozer, Cevahir; Egilmez, Tulga; 0000-0002-7850-6912; 0000-0001-5644-5672; 0000-0001-6037-7991; AAM-2222-2020; AAK-9166-2021
Obesity is a major public health problem and has been suggested to play a role in the etiology of urinary tract stone disease. Furthermore, the increasingly widespread use of surgery in the treatment of obesity also is related with urinary stone disease. In daily practice, patients to whom obesity surgery has been planned or who have undergone obesity surgery are seen more frequently. This review aims to highlight the urological evaluation and management of this patient group.
Bilateral synchronous ovarian tumours: an uncommon case and review of the literature
(2018) Tohma, Yusuf Aytac; Gunabakan, Emre; Haberal, Asuman Nihan; Ayhan, Ali; 30150919
Synchronous ovarian tumours are rare. Management of these patients can differ from that of patients with uniform tumours. We present a case of synchronous epithelial ovarian cancer and malignant mixed Mullerian tumour in different ovaries, its follow-up and management until death. To our knowledge this is the second case in the English literature to date. A 61-year-old woman with bilateral adnexal masses underwent complete debulking surgery for ovarian cancer. The final pathology was reported as malignant mixed Mullerian tumour in the right ovary with intact borders and stage 2 grade 3 serous carcinoma in the left ovary. She had a 17-month disease-free interval after 6 cycles of paclitaxel and carboplatin. Recurrence of malignant mixed Mullerian tumour was reported in the pathology after secondary debulking including a partial ileal resection. After 6 cycles of gemcitabine and cisplatin she had a widespread recurrence in the thorax and abdomen. The patient died of disease recurrence at the 25th month after diagnosis. Coexistence of serous and malignant mixed Mullerian tumour in different ovaries is very rare. The main treatment is complete cytoreduction followed with chemotherapy. Platinum-taxane based chemotherapy resulted in an acceptable disease-free interval in our case, but it is not standard yet. A management protocol may be developed with the increasing number of similar cases in the literature.
Blastic Plasmacytoid Dendritic Cell Neoplasm: Skin and Bone Marrow Infiltration of Three Cases and the Review of the Literature
(2015) Atalay, Figen; Demirci, Gulsen Tukenmez; Bayramgurler, Dilek; Atesoglu, Elif Birtas; Yildiz, Semsi; 25825579
Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a distinct and rare neoplastic entity and was classified as a subgroup of acute myeloblastic leukemia by the WHO in 2008. The median survival of patients was 15.2 months in a large case series. Allogeneic or autologous bone marrow transplantation has been recommended by some reports because of the disease's poor prognosis. We present three patients who presented with both skin and bone marrow infiltration. A 57-year-old man, a 62-year-old woman, a 64-year-old man were admitted to our outpatient clinic because of skin lesions. All of the patient's had bone marrow infiltration with positivity of the CD4, CD56, and CD123 staining. Survival of the patient's were 42, 6 and 12 months, respectively. Two of the patients who presented as blastic form didn't respond to any chemotherapy. BPDCN is a difficult disease to diagnosis and manage. CD4, CD56, CD123, CD303, and T cell leukemia/lymphoma 1. Cutaneous lesions can present as isolated nodules, macules, and disseminated macules and nodules. Positivities are crucial to the diagnosis of the disease in histological examination. Bone marrow infiltration or disease relapse at presentation were related to poor prognosis. Complete immunocytochemical staining must be performed for all patients who have cutaneous lesions with or without blood count abnormalities. Bone marrow (allogeneic or autologous) transplantation should be considered at the first remission.
A brief history of artificial intelligence and robotic surgery in orthopedics & traumatology and future expectations
(2020) Beyaz, Salih; 0000-0002-5788-5116; 32962606; K-8820-2019
Recently. the rate of the production and renewal of information makes it almost impossible to be updated. It is quite difficult to process and interpret large amounts of data by human beings. Unlimited memory capacities. learning abilities, artificial intelligence (AI) applications, and robotic surgery techniques cause orthopedic surgeons to be concerned about losing their jobs. The idea of AI. which was first introduced in 1956. has evolved over time by revealing deep learning and evolutionary plexus that can mimic the human neuron cell. Image processing is the leading improvement in developed algorithms. Theoretically. these algorithms appear to be quite successful in interpreting medical images and orthopedic decision support systems for preoperative evaluation. Robotic surgeons have emerged as significant competitors in carrying out the taken decisions. The first robotic applications of orthopedic surgery started in 1992 with the ROBODOC system. Applications started with hip arthroplasty continued with knee arthroplasty. Publications indicate that problems such as blood loss and infection caused by the long operation time in the early stages have been overcome in time with the help of learning systems. Comparative studies conducted with humans indicate that robots are better than humans in providing limb lengthening, patient satisfaction, and cost. As in all new technologies, the developments in both AI applications and robotics surgery indicate that technology is in favor in terms of cost/benefit analyses. Although studies indicate that new technologies are more successful than humans, the replacement of technology with experience and long-term results with traditional methods will not be observed in the near future.
Burnout among Turkish Physicians: A Systematic Review
(2021) Toktamis, Aydin; Akkucuk, M. Husamettin; https://orcid.org/0000-0003-4569-1143; https://orcid.org/0000-0001-8126-9228; AAJ-2828-2021; AAE-3687-2021
Introduction and objectives: By evaluating systematically and collectively studies examining burnout and accompanying factors of physicians in Turkey. we aimed to obtain a meta-perspective of the relevant reader or researcher. Material and Methods: English and in Turkish databases (Pub Med, Google Scholar, Ulakbim) were searched by using key words of physician, burnout and Turkey to identify Turkish physician burnout studies that have been published. Results: The databases search resulted in finding of forty-nine articles most of which were regional and only seven representing the nationwide perspective. A total of 12,598 physicians were evaluated in the surveys. The calculated mean values, supposedly roughly representing the total universe evaluated in all studies. were 18.3 for emotional exhaustion (EE), 7.9 for depersonalisation (DP) and 20.1 for personal accomplishment (PA), respectively. Conclusion: There is a low level of EE, DP and a high decrease in the sense of PA in physicians working in Turkey. The overall burnout experienced by them is not very high, but also is not very low. Female physicians appear to be at higher risk for EE sub-dimension and the risk of burnout is reduced with increasing age or experience.
Can Hepatitis A Vaccine Provide Protection Against COVID-19?
(2020) Sarialioglu, Faik; Apak, Fatma Burcu Belen; Haberal, Mehmet; 0000-0002-9278-6703; 0000-0002-3462-7632; 0000-0002-8257-810X; 32279655; AAJ-8171-2021; AAJ-8097-2021; AAL-7766-2021
Case of an Unusual Suprascapular Neuropathy: Case Report and Literature Review
(2018) Afsar, Sevgi Ilkbali; Karatas, Metin
Suprascapular neuropathy is a rare cause of shoulder pain and muscle weakness. Common causes include space-occupying lesions such as paralabral cysts, soft tissue or bone tumors, recurrent overhead activities in athletes, direct trauma, fractures of the scapula and iatrogenic causes. Diagnosis of suprascapular neuropathy can be difficult due to overlap in the clinical presentation with cervical region and other pathologies of the shoulder. We present a 33-year-old male patient admitted to our clinic with complaints of left shoulder pain and arm weakness starting in 8 months ago. The clinical and electrophysiological evaluations confirmed the left suprascapular nerve lesion at suprascapular notch level. This case is presented to emphasize that suprascapular neuropathy should keep in mind in the differential diagnosis of shoulder pain also without of a mass, trauma or excessive physical activity that may cause the neuropathy.
Clinical characteristics of avascular necrosis in patients with Behcet disease: a case series and literature review
(2019) Atas, Nuh; Bitik, Berivan; Varan, Ozkan; Babaoglu, Hakan; Tufan, Abdurrahman; Haznedaroglu, Seminur; Goker, Berna; Ozturk, Mehmet Akif; 30560445
Avascular necrosis (AVN), also known as osteonecrosis, is characterized by death of the osteocytes due to inadequate blood supply caused by various mechanisms. The hip is the most common affected joint followed by knee. Incidence of AVN in rheumatic diseases is variable and high corticosteroid (CS) therapy is a known major risk factor for development of AVN. Data on the AVN in Behcet disease (BD) are limited. The purpose of this study is to examine the clinical and treatment characteristics of BD patients with diagnosis of AVN. Retrospective medical records of 337 BD patients were reviewed. Nine BD patients with AVN were detected. The clinical data of these patients with AVN have been reviewed. All patients had MRI of the symptomatic joints compatible with AVN. All of the nine patients who were diagnosed with AVN were male. Median duration of BD was 7years. Median time between diagnosis of BD and detection of AVN was 3years (1-16years). Multiple joints were involved in seven patients. Six patients had bilateral knee AVN. Six patients had vascular BD. The median time interval between initial CS dose and AVN development was 24months (range=2-100). The median highest daily CS dose was 64mg/day (range=32-80) and median cumulative CS dose prior to AVN was 18g. All of patients had intravenous pulse steroids. CS treatment, smoking and vascular involvement may predispose to AVN in patients with BD. According to this cohort, AVN in BD frequently tended to be in the knee joint and bilateral.
Cloacogenic Adenocarcinoma of the Vulva: A Case Report and Review of the Literature
(2018) Tepeoglu, Merih; Uner, Halit; Haberal, Asuman Nihan; Ozen, Ozlem; Kuscu, Esra; 28272666
Primary adenocarcinoma of the vulva, unrelated to the native glands of perineum is an extremely rare neoplasm. Despite awareness of this lesion for over 40 years, the origin is not beyond speculation. The most reasonable hypothesis is based on the remnants of cloacal differentiation during early days of life. Here we report the case of a 60-year-old patient with a vulvar mass, who underwent partial vulvectomy and bilateral regional lymph node dissection. The tumor was composed of papillary and complex glandular structures and exhibited diffuse positivity for cytokeratin 20 and polyclonal CEA, CDX2, and focal positivity with cytokeratin 7. Unlike the indolent behavior of this malignant neoplasm according to the literature, we found two metastatic inguinal lymph nodes. She did not receive adjuvant therapy and is still alive, free of disease 38 months after surgery. We present different aspects of vulvar adenocarcinomas with a case report.
Conjunctivitis as sole symptom of COVID-19: A case report and review of literature
(2020) Ozturker, Zeynep Kayaarasi; 0000-0002-5513-9857; 32703010; AAC-5790-2021
Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel virus causing an ongoing pandemic in 2020. Although the symptomatic patients infected by SARS-CoV-2 generally show respiratory distress, atypical manifestations such as conjunctivitis are also observed. A series of cases is reported in which reverse transcriptase polymerase chain reaction (RT-PCR) testing on tears had demonstrated the presence of the virus. However, the transmission of the virus through ocular fluids remains unknown. Case description: In this case report, the development of conjunctivitis is presented as the sole symptom of a new coronavirus disease 2019 (COVID-19) in an emergency health care worker. The patient's first application was to the ophthalmology clinic due to redness, stinging, tearing, and photophobia for one day in the right eye. The patient had no symptoms of fever, cough, shortness of breath, or fatigue. Two days later, the RT-PCR test, blood analysis, and chest computed tomography (CT) were applied to the patient for being in contact with a COVID positive patient. Conjunctival swabs did not identify SARS-CoV-2 by RT-PCR. However, nasopharyngeal swab and blood test confirmed the diagnosis of COVID-19. Chest CT did not show pneumonia. Conclusion: This phenomenon shows that conjunctivitis may occur as a sole manifestation of COVID-19 which needs to be carefully evaluated by health care workers and eye care professionals during the pandemic.
COVID-19 Pandemic and the Global Perspective of Turkish Thoracic Society
(2020) Eyuboglu, A. Fusun Oner; 33352098
It has been more than 3 months now since the first case of COVID-19 was reported in Turkey. Globally, the number of confirmed cases and deaths reached 9,653,048 and 491,128 respectively, as reported by 216 countries by June 27, 2020. Turkey had 1,396 new cases, 194,511 total cases, and 5,065 deaths by the same date. From the first case until today, the Turkish Thoracic Society (TTS) has been very proactive in educating doctors, increasing public awareness, undertaking academic studies, and assisting with public health policies. In the present report, social, academic, and management perspectives of the pandemic are presented under appropriate subtitles. During this critical public health crisis, TTS has once again demonstrated its readiness and constructive stance by supporting public health, healthcare workers, and the environment. This review summarizes the perspective of TTS on each aspect of the COVID-19 pandemic and casts light on its contributions.
COVID-19 Treatment at a Glance
(2020) Esendagli, Dorina; 0000-0002-6619-2952; 33352100; ABF-9398-2020
As coronavirus disease 2019 (COVID-19) spreads across the world, the ongoing clinical trials are leading to a big race worldwide to develop a treatment that will help control the pandemic. Unfortunately, COVID-19 does not have any known effective treatment with reliable study results yet. In this pandemic, there is not a lot of time to develop a new specific agent because of the rapid spread of the disease. The process of developing a vaccine is long and requires hard work. Although the pathophysiology of the disease is not fully understood, some of the proposed treatment alternatives are based on old evidence and some have been used with the idea that they might work owing to their mechanism of action. The efficacy, reliability, and safety of the currently available treatment alternatives are therefore a matter of debate. Currently, the main therapies used in the treatment of COVID-19 are antiviral drugs and chloroquine/hydroxychloroquine. Other proposed options include tocilizumab, convalescent plasma, and steroids, but the mainstay of the treatment in intensive care units remains supportive therapies.
COVID-19: a novel menace for the practice of nephrology and how to manage it with minor devastation?
(2020) Ulu, Sena; Gungor, Ozkan; Gok Oguz, Ebru; Hasbal, Nuri Baris; Turgut, Didem; Arici, Mustafa; 0000-0001-7474-5927; 32713282; AAI-9418-2021
Coronavirus disease 19 (COVID-19) became a nightmare for the world since December 2019. Although the disease affects people at any age; elderly patients and those with comorbidities were more affected. Everyday nephrologists see patients with hypertension, chronic kidney disease, maintenance dialysis treatment or kidney transplant who are also high-risk groups for the COVID-19. Beyond that, COVID-19 or severe acute respiratory syndrome (SARS) due to infection may directly affect kidney functions. This broad spectrum of COVID-19 influence on kidney patients and kidney functions obviously necessitate an up to date management policy for nephrological care. This review overviews and purifies recently published literature in a question to answer format for the practicing nephrologists that will often encounter COVID-19 and kidney related cases during the pandemic times
Covid-19: The Biggest Threat of the 21st Century: In Respectful Memory of the Warriors All Over the World
(2020) Karcioglu, Oguz; Yuksel, Aycan; Baha, Ayse; Er, Aslihan Banu; Esendagli, Dorina; Gulhan, Pinar Yildiz; Karaoglanoglu, Selen; Ercelik, Merve; Serifoglu, Irem; Yildiz, Ethem; Kokturk, Nurdan; 0000-0002-6619-2952; 33352097; ABF-9398-2020
Since the first case was diagnosed in China, the new coronavirus infection (COVID-19) has become the number one issue in the world and it seems to remain trend-topic for a long time. Until 17 April, it affected 210 countries, infected over 2 million people and caused approximately 150000 deaths. Although the course of the disease ranges from asymptomatic state to severe ARDS; the majority of patients reveal only mild symptoms. Though adults are the most commonly affected group; it can also be seen in newborns and elderly patients. Unfortunately, elderly patients are the most vulnerable group with higher mortality. Elderly patients, smokers and patients with comorbid conditions are most affected by the disease. In certain diagnostical tool is the real-time reverse transcription-polymerase chain reaction (real-time RT-PCR) test. However, it can be resulted in false-negative results and in this case the computed thorax tomography (CT) is one of the most important tools with high sensitivity. Besides the supportive treatment, most commonly used agents are immunomodulatory drugs such as plaquenil and azitromycin, and anti-virals including oseltamivir, ritonavir-lopinavir, favipiravir. Until a vaccine or a specific therapy invented, the most important intervention to control the disease is to fight against transmission. This is a real war and the doctors are the soldiers.
Cytoreductive Nephrectomy in the Targeted Treatment Era
(2015) Yaycioglu, Ozgur
To evaluate the role of cytoreductive nephrectomy (CRN) in the treatment of metastatic renal cell carcinoma in targeted therapy era in the light of contemporary data reported in the literature. Recent findings reported in retrospective studies indicate that although the CRN rates are lower than before, the procedure is related with improved survival. Several objective criteria have been proposed for proper patient selection. Results of ongoing prospective studies will help to clarify the role of CRN in the targeted therapy era. Level one evidence is lacking for the role of CRN in the targeted treatment era. However, current data show that the procedure has an essential part in the multidisciplinary treatment of metastatic renal cell carcinoma. Individualization of the treatment decisions is important since not all patients benefit from the operation.