Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item A Case Report of Giant Malignant Schwannoma of the Sciatic Nerve Associated with Neurofibromatosis-1: A CARE-Compliant Article(2023) Gokkus, Kemal; Saylik, Murat; Birtay, Tayfun; Sahin, Mehmet Sukru; 0000-0002-4916-3471; 38013269; A-4410-2016Rationale:Neurofibromatosis type 1 (NF1) is an autosomal dominant neurocutaneous syndrome that causes multiple central and peripheral nerve sheath tumors. People with NF1 have a 10% chance of developing malignant peripheral nerve sheath tumors (MPNSTs). Here we report a unique instance of a malignant schwannoma that has remained free of metastasis since its initial removal a decade ago. The malign schwannoma has been infrequently documented in the literature, and remarkably, no instances of such an extensive postoperative time without metastases have ever been described.Patient concerns:A 46-year-old male patient with NF had multiple neurofibromas in different parts of his body, underwent surgery about 10 years ago (2013), and was diagnosed histopathologically as MPNST.Diagnoses:He was admitted to our institution with a recurrent mass in the posterior third of the proximal thigh and severe pain radiating to the left lower extremity, which presented as sciatic pain (2021). A magnetic resonance imaging and fluorodeoxyglucose-positron emission tomography examination revealed that the tumor was likely malignant.Interventions:Surgical excision was performed.Outcome:A 10-year follow-up revealed no metastases or neurologic impairment.Lessons:When articles about benign schwannomas are placed in a separate category, little is written about NF-1-related malignant schwannomas of the sciatic nerve. MPNSTs are high-grade, aggressive sarcomas with a high risk of local recurrence (40%-65%) and metastasis to other body parts. Therefore, among the various benign peripheral nerve sheath tumors in NF-1 patients, the diagnosis of MPNST is crucial.Orthopedic surgeons should be aware that neurofibromas in NF-1 have a significant risk of developing MPNSTs. This study reports the successful treatment of a giant malignant sciatic nerve schwannoma with a long follow-up period without metastasis.Lessons:When articles about benign schwannomas are placed in a separate category, little is written about NF-1-related malignant schwannomas of the sciatic nerve. MPNSTs are high-grade, aggressive sarcomas with a high risk of local recurrence (40%-65%) and metastasis to other body parts. Therefore, among the various benign peripheral nerve sheath tumors in NF-1 patients, the diagnosis of MPNST is crucial.Orthopedic surgeons should be aware that neurofibromas in NF-1 have a significant risk of developing MPNSTs. This study reports the successful treatment of a giant malignant sciatic nerve schwannoma with a long follow-up period without metastasis.Item Prognosis Of Patients Hospitalized With A Diagnosis Of COVID-19 Pneumonia İn A Tertiary Hospital İn Turkey(2021) Birtay, Tayfun; Bahadir, Suzan; Kabacaoglu, Ebru; Yetiz, Ozgur; Demirci, Mehmet Fatih; Genctoy, Gultekin; 0000-0002-0019-5851; 34873938; AAD-5931-2021BACKGROUND: SARS-CoV2/COVID-19 emerged in China and caused a global pandemic in 2020. The mortality rate has been reported to be between 0% and 14.6% in all patients. In this study, we determined the clinical and laboratory parameters of COVID-19 related morbidity and mortality in our hospital. OBJECTIVES: Investigate the relationship between demographic, clinical, and laboratory parameters on COVID-19-related morbidity and mortality. DESIGN: Retrospective observational study. SETTINGS: Tertiary care hospital. PATIENTS AND METHODS: Patients diagnosed with COVID-19 pneumonia from March until the end of December were included in the study. MAIN OUTCOME MEASURES: The relationship between demographic, clinical, and laboratory parameters and the morbidity and mortality rates of patients diagnosed with COVID-19. SAMPLE SIZE: 124 patients RESULTS: The mortality rate was 9.6% (12/124). Coronary artery disease (P<.0001) diabetes mellitus (P=.04) fever (>38.3 degrees C) at presentation (P=.04) hypertension (P<.0001), and positive smoking history (P<.0001) were significantly associated with mortality. Patients who died were older, had a higher comorbid disease index, pneumonia severity index, fasting blood glucose, baseline serum creatinine, D-dimer, and had lower baseline haemoglobin, SaO(2) percentage of lymphocyte counts and diastolic blood pressure. Patients admitted to the ICU were older, had a higher comorbidity disease index, pneumonia severity index, C-reactive protein, WBC, D-dimer, creatinine, number of antibiotics used, longer O-2 support duration, lower hemoglobin, lymphocyte (%), and baseline SaO(2) (%). CONCLUSIONS: Our results were consistent with much of the reported data. We suggest that the frequency, dosage, and duration of steroid treatment should be limited. LIMITATIONS: Low patient number, uncertain reason of mortality, no standard treatment regimen, limited treatment options, like ECMO.Item Concomitant usage of thrombolytic therapy and therapeutic hypothermia in a case of sudden cardiac arrest due to massive pulmonary embolism(2019) Coner, Ali; Birtay, Tayfun; 31483312Massive pulmonary embolism is a well-known cause of sudden cardiac arrest in the adult population. Systemic fibrinolysis can be a life-saving option. Therapeutic hypothermia is highly recommended for nontraumatic sudden cardiac arrest victims to minimize neurological complications. However, there are limited data about the use of therapeutic hypothermia for sudden cardiac arrest victims also treated with systemic fibrinolysis. Concerns about hypothermia-related coagulopathy and a possible tendency to bleeding have limited the use of cooling therapy in such cases. Presently described is a case of sudden cardiac arrest due to a massive pulmonary embolism that was successfully treated with the concomitant usage of systemic fibrinolysis and therapeutic hypothermia.Item Low baseline proBNP associated with increased risk of intraoperative hypotension during spinal anaesthesia for cesarean delivery(2015) Birtay, Tayfun; Genctoy, Gultekin; Saba, Tonguc; 26409800BACKGROUND AND OBJECTIVES: Brain natriuretic peptide (BNP) has a role in the regulation of body fluid volume and blood pressure (BP). BNP remains within a normal range during spinal anaesthesia (SA) in patients undergoing cesarean delivery. However, the effect of BNP on changes in BP during the perioperative period has not been evaluated. We aimed to investigate the effect of preoperative serum BNP on the risk of hypotension during cesarean delivery with SA. DESIGN AND SETTING: Patients were randomly selected among the patient group who were attending routine clinic visits for pregnancy monitoring. All had a healthy pregnancy and no other acute or chronic disease by their obstetrician. The study design was cross-sectional. PATIENTS AND METHODS: Patients who had uncomplicated pregnancy process and no known medical disease were selected consecutively during their last outpatient clinical examination. Baseline BP was recorded before SA. Simultaneously, blood samples were drawn for routine biochemistry and BNP. BP, SaO(2), and electro-cardiography were monitored during surgery. Intraoperative hypotension (IOH) was defined as >= 25% decrease in mean arterial pressure (MAP) at the 5th minute of SA. RESULTS: In 41 term pregnant women, 18 of the 41 patients (43.9%) fulfilled the criteria for IOH, while 23 (56.1%) showed a decrease 13.1 (11.3%) and were classified as normotensive. Baseline BNP was significantly lower in patients with IOH compared with normotensive patients 45.7 (26.9) vs. 70.2 (40.5); P=. 05. Baseline BNP had no significant correlation MAP at any time point. Age, body mass index, hemoglobin, baseline MAP and heart rate were not different between patients with and without IOH. CONCLUSION: Those findings suggest that higher baseline BNP levels might have a protective role in development of hypotension in healthy term pregnant women during SA for cesarean delivery.