Tıp Fakültesi / Faculty of Medicine

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Author: search.filters.author.Moray, G.Subject: search.filters.subject.MANAGEMENT

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    Early Proteinuria After Renal Transplantation and Allograft Outcomes
    (2014) Gulleroglu, K.; Baskin, E.; Bayrakci, U.; Akdur, A.; Moray, G.; Haberal, M.; https://orcid.org/0000-0003-1434-3824; https://orcid.org/0000-0003-4361-8508; https://orcid.org/0000-0002-8726-3369; https://orcid.org/0000-0003-2498-7287; https://orcid.org/0000-0002-3462-7632; 24507040; AAJ-8833-2021; B-5785-2018; AAA-3068-2021; AAE-1041-2021; AAJ-8097-2021
    Background. Proteinuria is among the major and nonspecific sign of the renal disease. It is well known that late-onset proteinuria after renal transplantation has been associated with poor allograft outcomes and with mortality. Knowledge about the impact of early proteinuria on the various outcomes is limited. We have evaluated the utility of measuring early proteinuria in the management of pediatric renal transplant recipients. Methods. We analyzed the effect of proteinuria at 3 months of posttransplantation on allograft rejection, graft loss, and estimated glomerular filtration rate (GFR) at 3 years. Proteinuria was assessed using 24-hour urine protein excretion. Renal biopsy was performed when elevated creatinine levels were elevated during routine follow-up and an acute rejection episode was proven with biopsy. Results. Sixty-seven pediatric renal transplant recipients were included to the study. Mean follow-up time after transplantation was 48.8 +/- 12.1 months. Thirty-nine recipients (58%) have proteinuria >500 mg/d. The relationship could not be shown between proteinuria at posttransplant month 3 and other outcomes parameters, such as graft loss and lower estimated GFR. A significant positive correlation between acute rejection and the proteinuria at posttransplant month 3 was shown. Conclusion. We demonstrated that early proteinuria is a common finding in children after transplantation. Posttransplant early proteinuria cannot be used as a long-term prognostic marker of poor renal outcome. However, early proteinuria is associated with an high risk of acute rejection episodes. This would permit an opportunity for early intervention.
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    Results of Surgical Treatment of Anterior Abdominal Wall Desmoid Tumours: 13 Cases Reviewed with Literature
    (2014) Yabanoglu, H.; Karagulle, E.; Aytac, H. O.; Caliskan, K.; Canpolat, T.; Koc, Z.; Akdur, A. C.; Moray, G.; Haberal, M.; https://orcid.org/0000-0002-1161-3369; https://orcid.org/0000-0002-8522-4956; https://orcid.org/0000-0002-3583-9282; https://orcid.org/0000-0002-8767-5021; https://orcid.org/0000-0003-0987-1980; https://orcid.org/0000-0002-8726-3369; https://orcid.org/0000-0003-2498-7287; https://orcid.org/0000-0002-3462-7632; 26021684; AAJ-7865-2021; C-6247-2017; AAJ-7913-2021; AAJ-7201-2021; AAK-8107-2021; S-8384-2016; AAA-3068-2021; AAE-1041-2021; AAJ-8097-2021
    Background : We retrospectively evaluated the results of surgical treatment for anterior abdominal wall desmoid tumours. Methods : Records for 13 patients operated on for desmoid tumours from 1997-2013 were searched for age, gender, abdominal/pelvic surgical history, pregnancy, Gardner's syndrome, pre-operative radiological examinations, tumour size, multifocality, surgical procedure, tumour presence at surgical margins, recurrence, morbidity, and mortality. Local recurrence-free survival probabilities were estimated by the Kaplan-Meier method and stratified by various clinicopathological variables. Results : There were 11 female (84,6%) and 2 male (15,4%) patients with a median age of 36 years. Seven (53,8%) patients had previous abdominal/pelvic surgery, five (38,5%) had a history of pregnancy, and one (7,6%) had Gardner's Syndrome. Two (15,3%) patients had multifocality on their pre-operative radiological examinations. Mean tumour diameter was 4,6 cm (SD 3,2 cm; range 2-12 cm). After the excision of the masses in five (38,5%) patients, synthetic materials were used to close the abdominal wall defects. Two (15,3%) patients with positive surgical margins after surgery were re-operated. Three (23%) patients required a second surgical intervention after the mass excisions were performed. Mean follow-up time was 56,7 months. Recurrence was observed in three patients during follow-up. Increased tumour size, history of previous abdominal/pelvic surgery, and the presence of multifocality had a negative effect on local recurrence-free survival. There was no mortality during follow-up. Conclusions : Desmoid tumours are characterized by high recurrence, even after proper surgical excisions. Preoperative differential diagnoses of these tumours should be done and a post-operative follow-up protocol should be followed.