PubMed Açık Erişimli Yayınlar

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The relationship between coronary collateral artery development and inflammatory markers
(2014) Oguz, Didem; Atmaca, Yusuf; Ozdol, Cagdas; Ozdemir, Ayhan Ongun; Kaya, Cansin Tulunay; Erol, Cetin
Objective: This study aims to show the effect of myeloperoxidase (MPO), hsCRP, TNF-alpha values and leukocyte count on the development of coronary collateral arteries in patients with severely diseased coronary arteries. Methods: Current study is an observational cross-sectional study. In the study, 295 patients who had functional obstruction or total coronary occlusion at least 1 month on their angiograms were included. We divided the study population into two groups according to their collateral grade as good collateral (Group 1) (169 patients) and poor collateral (Group 2) (126 patients). Multiple logistic regression analysis was used for independent variables associated with the coronary collateral grade. Results: History of stable angina pectoris was statistically more prevalent in good collateral group (61.5% and 48.4%, p=0.025). Furthermore, MPO activation was higher in good collateral group and the difference was statistically significant (3.7 U/mL and 3.0 U/mL p=0.001). In multiple logistic regression analysis, stable angina pectoris [OR 1.7, 95% CI (1.05-2.8), p=0.03] and high MPO levels [OR 2.7, 95% CI (1.7-4.3), p<0.001] were found to be independent predictors of good collateral development. Conclusion: We think that proinflammatory enzymes and cytokines released from these cells rather than inflammatory cells themselves may play an important role on the collateral development.
THE COST-EFFECTIVENESS ANA LYSIS FOR HIV TREATMENT ALTERNATIVES IN TURKEY
(2014) Kockaya, G.; Yenilmez, F.B.; Zengin, Elbir T.; Dalgic, C.; Malhan, S.; Cerci, P.; Oksuz, E.; Tayfun, K.; Unal, S.; 27202504
Effect of Topical Tetracycline on Seroma Formation in the Lichtenstein Technique: A Prospective Randomized Study
(2014) Turk, Emin; Karagulle, Erdal; Coban, Gokcen; Yildirim, Erkan; Moray, Gokhan
We sought to investigate whether application of topical tetracycline has a limiting effect on seroma formation in patients undergoing hernia repair using a polypropylene mesh. This study was conducted in 96 patients undergoing an elective groin hernia repair. Patients were randomized and divided into 2 groups. After the graft was placed, and before external oblique muscle aponeurosis was closed, 5 mL tetracycline was administered on the graft in the tetracycline group (tetra group, n = 50), and 5 mL isotonic saline was administered in the control group (n = 46) without putting in a drain. Seroma checks via surface ultrasonography were done. Seroma amounts measured on the first day were significantly higher in the tetra group (P = 0.04). There were no significant differences regarding seroma measurements on the seventh day or in the first and second months. Topical tetracycline application has no limiting effect on seroma formation after a groin hernia operation.
Interrelation of RDW and coronary flow reserve in patient with idiopathic dilated cardiomyopathy
(2014) Ozulku, Mehmet; Caliskan, Mustafa; Gullu, Hakan; Erdogan, Dogan; Caliskan, Zuhal; Muderrisoglu, Haldun
Objective: Idiopathic dilated cardiomyopathy (IDC) impairs and reduces coronary flow reserve (CFR). High level of red cell distribution width (RDW) is an independent risk factor for cardiovascular diseases. Therefore, in this observational case-control study we have aimed to determine whether RDW level is associated with CFR impairment in patients with IDC. Methods: We examined 36 patients with IDC and 35 healthy subjects formed as a control group. In addition to this, patients with IDC were divided into two subgroups according to their CFR levels [normal CFR group (CFR value >= 2) and lower CFR group (CFR value<2)]. Control and patients groups were compared using the student t-test for multiple comparisons. The subgroups were compared using the Mann-Whitney U test for continuous variables and chi-square for categorical variables. The Pearson's and Spearman correlation analysis was used to test the possible associations between CFR and the study variables as appropriate. The receiver-operating characteristic (ROC) curve was determined to evaluate the predictive performance of RDW to detect low CFR. Results: There were no significantly differences between the lower and higher CFR groups' clinical data, baseline hemodynamic, medication and biochemical data except RDW and high-sensitivity C-reactive protein (hsCRP) levels. We found that RDW level was a good predictor of low CFR at the receiver-operating characteristic curve. The area under the curve (AUC) was 73% (95% confidence interval between 0.56-0.90 is 95%, p:0.018) After adjusting potential confounders include age, body-mass index, blood pressure, lipid and glucose, RDW independently associated with CFR level (Beta:-0.374; p=0.015) and hsCRP value (Beta:-0.520; p=0.001) were the independent predictors of lower CFR. Conclusion: Results showed that there was an independent correlation between RDW level and CFR level in patients with IDC.
Surgical Interventions for Late Complications of Arteriovenous Fistulas
(2014) Belli, Sedat; Yabanoglu, Hakan; Aydogan, Cem; Parlakgumus, Alper; Yildirim, Sedat; Haberal, Mehmet; 25058786
Our aim was to determine the most effective surgical treatment for arteriovenous fistula (AVF) complications after all other methods of salvage have failed. We evaluated 110 patients for 139 complications that occurred after the initial AVF placement and for whom surgical intervention was the last hope for retaining fistula access. Vascular steal syndrome and venous hypertension were the most common complications seen in our patients. The anastomoses of 17 of the vascular steal syndrome cases were narrowed either by stitches or by a polytetrafluoroethylene graft. The second most performed revision surgery was excision of the aneurysm and repair with primary suturing, followed by excision of the aneurysm and interposition grafting. Successful surgical outcomes were achieved in 111 of 139 procedures after revision surgery without constructing a new AVF. AVF salvage surgery is of paramount importance in order to increase the patency rate, which prolongs survival and increases the patient's quality of life.
Skin Care in Organ Transplant Patients Europe Meeting Report from Annual Meeting, Leiden, The Netherlands, 15-18 May 2014
(2014) Hofbauer, Guenther F.L.; Seckin, Deniz; Gjersvik, Petter; Bavinck, Jan Nico Bouwes; 25381765
A rare cause of circulatory shock
(2014) Altin, Cihan; İzmir, Arzu; Osmanoglu, Sevda; Gezmis, Esin; Sagduyu, Afsin; 25233504
Delayed failure of rectovaginal fistula embolization with Amplatzer vascular plug 2
(2014) Kilickesmez, Ozgur; Andic, Cagatay; Oguzkurt, Levent; 25323835
Thyroid volume in patients with glucose metabolism disorders
(2014) Duran, Ayse Ocak; Anil, Cuneyd; Gursoy, Alptekin; Nar, Asli; Inanc, Mevlude; Bozkurt, Oktay; Tutuncu, Neslihan Bascil; 25465604
Objective: Thyroid volume and the prevalence of thyroid nodules are higher in patients with insulin resistance. A relationship between thyroid volume and glucose metabolism disorders (GMD) has not as yet been clarified. The present retrospective study aimed to investigate the association between GMD and thyroid volume. Subjects and methods: We investigated the data of 2,630 patients who were evaluated for thyroid biopsy in our hospital. The study population included 602 patients with GMD, 554 patients with diabetes mellitus (DM) and 1,474 patients with normal glucose metabolism as a control group. We obtained the levels of serum thyroid stimulating hormone (TSH) and the thyroid volumes of those patients retrospectively. Results: The median ages for the control group, GMD group and DM group were 55 (15-91) years, 60 (27-97) years, and 65 (27-91) years respectively and there was a statistically significant difference between the groups with regard to age and gender (p < 0.001). Levels of TSH were similar in all groups. The median total thyroid volumes for patients with DM and GMD were significantly higher than that of the control group [22.5 (3-202) mL, 20.2 (4-190) mL, and 19.2 (3-168) mL respectively, p <= 0.001 for all parameters]. Also the median total thyroid volume for patients with DM was significantly higher than that of the GMD group (p < 0.001). According to the correlation analysis, thyroid volume was significantly correlated with age (r = 0.92, p < 0.001) and TSH (r = 0.435, p < 0.001). Age, gender, TSH levels, GMD and DM diagnosis were independently correlated with thyroid volume. Conclusion: The thyroid gland is one of the target tissues of metabolic disorders. We reported a positive correlation between GMD/type 2 DM and thyroid volume. Further controlled, prospective, randomized studies on this subject are required to gain more information.
Inferior Vena Cava Oxygen Saturation during the First Three Postnatal Days in Preterm Newborns with and without Patent Ductus Arteriosus
(2014) Yapakci, Ece; Ecevit, Ayse; Ince, Deniz Anuk; Gokdemir, Mahmut; Tekindal, M. Agah; Gulcan, Hande; Tarcan, Aylin; 25337418
Background: Inferior vena cava (IVC) oxygen saturation as an indicator of mixed venous oxygenation may be valuable for understanding postnatal adaptations in newborn infants. It is unknown how this parameter progresses in critically ill premature infants. Aims: To investigate IVC oxygen saturation during the first three days of life in preterm infants with and without patent ductus arteriosus (PDA). Study Design: Case-control study. Methods: Twenty-seven preterm infants were admitted to the Neonatal Intensive Care. Preterm infants with umbilical venous catheterization were included in the study. Six umbilical venous blood gas values were obtained from each infant during the first 72 hours of life. Preterm infants in the study were divided into two groups. Haemodynamically significant PDA was diagnosed by echocardiography in 11 (41%) infants before the 72nd hour of life in the study group and ibuprofen treatment was started, whereas 16 (59%) infants who didn't have haemodynamically significant PDA were included in the control group. Results: In the entire group, the highest value of mean IVC oxygen saturation was 79.9% at the first measurement and the lowest was 64.8% at the 72nd hour. Inferior vena cava oxygen saturations were significantly different between the study and control groups. Posthoc analysis revealed that the first and 36th hour measurements made the difference (p=0.01). Conclusion: Inferior vena cava oxygen saturation was found to be significantly different between preterm infants with and without PDA. Further studies are needed to understand the effect of foetal shunts on venous oxygenation during postnatal adaptation in newborn infants.
Assessment of maxillofacial trauma in emergency department
(2014) Arslan, Engin D.; Solakoglu, Alper G.; Komut, Erdal; Kavalci, Cemil; Yilmaz, Fevzi; Karakilic, Evvah; Durdu, Tamer; Sonmez, Muge
Introduction: The incidence and epidemiological causes of maxillofacial (MF) trauma varies widely. The objective of this study is to point out maxillofacial trauma patients' epidemiological properties and trauma patterns with simultaneous injuries in different areas of the body that may help emergency physicians to deliver more accurate diagnosis and decisions. Methods: In this study we analyze etiology and pattern of MF trauma and coexisting injuries if any, in patients whose maxillofacial CT scans was obtained in a three year period, retrospectively. Results: 754 patients included in the study consisting of 73.7% male and 26.3% female, and the male-to-female ratio was 2.8:1. Mean age was 40.3 +/- 17.2 years with a range of 18 to 97. 57.4% of the patients were between the ages of 18-39 years and predominantly male. Above 60 years of age, referrals were mostly woman. The most common cause of injuries were violence, accounting for 39.7% of the sample, followed by falls 27.9% and road traffic accidents 27.2%. The primary cause of injuries were violence between ages 20 and 49 and falls after 50. Bone fractures found in 56,0% of individuals. Of the total of 701 fractured bones in 422 patients the most frequent was maxillary bone 28,0% followed by nasal bone 25,3%, zygoma 20,2%, mandible 8,4%, frontal bone 8,1% and nasoethmoidoorbital bone 3,1%. Fractures to maxillary bone were uppermost in each age group. 8, 9% of the patients had brain injury and only frontal fractures is significantly associated to TBI (p < 0.05) if coexisting facial bone fracture occurred. Male gender has statistically stronger association for suffering TBI than female (p < 0, 05). Most common cause of TBI in MF trauma patients was violence (47, 8%). 158 of the 754 patients had consumed alcohol before trauma. No statistically significant data were revealed between alcohol consumption gender and presence of fracture. Violence is statistically significant (p < 0.05) in these patients. Conclusion: Studies subjected maxillofacial traumas yield various etiologic factors, demographic properties and fracture patterns probably due to social, cultural and governmental differences. Young males subjected to maxillofacial trauma more commonly as a result of interpersonal violence.
Surgical and interventional management of complications caused by acute pancreatitis
(2014) Karakayali, Feza Y.; 25309073
Acute pancreatitis is one of the most common gastrointestinal disorders worldwide. It requires acute hospitalization, with a reported annual incidence of 13 to 45 cases per 100000 persons. In severe cases there is persistent organ failure and a mortality rate of 15% to 30%, whereas mortality of mild pancreatitis is only 0% to 1%. Treatment principles of necrotizing pancreatitis and the role of surgery are still controversial. Despite surgery being effective for infected pancreatic necrosis, it carries the risk of long-term endocrine and exocrine deficiency and a morbidity and mortality rate of between 10% to 40%. Considering high morbidity and mortality rates of operative necrosectomy, minimally invasive strategies are being explored by gastrointestinal surgeons, radiologists, and gastroenterologists. Since 1999, several other minimally invasive surgical, endoscopic, and radiologic approaches to drain and debride pancreatic necrosis have been described. In patients who do not improve after technically adequate drainage, necrosectomy should be performed. When minimal invasive management is unsuccessful or necrosis has spread to locations not accessible by endoscopy, open abdominal surgery is recommended. Additionally, surgery is recognized as a major determinant of outcomes for acute pancreatitis, and there is general agreement that patients should undergo surgery in the late phase of the disease. It is important to consider multidisciplinary management, considering the clinical situation and the comorbidity of the patient, as well as the surgeons experience. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.
Effects of ozone therapy and taurine on ischemia/reperfusion-induced testicular injury in a rat testicular torsion model
(2014) Aydos, Tolga Resat; Basar, Mehmet Murad; Kul, Oguz; Atmaca, Hasan Tank; Uzunalioglu, Tuba; Kisa, Ucler; Efe, Oguzhan Ekin; 25539540
Background/aim: To investigate the effect of ozone and/or taurine treatment comparatively on testicular damage due to ischemia/reperfusion (I/R) injury in an experimental torsion model in rats. Materials and methods: Adult Wistar rats with and without torsion/detorsion were used. In order to monitor the effect of ozone and/or taurine treatment on testicular damage due to I/R injury, following histopathological investigation apoptotic indexes were scored by TUNEL method. Moreover, tumor necrosis factor receptor 1 (TNFR1), caspase 3, caspase 8, endothelial nitric oxide synthase (eNOS), tumor necrosis factor alpha (TNF alpha), and cytochrome C immunostainings were performed and the levels of malondialdehyde, glutathione peroxidase, superoxide dismutase, catalase, total sulthydryl, and nitric oxide were determined in the testicular tissue. Results: Intraperitoneal ozone and/or taurine treatment prevented both histopathological damage and increase in the apoptotic index. Torsion did not exert an effect on the levels of TNFa and cytochrome C. Ozone and/or taurine treatment prevented increases in TNFR1, caspase 3, and caspase 8. The level of oxidative stress markers was unchanged. The increases in NO level and eNOS expression were prevented by ozone and/or taurine treatment in I/R groups. Conclusion: Using ozone therapy and/or taurine before reperfusion may be a solution for germ cell degeneration resulting from testicular torsion and related infertility.
Amiodarone Induced Epididymitis: A Case Report
(2014) Cicek, Tufan; Demir, Canan Cicek; Coban, Gokcen; Coner, Ali
Introduction: Amiodarone is an effective drug for life-threatening arrhythmias like recurrent ventricular fibrillation and atrial fibrillation. Amiodarone creates rarely genitourinary side effects are seen. These are epididymitis, testicular dysfunction and impotance. Amiodarone aggregates and triggers inflammation in the head of the epididym. Case report: We present the case of a patient who developed epididymitis after 17 months of amiodarone therapy, using a low dose (100 mg per day). Although cessation of medication or dose lowering was not performed, remission of the patient only by analgesics is a distinct case reported in urological literature. Conclusions: This case stresses the importance of considering an adverse effect of amiodarone treatment as a cause when making a differential diagnosis of epididymitis.
Depigmented skin and phantom color measurements for realistic prostheses
(2014) Tanner, Paul; Leachman, Sancy; Boucher, Kenneth; Ozcelik, Tuncer Burak
PurposeThe purpose of this study was to test the hypothesis that regardless of human skin phototype, areas of depigmented skin, as seen in vitiligo, are optically indistinguishable among skin phototypes. The average of the depigmented skin measurements can be used to develop the base color of realistic prostheses. Methods and MaterialsData was analyzed from 20 of 32 recruited vitiligo study participants. Diffuse reflectance spectroscopy measurements were made from depigmented skin and adjacent pigmented skin, then compared with 66 pigmented polydimethylsiloxane phantoms to determine pigment concentrations in turbid media for making realistic facial prostheses. ResultsThe Area Under spectral intensity Curve (AUC) was calculated for average spectroscopy measurements of pigmented sites in relation to skin phototype (P=0.0505) and depigmented skin in relation to skin phototype (P=0.59). No significant relationship exists between skin phototypes and depigmented skin spectroscopy measurements. The average of the depigmented skin measurements (AUC 19,129) was the closest match to phantom 6.4 (AUC 19,162). ConclusionAreas of depigmented skin are visibly indistinguishable per skin phototype, yet spectrometry shows that depigmented skin measurements varied and were unrelated to skin phototype. Possible sources of optical variation of depigmented skin include age, body site, blood flow, quantity/quality of collagen, and other chromophores. The average of all depigmented skin measurements can be used to derive the pigment composition and concentration for realistic facial prostheses.
Primary Extranodal Non-Hodgkin's Lymphoma: Clinicopathological Features, Survival and Treatment Outcome in Two Cancer Centers of Southern Turkey
(2014) Mertsoylu, Huseyin; Muallaoglu, Sadik; Besen, Ayberk Ali; Erdogdu, Suleyman; Sezer, Ahmet; Sedef, Ali Murat; Kose, Fatih; Arican, Ali; Ozyilkan, Ozgur
Background: The aim of this study was to assess the epidemiological and clinicopathological characteristics of primary extranodal non-Hodgkin's lymphoma (pENL) patients, focusing on treatment and survival outcome. Materials and Methods: Between October 2003 and March 2012, 802 patients with non-Hodgkin's lymphoma (NHL) were diagnosed and treated in two different cancer centers of Southern Turkey. Results: pENL, constituted 12.4% (100/802) of all NHL studied during this period. Median age of the patients was 56 years (range 17-87 years) and the male: female distribution was 3:2. Eighty-five of 100 patients (85%) were in stage I/II, 9/100 (9%) in stage III, whereas 6/100 (6%) were in stage IV. Head and neck constituted the most common site (51/100, 51%), followed by gastrointestinal tract (GIL) (37/100, 37%), and cerebrum (CL) (5/100, 5%). Diffuse large B cell lymphoma (DLBCL) was the most common histological type, observed in 53% of patients, followed by marginal zone extranodal lymphoma (13%). Most of patients (76%) received a CHOP containing regimen. Complete remission (CR) were achieved in 71% of patients. The median follow-up duration of all patients was reported as 37.6 months (range, 0.8-165 months). This period was reported as 137.5 months (range, 117.5-1578.6 months) in gastrointestinal lymphoma (GIL) patients, 119.0 months (range, 91.8-146.1 months) in head and neck lymphoma (HNL) patients, and 18.4 months (range, 12.6-24.1 months) in cerebral lymphoma (CL) patients. Conclusions: Head and neck, and the gastrointestinal tract were the two most common extranodal sites observed. Histologically DLBC accounted for the majority of cases. Most patients were on earlier stages, had low-low intermediate IPI scores and had a favorable prognosis.
Simultaneous integrated boost to intraprostatic lesions using different energy levels of intensity-modulated radiotherapy and volumetric-arc therapy
(2014) Onal, C.; Sonmez, S.; Erbay, G.; Guler, O.C.; Arslan, G.
Objective: This study compared the dosimetry of volumetric-arc therapy (VMAT) and intensity-modulated radiotherapy (IMRT) with a dynamic multileaf collimator using the Monte Carlo algorithm in the treatment of prostate cancer with and without simultaneous integrated boost (SIB) at different energy levels. Methods: The data of 15 biopsy-proven prostate cancer patients were evaluated. The prescribed dose was 78 Gy to the planning target volume (PTV78) including the prostate and seminal vesicles and 86 Gy (PTV86) in 39 fractions to the intraprostatic lesion, which was delineated by MRI or MR-spectroscopy. Results: PTV dose homogeneity was better for IMRT than VMAT at all energy levels for both PTV78 and PTV86. Lower rectum doses (V-30-V-50) were significantly higher with SIB compared with PTV78 plans in both IMRT and VMAT plans at all energy levels. The bladder doses at high dose level (V-60-V-80) Were significantly higher in IMRT plans with SIB at all energy levels compared with PTV78 plans, but no significant difference was Observed in VMAT plans. VMAT plans resulted in a significant decrease in the mean monitor units (MUs) for 6,10, and 15 MV energy levels both in plans with and those without SIB. Conclusion: Dose escalation to intraprostatic lesions with 86 Gy is safe without causing Serious increase in organs at risk (OARs) doses. VMAT is advantageous in sparing OARs and requiring less MU than IMRT. Advances in knowledge: VMAT with SIB to intraprostatic lesion is a feasible method in treating prostate cancer. Additionally, no dosimetric advantage of higher energy is observed.
CHARACTERISTICS OF THE MEDICINES WHICH HAVE ANNUAL AVERAGE HIGHEST AMOUNT OF SALES OF BETWEEN YEARS 2008-2013
(2014) Akbulat, A.; Dogan, E.; Babacan, S.; Uman, N.; Tolun, C.; Vural, I. M.; Vural, E. H.; Yilmaz, Safak E.; Dasdag, M. M.; Kahveci, R.; Malhan, S.; Artiran, G.; Kerman, S.; 27201011
Evaluation of choroidal thickness using spectral-domain optical coherence tomography in migraine patients during acute migraine attacks: a comparative study
(2014) Karalezli, A.; Simsek, C.; Celik, G.; Eroglu, F.C.; 25257772
Purpose The purpose of this study was to assess choroidal thickness in migraine patients during acute migraine attacks and compare them with healthy controls, using spectral domain optical coherence tomography (OCT). Patients and methods In this prospective case-control study, choroidal thicknesses of 46 migraine patients during acute migraine attacks and 46 age-and sex-matched healthy subjects were measured using a high-speed, high-resolution frequency domain-OCT device. All patients underwent a complete ophthalmic examination before the measurements. OCT measurements were taken at the same time of day (0900 hours), in order to minimize the effects of diurnal variation. Results There was a statistically significant difference in mean choroidal thickness between the migraine patients during acute migraine attacks (356.3 +/- 21.46 mm) and the controls (302.3 +/- 18.34 mu m; P = 0.000). There were significant differences at all measurement points (P < 0.001 for all). Conclusion The increased choroidal thickness of the migraine patients during acute migraine attacks might be related to the vascular pathology of the disease. Further studies are needed to evaluate the etiopathologic relationship between choroidal thickness and acute migraine attack.
OPERATING ON PENETRATING TRAUMA TO THE MEDIASTINAL VESSELS
(2014) Yilmaz, T. H.; Evers, T.; Sussman, M.; Vassiliu, P.; Degiannis, E.; Doll, D.; 24520100
Background and Aims: Patients with penetrating trauma of the major vessels of the chest are infrequently encountered. This is due to the fact that the majority of these patients die on scene, as well as due to the overall dramatic decline in the incidence of penetrating trauma in the Western world. A certain proportion of survivors are physiologically stable and can be transferred to adequate care. Patients who are physiologically unstable must be dealt with by the surgeons available without delay. Rapid diagnosis and operation can salvage patients who would otherwise be lost, and all general surgeons should be capable of recognizing these injuries and intervening if a trauma and/or cardiothoracic surgeon is not immediately available. Material and Methods: Technical description of practical emergency surgery approaches to patients bleeding to death from penetrating mediastinal vessel injuries. Results: The scope of this review familiarizes the uninitiated surgeon with the operative management of this rare and lethal type of injuries. Technical aspects are described, and pitfalls as well as tips and tricks of the trade are discussed. Conclusions: Patients with penetrating injuries to the mediastinal vessels can be saved by swift and knowing operative management of this rare and lethal type of injuries, even if a trauma and/or cardiothoracic surgeon is not immediately available.