Fakülteler / Faculties
Permanent URI for this communityhttps://hdl.handle.net/11727/1395
Browse
5 results
Search Results
Item Long-Term Follow-up of Over 600 Living Related Kidney Donors: Single-Center Experience(2022) Sayin, Burak; Akdur, Aydincan; Karakaya, Emre; Soy, Ebru H. Ayvazoglu; Haberal, Mehmet; https://orcid.org/0000-0002-4879-7974; https://orcid.org/0000-0002-3462-7632; 35384802; AAD-5466-2021; AAJ-8097-2021Objectives: Kidney transplant is the treatment of choice in patients with end-stage renal disease because it offers improved survival and better quality of life. Although most epidemiologic studies have suggested that living kidney donors have a minimal lifetime risk of developing end-stage renal disease, long-term complications and physiologic and psychologic sequelae resulting from donation remain unclear. Here, we examined the long-term results of living-related kidney donors who donated kidneys at the Baskent University Ankara Hospital over the past 25 years. Materials and Methods: We were able to examine 607 kidney transplant donors (mean age of 52.03 +/- 11.54 years) who were seen at our center from 1986 to 2021 and who agreed to a general health evaluation. Collected data included donor age, sex, blood type, body mass index, duration after donation, blood pressure measurements, biochemical parameters, abdominal ultrasonograph for size, structure, and renal blood flow of the solitary kidney, comorbid conditions, chronic drug use, and surgical procedures after donation. Results: Mean time after donation was 10.4 +/- 3.2 years. Twenty-four donors (3.9%) were diagnosed with diabetes and 21 (3.4%) with thyroid disease, 64 (10.5%) developed hypertension, and 48 (8.8%) developed atherosclerotic cardiovascular disease. Obesity was found to be an increasing problem in our donor population, with 174 (28.6%) developing mild to moderate obesity (body mass index >25 kg/m2). Older age, obesity, smoking, and hyperlipidemia were found to be the major and independent risk factors of both hypertension and atherosclerotic cardiovascular disease in donors. None of our donors developed endstage renal disease. Conclusions: Obesity and hypertension were the most common comorbidities that developed in our kidney donor population. Our principle is to avoid unrelated and nondirected donors because of the possible long-term complications. Unrelated donors may be desperate if a family member needs donation in the future.Item Anesthesia Management with Ultrasound Guided Thoracic Paravertebral Block for Donor Nephrectomy: A Prospective Randomized Study(2017) Yenidunya, Ozlem; Bircan, Huseyin Yuce; Altun, Dilek; Caymaz, Ismail; Demirag, Alp; Turkoz, Ayda; 28235492; AAR-7467-2020; R-6394-2019Study objective: To determine the efficacy of ultrasound-guided thoracic paravertebral block intraoperatively and 24 hours postoperatively in patients undergoing donor nephrectomy. Design: Prospective randomized controlled study. Setting: Private foundation university hospital; November 2014 to June 2015. Patients: Thirty-two patients undergoing donor nephrectomy (exclusion criteria: coagulation disorders, allergy to local anesthetics, and unwillingness to participate). The final study population comprised 30 patients (15 male, 15 female) randomly assigned to either Group P (paravertebral block, n = 14) or Group M (morphine, n = 16). Interventions: In Group P, a unilateral paravertebral catheter was inserted 1 day preoperatively; on the day of surgery, a single-level unilateral paravertebral block was administered through the catheter before general anesthesia. Infusion of bupivacaine continued intraoperatively and postoperatively. Patients in Group M received only general anesthesia, and morphine patient-controlled analgesia was begun postoperatively. Measurements: Intraoperative analgesic and anesthetic requirement, postoperative numerical rating scale pain scores, additional analgesic consumption during the postoperative period, and incidence of complications related to thoracic paravertebral block (TPVB) like pleural puncture, pneumothorax, epidural spread, injection into the subarachnoid space, intravascular injection, and Homer's syndrome and rate of opioid related adverse reactions like nausea and vomiting, itching, constipation, and respiratory depression. Results: Intraoperative remifentanil consumption was significantly higher in Group M, and postoperative morphine consumption was significantly lower in Group P (P <.001). During the first 24 hours postoperatively, the mean numerical rating scale pain scores were similar and there were no significant differences between the 2 groups. There were no statistically significant differences in the additional analgesic consumption and rate of adverse reactions between the 2 groups. We didn't detect any complication related to TPVB in group P. Conclusions: Continuous thoracic paravertebral block provides good intraoperative stability with a low anesthetic requirement and reduces postoperative morphine consumption for up to 24 hours. Ultrasound guided technique enhanced the safety of TPVB and provides analgesia without major complications. (C) 2016 Elsevier Inc. All rights reserved.Item Renal Stiffness on Patients with Gestational Diabetes(2017) Yilmaz, Birnur; Cevik, Halime; Bildaci, Tevfik Berk; Ozdogan, SerdincIntroduction: Gestational diabetes is defined as glucose intolerance first recognized in pregnancy. Oral glucose tolerance testing is the cornerstone in diagnosing gestational diabetes. In this study, we aimed to find a new method of diagnosis in addition to conventional diagnosed by 75 gr oral glucose tolerance testing. Material and methods: 121 pregnant woman were included part in this study, forming two groups as gestational diabetic patients (51 patients) and control group (70 pregnant woman). Both kidneys are evaluated with B Mode Ultrasound and Colour Doppler Ultrasound mode by measuring resistive index for depiction of other renal pathologies. Stiffness of renal tissue determined by Acoustic Radiation Force Impulse (ARFI) technology utilized by two blinded radiology specialists. Results: We were not able to find any correlation between gestational diabetes mellitus and resistivity index measurements (p > 0.05). But a correlation between second hour glucose levels in oral glucose tolerance test and bilateral renal stiffness was found (p < 0,05). Conclusion: ARFI ultrasound may be a non-invasive technique in determining the course of the disease.Item Value of in Vitro Acoustic Radiation Force Impulse Application on Uterine Adenomyosis(2018) Bildaci, Tevfik Berk; Cevik, Halime; Yilmaz, Birnur; Desteli, Guldeniz Aksan; 10.1007/s10396-017-0845-yAdenomyosis is the presence of endometrial glandular and stromal tissue in the myometrium. This phenomenon can be the cause of excessive bleeding and menstrual pain in premenopausal women. Diagnosis of adenomyosis may present difficulty with conventional methods such as ultrasound and magnetic resonance imaging. Frequently, diagnosis is accomplished retrospectively based on the hysterectomy specimen. This is a prospective case control study done in vitro on 90 patients' hysterectomy specimens. Acoustic radiation force impulse (ARFI) and color elastography were used to determine the elasticity of hysterectomy specimens of patients undergoing indicated surgeries. Based on histopathological examinations, two groups were formed: a study group (n = 28-with adenomyosis) and a control group (n = 62-without adenomyosis). Elasticity measurements of tissue with adenomyosis were observed to be significantly higher than measurements of normal myometrial tissue (p < 0.01). Uterine fibroids were found to have higher values on ARFI study compared to normal myometrial tissues (p < 0.01). The findings lead to the conclusion that adenomyosis tissue is significantly softer than the normal myometrium. ARFI was found to be beneficial in differentiating myometrial tissue with adenomyosis from normal myometrial tissue. It was found to be feasible and beneficial to implement ARFI in daily gynecology practice for diagnosis of adenomyosis.Item The Role of Shear-Wave Elastography in the Differentiation of Benign and Malign Non-Mass Lesions of the Breast(2018) Aslan, Hulya; Pourbagher, Aysin; Ozen, Merve; 0000-0002-7138-246X; 30569901; AAK-9104-2021; HCH-8774-2022AIM: The aim of this study is to retrospectively assess the additional diagnostic value of shear wave elastography (SWE) added to ultrasound (US) versus US alone in differentiating malignant and benign non-mass lesions (NMLs) of the breast by readers with different experience levels and to assess interreader agreement. MATERIAL AND METHODS: This retrospective study enrolled 53 NMLs (31 benign, 22 malignant). Two radiologists (readers 1 and 2 had 15 years and 1 year of experience in breast imaging, respectively) independently reviewed each study and determined the BI-RADS category using US alone and again after adding SWE to US. Diagnostic performances of US alone and US combined with SWE were compared for both readers. Areas under receiver operating characteristic curves (AUCs) were estimated. The levels of interobserver agreement were determined by the calculated kappa coefficient. RESULTS: With the addition of SWE to US, AUCs for differentiation of benign and malignant lesions increased sign/ icantly for the less experienced reader (0.56 vs. 0.79; p=0.028), but not for the more experienced reader (0.60 vs. 0.75; p=0.170). While evaluating US alone, the interobserver agreement was moderate, and the interobserver variability among the readers was statistically significant (k=0.493, p<0.001). After adding SWE, the agreement increased to 0.773, and the interobserver variability among the readers became non-significant (k=0.773, p=0.688) CONCLUSIONS: SWE increased the diagnostic performance of relatively less experienced reader significantly. SWE improved interobserver agreement of two readers with different levels of experience and reduced the interobserver variability in differentiating benign and malignant NMLs of the breast.