Acibadem Kayseri Hospital

Kayseri, Turkey

Acibadem Kayseri Hospital

Kayseri, Turkey
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Anterior cruciate ligament (ACL) injury is the most common ligament injury in the knee, and progressive instability and disability may develop in a significant number of patients. The incidence of ACL reconstruction is rapidly increasing, as is the number of failures. Although ACL reconstruction is a common procedure, less than satisfactory outcomes have been reported to occur in up to 25% of patients. The reasons for clinical failure after ACL reconstruction are numerous but can be broadly separated into 3 categories: technical, biological, and mechanical failures. It is generally thought that poor tunnel positioning (especially the femoral tunnel) is the most common technical error. Revision ACL reconstruction can be performed in 1 or 2 stages. The decision to perform a multistage approach is based on the position and size of the original tunnels. The varied success rates and associated advantages and disadvantages of each method have resulted in controversy as to the best treatment for revision ACL surgery. We describe our preferred operative technique to remove a fractured nitinol synthetic ACL graft and manage single-stage revision ACL reconstruction without bone grafting. © 2016 Arthroscopy Association of North America.

Mutlu H.,Acibadem Kayseri Hospital | Buyukcelik A.,Acibadem University | Akca Z.,Mersin Goverment Hospital | Erden A.,Kayseri Training and Research Hospital
Journal of Oncology Pharmacy Practice | Year: 2015

Capecitabine plus lapatinib combination is an effective chemotherapy regimen in patients with advanced breast cancer. Neurological adverse effects secondary to this regimen were reported rarely in literature. A woman with breast cancer presented with complaints of slurred speech while using the capecitabine and lapatinib combination. Her major complaint was slurred speech. No other radiologic or laboratory disorders were detected in the patient. Slurred speech improved one week after the capecitabine and lapatinib combination was discontinued without any further intervention. © The Author(s) 2013 Reprints and permissions:

Mutlu H.,Acibadem Kayseri Hospital | Buyukcelik A.,Acibadem University | Erden A.,Kayseri Training and Research Hospital | Aslan T.,Kayseri Training and Research Hospital | And 6 more authors.
Asian Pacific Journal of Cancer Prevention | Year: 2013

Background: Of patients with non small cell lung cancer (NSCLC), around one third are locally advanced at the time of diagnosis. Because only a proprotion of stage III patients can be cured by surgery, in order to improve the outcomes , sequential or concurrent chemoradiation, or concurrent chemoradiation with induction or consolidation is offered to the patients with locally advanced NSCLC. Today, PET combined with computerized tomography (PET-CT) is accepted as the most sensitive technique for detecting mediastinal lymph node and extracranial metastases from NSCLC. We aimed to compare PET-CT and conventional staging procedures for decisions regarding curative treatment of locally advanced NSCLC. Materials and Methods: A total of 168 consecutive patients were included from Acibadem Kayseri Hospital, Acibadem Adana Hospital and Kayseri Research and Training Hospital in this study. Results: While the median PFS was 13.0±1.9 months in the PET-CT group, it was only 6.0±0.9 in the others (p<0.001). The median OS values were 20.5±15.6 and 11.5±1.5 months, respectively (p<0.001). Discussion: As a result, we found that staging with PET CT has better results in terms of survival staging. This superiority leads to survival advantage in patients with locally advanced NSCLC.

PubMed | Kayseri Research and Training Hospital, Acibadem Kayseri Hospital, Mersin Goverment Hospital and Acibadem University
Type: Journal Article | Journal: Medical archives (Sarajevo, Bosnia and Herzegovina) | Year: 2013

Only 20% of patients with stage III NSCLC are cured by surgery. There is a disagreement among the oncologists in terms of whether which regimen (induction chemotherapy followed chemoradiotherapy, concurrent chemoradiation or concurrent chemoradiation followed consolidation chemotherapy) is best choice in inoperable LA NSCLC.To evaluate chemotherapy timing in inoperable LA NSCLC (before, only concomitant or after curative chemotherapy).Total of 74 consecutive patient with LA NSCLC which was inoperable due to medical condition or stage from Kayseri Research and Training Hospital were analyzed retrospectively. The patients were divided into three groups according to treatment protocols: Induction chemotherapy followed chemoradiotherapy (Ind. CTCRT), chemoradiotherapy (CRT) and chemoradiotherapy followed consolidation chemotherapy (CRTCons. CT).When evaluating progression free survival (PFS), PFS did not significantly differed among the groups (p=0,078). We found significant difference among groups (p = 0.047) in terms of overall survival. While CRTCons. CT arm had highest mean and median survival times, Ind. CTCRT arm had worst OS.CRTCons. CT treatment modality seems preferable regimen for treatment of inoperable LA NSCLC.

PubMed | Acibadem Kayseri Hospital, Kafkas University, U.S. National Institutes of Health and Acibadem University
Type: Journal Article | Journal: Urology journal | Year: 2015

Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) is a chronic pain condition and a common problem in urology clinics. Although many different etiologies and mechanisms exist, the exact cause of the disease has been unknown. Central sensitization (CS) is defined as an augmentation of responsiveness of central cortical neurons to input from peripheral nociceptive structures. Somato-sensory evoked potentials (SEPs) is an electroneurophysiological method to assess cortical activity in somatosensory area of brain related to sensorial stimuli. We aimed to determine the presence of CS using the SEPs of dorsal penile nerve stimulation in patients with CP/CPPS.Seventeen male patients diagnosed CP/CPPS and 17 male healthy controls were prospectively included in the study. For SEP study, electrical stimulus was applied with penile ring electrodes. Recording electrodes were placed as active to Cz and reference electrode on Fz according to the 10-20 International System. Latency of N50 was defined as the second negative (up-ward) deflection of the W-shaped averaged cortical waveform.N50 latencies were significantly shortened in the patient group compared to the healthy controls (P < .001).These results support the presence of central sensitization because of exaggerated trans-mission of pain sensation to the somatosensory cortex. Therefore, normalization of transmission might be an important step in treatment of pain in patients with CP/CPPS. This study can be counted as an important guiding on pathogenesis and treatment of disease.

Basaran A.,ACIBADEM Kayseri Hospital | Basaran M.,Konya Education and Research Hospital | Topatan B.,Baskent University
Archives of Gynecology and Obstetrics | Year: 2011

Objective: To perform systematic review and meta-analysis to evaluate the risk of preeclampsia after chorionic villus sampling (CVS). Data sources: A systematic search of PubMED and Web of Science from inception through August 2010, and bibliographies of review articles and eligible studies were performed. Methods of study selection: Six studies reported the risk of preeclampsia after CVS. All of the identified studies were retrospective and included in analysis. Tabulation, integration, and results: Reporting quality of the identified studies according to quality assessment scale for methodology in retrospective clinical reporting was moderate. Pooling was performed in two strata for control: (1) patients without any invasive prenatal diagnostic procedure served as control group: no significant difference was found in the odds ratio (OR) of preeclampsia (OR 0.79, 95% CI 0.38-1.64), severe preeclampsia (OR 0.49, 95% CI 0.04-5.78), gestational hypertension (OR 0.76, 95% CI 0.46-1.26), all pregnancy-induced hypertensive disorders (OR 0.80, 95% CI 0.46-1.41) between CVS and control groups. (2) Patients with amniocentesis combined with patients without any invasive prenatal diagnostic procedure served as control group: no significant difference was found in the OR of preeclampsia (OR 0.76, 95% CI 0.37-1.53), severe preeclampsia (OR 0.83, 95% CI 0.14-4.85), all pregnancy-induced hypertensive disorders (OR 0.92, 95% CI 0.55-1.53) between CVS and combined control groups. Conclusion: None of the included studies were randomized prospective trials designed to investigate the effect of CVS on preeclampsia. Accordingly, this review is limited by the heterogeneity, small number and retrospective nature of the available studies. CVS does not seem to increase the risk of preeclampsia or other pregnancy-induced hypertensive disorders. However, randomized prospective trials that are designed to investigate the risk of preeclampsia after CVS are needed to make a definite conclusion. © 2011 Springer-Verlag.

PubMed | Acibadem Kayseri Hospital, Kayseri Education and Research Hospital of Medicine and Kayseri Military Hospital
Type: Journal Article | Journal: International journal of surgery case reports | Year: 2014

Ovarian torsion (OT) is a rare cause of acute abdominal pain that requires prompt recognition and treatment during puerperium. Diagnosis of OT can be challenging due to nonspecific clinical features and uncommon objective findings. The management of OT is often delayed because of diagnostic uncertainty. Early and timely recognition and prompt intervention are crucial to preserve ovarian function and to minimize morbidity.We report a 29-year-old postpartum woman who presented to the emergency department (ED) with severe right flank pain, nausea and anorexia initially considered as renal colic. After further investigation, OT caused by large mucinous cyst was diagnosed. Right-sided salpingo-oophorectomy was performed due to hemorrhagic ovary and huge cystic mass causing ischemic OT.OT is often diagnosed based on the clinical presentation, including severe, sharp, sudden onset of unilateral lower abdominal pain and tenderness with a palpable laterouterine pelvic mass and nausea/vomiting. Emergency surgical intervention should be performed if OT is suspected to confirm the diagnosis and uncoil the twist to prevent ovarian damage.In conclusion, emergency physicians should be aware of the possibility of OT in postpartum women. Therefore, early and timely surgical intervention should be undertaken.

Basaran A.,ACIBADEM Kayseri Hospital | Basaran M.,Konya Education and Research Hospital | Topatan B.,University of Konya
Obstetrical and Gynecological Survey | Year: 2010

Objective. To perform a systematic review and meta-analysis of the effectiveness of combined vitamin C and E (vitCE) supplementation for the prevention of preeclampsia. Data Sources. PubMED, Web of Science, and Cochrane Central Register of Controlled Trials from inception through June 2010, and bibliographies of review articles and eligible studies. Methods of Study Selection. Fifteen eligible studies that evaluated vitCE supplementation for the prevention of preeclampsia were identified. On the basis of prespecified inclusion and exclusion criteria, 9 were included in the meta-analysis. All were randomized controlled trials. The reporting and methodologic quality of the included studies was assessed with the CONSORT checklist and the Jadad scale. Tabulation, Integration, and Results. The 9 included studies had moderate-to-high CONSORT and Jadad scores. The incidence of preeclampsia was 9.7% (949 of 9833) in the vitCE group and 9.5% (946 of 9842) in the placebo group. A random effects model was used for pooling and no difference was found in the relative risk (RR) of preeclampsia between the vitCE and placebo groups (RR: 0.98; 95% confidence interval [CI]: 0.87-1.10). The incidence of gestational hypertension was 22.6% (1915 of 8491) in the vitCE group and 20.3% (1728 of 8500) in the placebo group (RR: 1.11, 95% CI: 1.05-1.17). The incidence of placental abruption was 0.58% (43 of 7379) in the vitCE group and 0.87% (64 of 7361) in the placebo group (RR: 0.67, 95% CI: 0.46-0.98). No significant differences were observed for other maternal and neonatal outcomes. Conclusion. Combined VitCE supplementation does not decrease the risk of preeclampsia and should not be offered to gravidas for the prevention of preeclampsia or other pregnancy induced hypertensive disorders. Furthermore, combined supplementation with vitCE increased the risk of GH but decreased the risk of placental abruption. However, these latter associations may not be causal, especially since they were the product of multiple statistical comparisons, and the 95% CI around the point estimates almost included one. Learning Objectives: After completion of this educational activity, the obstetrician/gynecologist should be better able to assess the causes of preeclampsia and related conditions; evaluate and interpret the evidence regarding the use of combined vitamins C and E in prevention of preeclampsia and related conditions; and interpret and understand the effects of the supplementation of vitamins C and E for the prevention of preeclampsia or other pregnancy induced hypertensive disorders. Target Audience: Obstetricians & Gynecologists, Family Physicians. © Copyright 2010 by Lippincott Williams & Wilkins.

Basaran A.,ACIBADEM Kayseri Hospital | Basaran M.,Konya Education and Research Hospital | Sen C.,Istanbul University
Journal of Maternal-Fetal and Neonatal Medicine | Year: 2012

Objective: Maternal corticosteroid administration has been reported to improve the blood pressure, urine output, laboratory values of liver enzymes and platelets in HELLP syndrome. In this controversial subject, recently, Cochrane Database had updated its systematic review and in the subgroup analysis they indicated that dexamethasone was superior to betamethasone for the improvement of platelet counts and liver enzymes. However, there are several issues which need to be clarified about the subgroup analysis and the consequent conclusion. Methods: Systematic review and re-analysis of the indicated studies. Results: In the subgroup analysis two studies were included, which had used non-parametric methods for statistical analysis and yielded insignificant p-values that showed indifference between betamethasone and dexamethasone. However, the Cochrane meta-analysis had used parametric methods in contradistinction to the included studies and indicated significant difference between two steroids. Accordingly, results and conclusions of the Cochrane meta-analysis in this subgroup analysis cannot be justified with the indicated two studies. Conclusion: Here we can only urge further studies to provide frank evidence about the comparison of dexamethasone and betamethasone in HELLP syndrome. Until shown to be true, we doubt the credibility of the subgroup analysis results of the Cochrane review and the application of these subgroup results into clinical practice. © 2012 Informa UK, Ltd.

PubMed | Acibadem Kayseri Hospital and Bozok University
Type: | Journal: Acta orthopaedica et traumatologica turcica | Year: 2016

Alkaptonuria is a rare metabolic disease caused by a partial or total deficiency of homogentisic acid oxidase, which results in excess homogentisic acid (HGA) levels. Homogentisic acid and its oxidation products can accumulate in hyaline cartilage, tendons, and ligaments. A 55-year-old male was admitted complaining of worsening chronic pain in his left knee. A radiographic evaluation showed tricompartmental end- stage osteoarthritis. A cemented total knee replacement was performed. At the 10-year follow-up, he had returned to full activity, had no knee pain, and was very satisfied with the outcome. No abnormality was observed in the femoral, tibial, or patellar components on radiography. We believe that total knee replacement is a good option in a patient with marked degenerative arthritis secondary to ochronotic arthritis.

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