Ankara Educational and Research Hospital

Ankara, Turkey

Ankara Educational and Research Hospital

Ankara, Turkey
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Basar O.,Dskap Yldrm Beyazt Educational and Research Hospital | Akbal E.,Ankara Educational and Research Hospital | Koklu S.,Ankara Educational and Research Hospital | Kocak E.,Ankara Educational and Research Hospital | And 5 more authors.
Scandinavian Journal of Clinical and Laboratory Investigation | Year: 2012

Background and aims. Non-alcoholic fatty liver disease (NAFLD) is one of the most common liver pathology worldwide and is strongly associated with obesity and insulin-resistance and food intake. Nesfatin-1 is a new peptide that controls appetite and food intake. The objective of this research was to examine the serum concentrations of nesfatin-1 in NAFLD. Material and methods. Thirty NAFLD patients who had elevated liver enzymes and 40 age-and sex-matched healthy subjects were included in this study. NAFLD was diagnosed and graded with the findings of liver ultrasound scan. Nesfatin-1 concentrations were measured using an ELISA method and the relationship between nesfatin-1 and metabolic parameters were investigated. The subjects were divided into two groups according to their body mass index (≥30 and <30) and nesfatin-1 concentrations were examined between both groups. Results. Serum nesfatin-1 concentrations in NAFLD patients were lower than healthy controls (0.26±0.14 ng/ml, 0.38±0.18 ng/ml, respectively, and p 0.008). We found a negative correlation between nesfatin-1 and fasting glucose and body mass index. In obese subjects, serum nesfatin-1 concentrations were significantly lower when compared with non-obese subjects (0.26±0.12 ng/ml, 0.37±0.19 ng/ml, respectively; p 0.014). In addition, we showed that nesfatin-1 concentrations in subjects with insulin resistance were significantly lower in comparison with insulin-sensitive ones (0.27±0.17 ng/ml, 0.38±0.17 ng/ml, respectively; p 0.015). Conclusion. Our study has shown that nesfatin-1 concentrations were reduced in NAFLD. The results of this study indicate that nesfatin-1 may have a significant role in NAFLD. © 2012 Informa Healthcare.


PubMed | Sakarya Educational and Research Hospital and Ankara Educational and Research Hospital
Type: Journal Article | Journal: European journal of ophthalmology | Year: 2016

To describe and compare ocular surface changes in patients with type 2 diabetes treated with either oral antidiabetic drugs (OAD) or insulin.Forty eyes of 20 patients treated with OAD, 40 eyes of 20 patients treated with insulin, and 10 nondiabetic controls seen at Ministry of Health Ankara Educational and Research Hospital, 1st Eye Clinic, were studied. All subjects underwent routine ophthalmic examinations, Schirmer test, tear film break-up time analysis, and conjunctival impression cytologic analysis. Patients treated with OAD or insulin and a control group were compared for tear function parameters, goblet cell density, and squamous metaplasia grade. The relation between status of retinopathy and ocular surface disorder and serum HbA1c levels of diabetic patients were also noted.The tear film break-up time values were significantly lower in patients treated with OAD (p<0.05). There was no statistically significant difference in Schirmer test results of the 3 groups. Goblet cell density and squamous metaplasia grade were similar in all groups. The median grade was grade 1, in which epithelial cells are slightly larger, more polygonal, have eosinophilic staining cytoplasm, and goblet cells are decreased in number. Status of retinopathy did not seem to relate to ocular surface disorder. The serum HbA1c level of diabetic patients treated with insulin or OAD was similar (p>0.05).Precorneal tear film stability was worse in patients treated with OAD; however, impression cytology analysis and Schirmer test results were similar in all groups.


Komurcu E.,Canakkale Onsekiz Mart University | Yuksel H.Y.,Ankara Numune Educational and Research Hospital | Ersoz M.,Ankara Physical Medicine and Rehabilitation Training and Research Hospital of Ministry of Health | Aktekin C.N.,Ankara Educational and Research Hospital | And 4 more authors.
Knee Surgery, Sports Traumatology, Arthroscopy | Year: 2014

Purpose: The aim of this study was to evaluate the effect of knee position during wound closure (flexed vs. extended) in total knee arthroplasty on knee strength and function, as determined by knee society scores and isokinetic testing of extensor and flexor muscle groups.Methods: In a prospective, randomized, double-blind trial, 29 patients were divided in two groups: for Group 1 patients, surgical closing was performed with the knee extended, and for Group 2 patients, the knee flexed at 90°. All the patients were treated with the same anaesthesia method, surgical team, surgical technique, prosthesis type, and rehabilitation process. American Knee Society Score values and knee flexion degrees were recorded. Isokinetic muscle strength measurements of both knees in flexion and extension were taken using 60° and 180°/s angular velocity. The peak torque and total work values, isokinetic muscle strength differences, and total work difference values were calculated for surgically repaired and healthy knees.Results: No significant difference in the mean American Knee Society Score values and knee flexion degrees was observed between the two groups. However, using isokinetic evaluation, a significant difference was found in the isokinetic muscle strength differences and total work difference of the flexor muscle between the two groups when patients were tested at 180°/s. Less loss of strength was detected in the isokinetic muscle strength differences of the flexor muscle in Group 2 (−4.2 %) than in Group 1 (−23.1 %).Conclusion: For patients undergoing total knee arthroplasty, post-operative flexor muscle strength is improved if the knee is flexed during wound closure.Level of evidence: II. © 2014, Springer-Verlag Berlin Heidelberg.


Kizilkan N.,University of Gaziantep | Davutoglu V.,University of Gaziantep | Erbagci H.,University of Gaziantep | Karagoz A.,University of Gaziantep | And 4 more authors.
Saudi Medical Journal | Year: 2010

Objectives: To evaluate the usefulness of examining the coronary sinus (CS) anatomic diameter as an additional surrogate marker of severity in chronic rheumatic valve disease (RVD). Methods: In this cross-sectional observational study, we echocardiographically analyzed 88 patients with RVD, and 104 normal subjects in the Department of Cardiology, Gaziantep University Medical Faculty, Gaziantep, Turkey between February 2007 and April 2007. Echocardiographically all valve regurgitation, stenosis, left ventricular function, left/right atrial volume, and pulmonary artery pressure were obtained. Coronary sinus was assessed as a sonolucency in the posterior atrioventricular groove. Results: Strong positive correlation was present between CS measurements and mitral mean gradient, mitral and tricuspid regurgitation grade, tricuspid stenosis gradient, pulmonary artery systolic pressure, left and right atrial volume, and New York Heart Association class. A statistically negative correlation was present between CS measurements and mitral valve area and ejection fraction. Only the mitral valve area, tricuspid regurgitation grade, and the right atrial volume were predictors of body surface area adjusted mean CS dilatation. Conclusion: In this preliminary study, we showed that echocardiographic assessment of dilated CS may provide useful additional information in predicting the severity of mitral/tricuspid RVD. Findings of this study needs to be confirmed in further studies.


Akcay A.B.,Mustafa Kemal University | Yuce M.,University of Gaziantep | Akcay M.,Ankara Educational and Research Hospital | Sen N.,Mustafa Kemal University | And 2 more authors.
Clinical and Applied Thrombosis/Hemostasis | Year: 2011

We present a 15-week pregnant woman who developed mechanical mitral valve thrombosis on a fixed dose of enoxaparin therapy 60 mg twice daily. No reductions were observed in the thrombus size or mean mitral gradient on transesophageal echocardiography (TEE) with 1 week of unfractioned heparin therapy. As the thrombus on TEE imaging was hypermobile and fragile, in addition to a higher dose of enoxaparin (80 mg twice daily), trofiban infusion 0.20 μg/kg per minute was administered for another 1 week. The thrombus on the valve was reduced in size, mobility and fragility of the thrombus diminished, and mean valve gradient decreased on TEE. As complete thrombus resolution was not observed and limitation of valve mobility continued, tissue plasminogen activator (tPA) was given to the patient. A complete thrombus resolution was observed on this therapy. The patient is presented for being the first case in literature whose valvular thrombus reduced with trofiban therapy. © SAGE Publications 2011.


Ozer O.,University of Gaziantep | Davutoglu V.,University of Gaziantep | Soydinc H.E.,University of Gaziantep | Cebesoy F.B.,Konukoglu Medical Center | And 2 more authors.
Clinical and Applied Thrombosis/Hemostasis | Year: 2010

The incidence of prosthetic valve thrombosis (PVT), which is a life-threatening complication, increased during pregnancy because of the hypercoagulable state. Despite adequate anticoagulation, the incidence of PVT has been estimated as 4% to 14% during pregnancy. Prosthetic valve thrombosis occurring during pregnancy requires urgent therapy including fibrinolytic therapy, valve replacement, and surgical thrombectomy due to high mortality. Although surgery has traditionally been the standard procedure for treatment of PVT, fibrinolytic therapy may be used as first-line therapy according to data from the recent reports. Data about the fibrinolytic therapy is scarce and controversial in the setting of pregnancies complicated with PVT. Herein, we share the outcomes of 3 pregnant women complicated with PVT and treated with recombinant tissue-type plasminogen activator. © 2010 The Author(s).


Altay A.,Ankara University | Bozdayi G.,Ankara University | Meral M.,Ankara University | Dallar Bilge Y.,Ankara Educational and Research Hospital | And 3 more authors.
Mikrobiyoloji Bulteni | Year: 2013

Norovirus causes severe gastroenteritis requiring hospitalization especially in children less than five years of age both in developed and developing countries. Therefore, we aimed to investigate the incidence of norovirus (NoV) in 0-5 years old children with acute gastroenteritis in two large hospitals in Ankara, Turkey. Stool samples were obtained from 1000 (413 female, 587 male) children between 0-5 years old with acute gastroenteritis who attended to the Department of Paediatrics, Ministry of Health Ankara Training and Education Hospital and affiliated hospital of Gazi University Faculty of Medicine between October 2004 and June 2011. Antigens of norovirus GI and GII genogroups in the stool specimens were detected by ELISA(RIDASCREEN® Norovirus (C1401) 3rd Generation, R-Biopharm, Germany). Norovirus GI and GII antigens were determined in a total of 141 (14.1%) samples, of them 62 (15%) were female and 79 (13.5%) were male, yielding no statistically significant difference (p>0.05). The highest NoV positivity was detected in children between 12-23 months (17.1%), however there was no statistically significant difference between ELISA positivity and age (p>0.05). NoV detection rate was highest in 2007 (18.4%) and in 2009 (18%), and the difference regarding ELISA positivity among the study years was not statistically significant (p>0.05). The prevalences of norovirus infection in spring, summer, autumn and winter were 13.8%, 17.7%, 14.7% and 11.2%, respectively. Therefore no seasonal variation was found in the incidence of norovirus infection. However when the monthly prevalence was analyzed, a statistically significant difference was found (p<0.05) between the rate of norovirus infection in July (24.2%) and december (4.1%). When evaluating the clinical symptoms, all of 141 patients (100%) had diarrhoea, while 72 (51.1%) had vomiting. Stool samples were also evaluated for the presence of parasitic and bacterial agents. Confection rate with parasites was detected as 3.3% (4/122; norovirus + Entamoeba histolytica in three cases, norovirus + Enterobius vermicularis in one case), while no pathogenic bacteria were isolated from norovirus positive stool samples. The prevalence rate of 14.1% for NoV GI/GII infection detected in this retrospective study including 0-5 years old children in Ankara for 20042011 period was thought to reflect the regional data and would contribute to national epidemiological data. We anticipate that the incidence of norovirus will increase in 0-5 year old children as a result of increasing use of rotavirus vaccine in Turkish children. It was concluded that, NoV antigen detection tests should be used in routine laboratories for appropriate diagnosis of sporadic and/or epidemic norovirus infections.


Duranay M.,Ankara Educational and Research Hospital | Kanbay M.,Ankara Educational and Research Hospital | Akay H.,Ankara Educational and Research Hospital | Unverdi S.,Ankara Educational and Research Hospital | And 5 more authors.
Nephron - Clinical Practice | Year: 2010

Renal artery stenosis (RAS) is a progressive disease and may lead to chronic kidney disease by deterioration of renal functions. Endothelial dysfunction is an important causative factor for kidney damage after RAS revascularization. Nebivolol, a new generation beta blocker induces endothelium-related arterial relaxation by nitric oxide (NO) and may improve endothelial dysfunction. This pilot study tested the effect of nebivolol on the glomerular filtration rate (GFR) in a series of 33 patients with severe RAS (>70%) who underwent revascularization. After revascularization, nebivolol was added to antihypertensive treatment in 17 randomly selected patients while 16 patients (control group) continued their standard treatment. Estimated glomerular filtration rate (eGFR), proteinuria as well as nitrite and nitrate levels were measured at baseline and 6 months after the revascularization procedure. Six months after revascularization, eGFR increased from 44.8 to 50.6 ml/min in the nebivolol group. In contrast, eGFR did not change in the control group. Nitrite/nitrate levels decreased to a significant extent both in the nebivolol and in the control group. Proteinuria decreased more in the nebivolol group compared to the control group. These pilot data support a full-fledged clinical trial, testing whether nebivolol may be beneficial in the post-revascularization phase in patients with RAS. © 2009 S. Karger AG, Basel.


Ekiz F.,Diskapi Yildirim Beyazit Educational and Research Hospital | Yuksel O.,Diskapi Yildirim Beyazit Educational and Research Hospital | Kocak E.,Ankara Educational and Research Hospital | Yilmaz B.,Diskapi Yildirim Beyazit Educational and Research Hospital | And 5 more authors.
Journal of Clinical Laboratory Analysis | Year: 2011

Introduction: Many noninvasive tests have been studied for the diagnosis and determining the liver fibrosis score (LFS). In this study, we aimed to research the correlation of mean platelet volume (MPV) and stage of liver fibrosis in patients with chronic hepatitis B (CHB). Patients and Methods: Fifty-nine patients with CHB were enrolled retrospectively into the study. Age-sex matched 25 healthy subjects were used as control group. The following data were obtained from computerized patient registry database: HBV-DNA level, hepatitis B e-antigen seropositivity, liver enzymes and function tests, white blood cell count, platelet count, hemoglobin, histological activity index, LFS, and MPV. Patients were divided into two groups: patients without significant fibrosis (F0, F1, or F2) (Group 1) and patients with advanced fibrosis (F3, F4) (Group 2). Results: A statistically significant increase in MPV was seen in patients with CHB compared with healthy controls (8.49±0.84fl vs.7.65±0.42fl, P<0.001). Receiver operating characteristic curve analysis suggested that the optimum MPV level cut-off points for CHB was 8.0fl, with sensitivity, specificity, PPV, and NPV of 68, 76, 86, and 50%, respectively. MPV levels were significantly higher in Group 2 (8.91±0.94fl, P: 0.009) compared with Group 1 (8.32±0.74fl). ROC curve analysis suggested that the optimum MPV level cut-off points for Group 2 was 8.45fl, with sensitivity, specificity, positive and negative predictive value of 77, 59, 45, and 85%, respectively. Multivariable logistic regression model, which consisted of HAI, ALT, HBV-DNA, platelet count, and MPV, was performed. We showed that MPV was independently associated with advanced fibrosis (P: 0.031). Conclusion: We suggest that MPV might help in the assessment of fibrosis in CHB. It should not be considered a stand-alone test for this use owing to nonspecificity with other diseases. © 2011 Wiley-Liss, Inc.


Cakr B.K.,Sakarya Educational and Research HospitalSakarya | Katrcoglu Y.,Ankara Educational and Research Hospital | Unlu N.,Ankara Educational and Research Hospital | Duman S.,Ankara Educational and Research Hospital | Ustun H.,Ankara Educational and Research Hospital
European Journal of Ophthalmology | Year: 2016

Purpose: To describe and compare ocular surface changes in patients with type 2 diabetes treated with either oral antidiabetic drugs (OAD) or insulin. Methods: Forty eyes of 20 patients treated with OAD, 40 eyes of 20 patients treated with insulin, and 10 nondiabetic controls seen at Ministry of Health Ankara Educational and Research Hospital, 1st Eye Clinic, were studied. All subjects underwent routine ophthalmic examinations, Schirmer test, tear film break-up time analysis, and conjunctival impression cytologic analysis. Patients treated with OAD or insulin and a control group were compared for tear function parameters, goblet cell density, and squamous metaplasia grade. The relation between status of retinopathy and ocular surface disorder and serum HbA1c levels of diabetic patients were also noted. Results: The tear film break-up time values were significantly lower in patients treated with OAD (p<0.05). There was no statistically significant difference in Schirmer test results of the 3 groups. Goblet cell density and squamous metaplasia grade were similar in all groups. The median grade was grade 1, in which epithelial cells are slightly larger, more polygonal, have eosinophilic staining cytoplasm, and goblet cells are decreased in number. Status of retinopathy did not seem to relate to ocular surface disorder. The serum HbA1c level of diabetic patients treated with insulin or OAD was similar (p>0.05). Conclusions: Precorneal tear film stability was worse in patients treated with OAD; however, impression cytology analysis and Schirmer test results were similar in all groups. © 2015 Wichtig Publishing.

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