PubMed | Eskiehir Osmangazi University, Dumlupnar University Evliya Celebi Training and Education Hospital and Bagcilar Research and Training Hospital
Type: | Journal: The West Indian medical journal | Year: 2016
Hypotension, hypoxia or hypotension and hypoxia together may proceed to ischaemic hepatitis; hypotension is often as a result of cardiovascular diseases. Ischaemic hepatitis not due to cirrhotic process or malignancy but due to acute thrombosis of the portal venous system is rare. In this article, we present a case of acute ischaemic hepatitis due to an acute thrombus developing after a ketoacidosis coma which was thought to have triggered this event. Other reasons which could be have triggered this event, such as a thrombophilia and cirrhosis or malignancy, were excluded.
Basaran K.,Bagcilar Research and Training Hospital |
Saydam F.A.,Bagcilar Research and Training Hospital |
Ersin I.,Bagcilar Research and Training Hospital |
Yazar M.,Sisli Etfal Hospital Istanbul |
Aygit A.C.,Istanbul Kemerburgaz University
Aesthetic Plastic Surgery | Year: 2014
Background: Although the free-nipple breast-reduction technique is essentially an amputation, achieving aesthetic results still is important. The authors present their technique for free nipple–areola complex (NAC) transfer over the superomedial or superior pedicle full-thickness flaps in patients for whom a free-nipple technique is inevitable due to certain risk factors.Methods: The study included 25 patients who underwent surgery with the aforementioned method for addressing severe gigantomastia. The patients had a mean age of 43 years (range 34–59 years) and a mean body mass index (BMI) of 35.8 kg/m2 (range 28–42 kg/m2). During the operation, the NAC was elevated as a full-thickness skin graft, then transposed to the superior or superomedial pedicles, which had been planned previously. The subsequent stages of the operation thus became a Wise-pattern breast reduction.Results: The mean resection per breast was 1,815 g (range 1,620–2,410 g). Breast projection, shape, and areolar pigmentation were assessed during the follow-up visit. One patient experienced a partial loss of the NAC graft, which healed secondarily, and three patients experienced a patchy hypopigmentation of the NAC. Breast projection and conical structure were observed to be preserved during the follow-up period.Conclusions: The modified free-nipple technique aimed to convert the reduction procedure to a technique similar to pedicle methods, yielding successful results during the early phases. The full-thickness flap constructed in this way provides more fullness and a maximum contribution to projection in patients who will inevitably undergo breast reduction with the free-nipple method. © Springer Science+Business Media New York and International Society of Aesthetic Plastic Surgery 2014.
PubMed | Harran University, Izmir Kâtip Celebi University, 14th Family Health Care Center and Bagcilar Research and Training Hospital
Type: | Journal: Journal of endourology | Year: 2016
To compare the efficacy between motorized articulating (AI) and rigid conventional laparoscopic instruments (CI) in chancing visualizing systems, respectively 2-dimension (2D) and 3-dimension (3D).Sixty physicians were divided into 3 groups according to their previous experience as medical students (Group 1), residents (Group 2), and expert surgeons (Group 3). Four experimental sets were created, respectively CI-2D visualizing system (CI-2D), CI-3D visualizing system (CI-3D), AI-2D visualizing system (AI-2D), and AI-3D visualizing system (AI-3D) platforms. European training in basic laparoscopic urological skills (E-BLUS) and anastomosis tasks (n total 5 tasks) were used. All participants were randomly required to perform tasks in each one of the technical platforms, except anastomosis exercises that was performed as the last exercises. Duration of tasks were measured and predefined errors were counted. All these were recorded and successfully completion quality samples were evaluated. Significant p was p<0.05.Significant time reduction and improvement in quality of tasks were observed in favour of Group 3, in all sets for all tasks (p<0.001). Quality of the tasks were significant improved in AI-3D in Group 1 and Group 2 for all tasks. Task 5 was the most difficult one and needed more experience to complete with quality. Even, Group 3 was the experienced group, AI with 3D display provided Group 3 to improve performance with increased quality without statistical significance.The AI-3D visualizing system can provide more successful completion in E-BLUS tasks than CI-2D, AI-2D, and CI-3D visualizing systems for the beginners in urologic laparoscopy, not for experts. Besides, AI with 3D display provide surgeons to improve their performance with increased quality of tasks, in anastomosis.
Tas B.,Bagcilar Research and Training Hospital |
Turker K.,Bagcilar Research and Training Hospital |
Balci E.,Erciyes University
Archives of Iranian Medicine | Year: 2016
Background: Anogenital warts (AGWs) are epithelial tumors which develop as a result of human papilloma virus (HPV) infection. We aimed to assess the sociodemographic, sexual and other possible risk-factors, and awareness of the HPV infection among Turkish people with AGW in the Bagcilar district of Istanbul. Methods: A cross-sectional study was conducted on 273 patients (183 men, 90 women) with AGW between October 2014 - March 2015. The patients’ sociodemographics were recorded along with their possible risk-factors and clinical findings. The patients’ answers to questions regarding HPV/AGW were checked for awareness. Data were analyzed by Chi-square test using SPSS (Statistical Package for the Social Sciences) version 15.0. The results were evaluated with P < 0.05 considered significant. Results: The major parameters detected were 26-39 age-range (52.6%), self-employed (54.6%), primary school graduate (44,7%), low/ middle income (91.2%), married (59.3%), heterosexual (98.9%), sexually active (93.8%), sex in previous 3 months (87,6%), multi-partners (53.5%), partners without AGW (60.8%), mixed location (32.2%), concomitant verruca on hands (26%), 3-6 month duration (38.8%), nonrecurrent lesion (98.2%), tinea cruris [TC](25.3%) and smoking (54.2%). However, self-employed (70.5%), middle-income (47%), polygyny (71.6%), pubic-location (43.2%), long-duration (46.4%), concomitant TC (31.7%) diabetes mellitus (9.8%), and verruca on hands (33.3%) were mostly encountered in males, while housewife (57.7%), low-income (60%), monoandry (67.8%), perianal-location (48.9%), short-duration (58.9%), smoking (64.4%), concomitant candidiasis (15.6%) and depression (31.1%) were mostly found in females. Awareness of HPV hearing, HPV-AGWand HPV-cancer relationships, transmission-routes, risk-factors (each at 5.5%), and prevention methods (2.2%) was very low. Conclusions: AGWs are seen in sexually-active, less-educated, married heterosexuals in Bagcilar. Self-employed, middle-income, polygyny, pubic-location, long-duration, concomitant TC and diabetes mellitus, and verruca on hands are mostly seen in males, while housewife, low-income, monoandry, perianal-location, short-duration, smoking, candidiasis and depression are more common in females. Awareness is very low. © 2016, Academy of Medical Sciences of I.R. Iran. All rights reserved.
Kaya A.,Istanbul University |
Ergul N.,Bagcilar Research and Training Hospital |
Kaya S.Y.,Istanbul University |
Kilic F.,Istanbul University |
And 3 more authors.
Expert Review of Anti-Infective Therapy | Year: 2013
Prolonged fever presents a challenge for the patient and the physician. Fever with a temperature higher than 38.3°C on several occasions that lasts for at least 3 weeks and lacks a clear diagnosis after 1 week of study in the hospital is called a fever of unknown origin (FUO). More than 200 diseases can cause FUO, and the information gathered from history taking, physical examination, laboratory and imaging studies should be evaluated with care. History taking and physical examination may provide some localizing signs and symPToms pointing toward a diagnosis. Infection, cancers, noninfectious inflammatory diseases and some miscellaneous diseases are the main etiologies, and some patients remain undiagnosed despite investigations. Tuberculosis, lymphoma and adult-onset Still's disease are the main diseases. Fluorodeoxyglucose PET is a promising imaging modality in FUO. Establishing a uniform algorithm for FUO management is difficult. Every patient should be carefully evaluated individually considering the previous FUO management experience. © 2013 Informa UK Ltd.
Gumus F.,Bagcilar Research and Training Hospital |
Polat A.,Bagcilar Research and Training Hospital |
Sinikoglu S.N.,Bagcilar Research and Training Hospital |
Yektas A.,Bagcilar Research and Training Hospital |
And 2 more authors.
Journal of Cardiothoracic and Vascular Anesthesia | Year: 2013
Objective: There is an increasing interest in reexamining the relationship between glucose levels and postoperative complications. Threshold levels of HbA1c below those currently recommended may be additional indicators of risk for renal and cardiovascular dysfunction. In this study, the authors analyzed the perioperative outcomes of coronary artery bypass graft (CABG) operations to evaluate the association of HbA1c levels and renal complications. Design: Retrospective. Setting: Research and training hospital, single institution. Participants: The prospectively collected data of 510 coronary bypass patients with documented HbA1c levels were analyzed. Interventions: The relationship of HbA1c with postoperative renal morbidity was evaluated with logistic regression analysis with lower threshold value (5.9%) for elevated levels. Measurements and Main Results: Two hundred ninety-three patients (57.5%) had elevated HbA1c values. Patients with high HbA1c levels (>5.9%) had higher incidences of atherosclerotic vascular diseases. The incidence of acute kidney injury was higher in the high HbA1c group (11.9% v 1.8%; p = 0.0001). The high HbA1c group had higher incidence of renal morbidity (odds ratio = 4.608), and every 1% increase over 5.9% increased risk of renal complications by 23.6%. The other factors associated with renal morbidity were known history of diabetes, chronic renal disease, and performance of any concomitant procedure. Conclusions: The elevated levels of HbA1c are associated with increased renal complications and the cut-off values of HbA1c could be lowered to the upper range of normal limits. © 2013 Elsevier Inc.
Aygit A.C.,Bagcilar Research and Training Hospital |
Basaran K.,Bagcilar Research and Training Hospital |
Mercan E.S.,Bagcilar Research and Training Hospital
Plastic and Reconstructive Surgery | Year: 2013
BACKGROUND:: The transaxillary route is a popular method of breast augmentation because it is associated with inconspicuous scars. The subfascial plane carries the advantages and decreases the disadvantages of subglandular and submuscular planes. In the technique described, the authors placed the implant totally subfascially to strengthen the advantages of the traditional subfascial plane. METHODS:: Twenty-seven patients (50 breasts) were included in the study from 2009 to 2012. The mean patient age was 27.3 years (range, 19 to 32 years). An axillary incision was performed and the pectoralis major fascia was opened initially. With endoscopic assistance, the dissection continued craniocaudally underneath the fasciae of the pectoralis, serratus, and rectus abdominis muscles. Patients were followed up in terms of rippling, implant visibility, capsular contracture, and asymmetry. RESULTS:: Patients were followed up for an average of 21 months (range, 7 to 28 months). Anatomical, textured, and cohesive gel implants were used, with a mean implant size of 235 cc (range, 180 to 300 cc). In terms of the Baker classification, only 16 percent of the patients had grade II capsular contractures. There were no cases of malpositions, wrinkling, or rippling. Overall satisfaction was quite high (96 percent), and none of the patients required an implant removal or change. CONCLUSIONS:: A modification of the subfascial plane was demonstrated where the implants have been placed totally subfascially, in contrast to the traditional subfacial techniques. Satisfactory results have been obtained in terms of breast shape, nipple sensitivity, capsular contracture, and implant visibility. However, more long-term results are needed to evaluate the exact effect of total fascial coverage. CLINICAL QUESTION/LEVEL OF EVIDENCE:: Therapeutic, IV. © 2013 by the American Society of Plastic Surgeons.
Cerkes N.,Bagcilar Research and Training Hospital |
Basaran K.,Bagcilar Research and Training Hospital
Plastic and Reconstructive Surgery | Year: 2016
Background: Dorsum augmentation is one of the most delicate components of rhinoplasty. Although various solid grafts have been used in the past for this purpose, diced cartilage grafts wrapped in fascia have become popular in recent decades. In this study, the authors analyze and discuss the results of using diced cartilage grafts wrapped in rectus abdominis muscle fascia for dorsal augmentation. Methods: Nasal dorsum augmentation using the diced cartilage wrapped in rectus abdominis fascia technique was performed on 109 patients between 2008 and 2014. Six patients were primary cases, 69 patients were secondary, and 18 were tertiary. Sixteen patients had previously undergone more than three operations. In all patients, the rectus abdominis fascia was harvested with the described technique and wrapped around the diced cartilages obtained from the costal cartilage. Results: The average follow-up period was 19.6 months (range, 6 to 47 months). Satisfactory results were obtained with acceptable complications and revision rates. Three patients underwent reoperation because of overcorrection. Insufficient augmentation was seen in five patients. In four patients, infection developed after postoperative day 5. One patient complained of a hypertrophic scar on the donor site. None of the patients showed any symptoms indicating an abdominal hernia. Conclusions: Techniques using diced cartilage grafts wrapped in fascia have now become the gold standard for dorsal augmentations. When it is considered that secondary cases requiring dorsal augmentation are usually those also needing costal cartilage grafts, rectus abdominis fascia becomes a useful carrier for diced cartilages, which is in the same donor area. © 2015 by the American Society of Plastic Surgeons.
Boyacioglu K.,Bagcilar Research and Training Hospital |
Kalender M.,Konya Research and Training Hospital |
Ozkaynak B.,Bagcilar Research and Training Hospital |
Mert B.,Bagcilar Research and Training Hospital |
And 2 more authors.
Heart Lung and Circulation | Year: 2014
Chest tubes are commonly used for patients who have undergone a cardiothoracic procedure to avoid the complications related to the accumulation of blood and serous fluid in the chest. Although the traditional methods such as milking, stripping or active chest tube clearence devices are used to establish patency of the chest tubes, they can become clogged at any time after their placement. Our technique may re-establish the tube patency with utilising Fogarty catheter and without any detriment to tissues. © 2014 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ).
PubMed | Bagcilar Research and Training Hospital
Type: Journal Article | Journal: The West Indian medical journal | Year: 2016
This is a case of generalized annular elastolytic giant cell granuloma (AEGCG) associated with borrelia infection and genes of p-30, p-31, p-39. A possible cross-mediated reaction from the T-cell type which might have induced the AEGCG is discussed from the concept of heat-shock proteins (HSPs) and molecular mimicry.