Bakirkoy Education and Research Hospital

İstanbul, Turkey

Bakirkoy Education and Research Hospital

İstanbul, Turkey
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Tugcu B.,Bakirkoy Education and Research Hospital | Soysal A.,Bakirkoy Education and Research Hospital for Psychiatric and Neurological Diseases | Kilic M.,Bakirkoy Education and Research Hospital | Yuksel B.,Bakirkoy Education and Research Hospital for Psychiatric and Neurological Diseases | And 3 more authors.
Journal of the Neurological Sciences | Year: 2013

The purpose of this study is to consider the clinical utility of optical coherence tomography (OCT) and find a correlation with VEP. Effects of different disease modifying treatments (DMT) were further evaluated by measuring OCT parameters and whether a correlation exists between the RNFL thickness, disease duration and expanded disability status scale (EDSS) were also assessed. 13 patients were on interferon beta-1a (IFN), 14 patients were receiving glatiramer acetate (GA), 19 patients were not being treated with any DMT and 21 healthy controls were included the study. During OCT examination, retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thickness was found to be lower in all MS groups but macular volume (MV) was lower only in GA group than controls. Although, P100 latencies were longer than controls in all MS groups, there was no statistically significant difference between IFN and w/o DMT groups. Patients with ON history, P100 latencies were found significantly longer than those without ON. VEP amplitudes were found lower with ON history patients than those without ON, however this was not statistically significant. EDSS strongly correlated with P100 latency, RNLF, GCC but no correlation was observed with VEP amplitude and MV. Our results show that RNFL, GCC and MV were all decreased in MS patients with or without DMT comparing to controls and it is more prominent in eyes with ON. Further follow-up studies are warranted to understand the pathophysiology of CNS axonal degeneration and involvement of optic nerves. © 2013 Elsevier B.V. All rights reserved.


Kunt A.G.,Ataturk Education and Research Hospital | Kurtcephe M.,Bilkent University | Hidiroglu M.,Ataturk Education and Research Hospital | Cetin L.,Ataturk Education and Research Hospital | And 4 more authors.
Interactive Cardiovascular and Thoracic Surgery | Year: 2013

OBJECTIVESThe aim of this study was to compare additive and logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE), EuroSCORE II and the Society of Thoracic Surgeons (STS) models in calculating mortality risk in a Turkish cardiac surgical population.METHODSThe current patient population consisted of 428 patients who underwent isolated coronary artery bypass grafting (CABG) between 2004 and 2012, extracted from the TurkoSCORE database. Observed and predicted mortalities were compared for the additive/logistic EuroSCORE, EuroSCORE II and STS risk calculator. The area under the receiver operating characteristics curve (AUC) values were calculated for these models to compare predictive power.RESULTSThe mean patient age was 74.5 ± 3.9 years at the time of surgery, and 35.0% were female. For the entire cohort, actual hospital mortality was 7.9% (n = 34; 95% confidence interval [CI] 5.4-10.5). However, the additive EuroSCORE-predicted mortality was 6.4% (P = 0.23 vs observed; 95% CI 6.2-6.6), logistic EuroSCORE-predicted mortality was 7.9% (P = 0.98 vs observed; 95% CI 7.3-8.6), EuroSCORE II- predicted mortality was 1.7% (P = 0.00 vs observed; 95% CI 1.6-1.8) and STS predicted mortality was 5.8% (P = 0.10 vs observed; 95% CI 5.4-6.2). The mean predictive performance of the analysed models for the entire cohort was fair, with 0.7 (95% CI 0.60-0.79). AUC values for additive EuroSCORE, logistic EuroSCORE, EuroSCORE II and STS risk calculator were 0.70 (95% CI 0.60-0.79), 0.70 (95% CI 0.59-0.80), 0.72 (95% CI 0.62-0.81) and 0.62 (95% CI 0.51-0.73), respectively.CONCLUSIONSEuroSCORE II significantly underestimated mortality risk for Turkish cardiac patients, whereas additive and logistic EuroSCORE and STS risk calculators were well calibrated. © 2013 The Author 2013.


Yumusakhuylu A.C.,Marmara University | Yazici M.,Bakirkoy Education and Research Hospital | Sari M.,Marmara University | Binnetoglu A.,Marmara University | And 6 more authors.
International Journal of Pediatric Otorhinolaryngology | Year: 2012

Objective: The aim of this study was to evaluate the effectiveness of systemic administration of resveratrol against cisplatin-induced ototoxicity in guinea pigs. Materials and methods: Healthy guinea pigs (n= 24) were randomly divided into four groups. Group 1 (n= 6) received resveratrol. +. cisplatin, group 2 (n= 6) received 4% ethanol. +. cisplatin, group 3 (n= 6) received cisplatin, and group 4 (n= 6) received saline. Cisplatin was administered at a dose of 10. mg/kg/day on days 14 and 15 of the study. Resveratrol (10. mg/kg/day), 4% ethanol, and saline were administered throughout the study. Baseline auditory brainstem responses (ABR) (4. kHz, 8. kHz, and click stimulus) were determined for all groups. ABR was repeated 72. h after the last dose of cisplatin in order to record the threshold shifts. The ABR threshold shifts for the click stimulus, 4-kHz- and 8-kHz-frequency stimuli were compared after drug administration. After follow-up ABRs the animals sacrificed under deep sedation and their cochleae were removed. Left cochleae were immediately harvested for measurement of level of reactive oxygen species (ROS). Right cochleae were prepared for histological changes which were observed by scanning electron microscopy (SEM). Results: For the all stimulus, there was a significant threshold difference among the groups (p< 0.01). Group 3 had a significantly higher threshold shift at all stimuli when compared with groups 1 and 4. There was no significant threshold shifts in all stimuli between groups 2 and 3. The resveratrol-treated group 1 showed preservation of threshold in ABR (p≤ 0.05). SEM showed that inner and outer hair cells were preserved in the group 1. Level of reactive oxygen species (ROS) were significantly higher in groups 2 and 3 compared with groups 1 and 4 (p≤ 0.05). Conclusion: These results indicated that systemic administration of resveratrol afforded statistically significant protection to the cochlea of guinea pigs from cisplatin toxicity. Experimental dose of resveratrol injections may have a protective effect against cisplatin ototoxicity in guinea pigs. © 2011 Elsevier Ireland Ltd.


Sarica O.,Taksim Education and Research Hospital | Ozturk E.,Bakirkoy Education and Research Hospital | Demirkurek H.C.,Taksim Education and Research Hospital | Uluc F.,Taksim Education and Research Hospital
Breast Care | Year: 2013

Background: Today, in cases of nipple discharge of unclear origin, the abundance of diagnostic procedures - a diagnostic dilemma' - becomes apparent, because unequivocal indications and a current, standardized examination sequence are presently not available. The diagnostic workup of patients with nipple discharge usually includes the clinical history, physical examination, mammography, ultrasonography, galactography, and nipple discharge cytology, but not ductoscopy. Methods: In this review we analyze and discuss the possible role of ductoscopy in evaluating intraductal pathologies and its combined use with diagnostic imaging modalities. For this purpose, we reviewed and compared the results of the radiological, pathological, and surgical studies independently. Conclusions: Currently, there is no solitary accurate modality to reach our definitive purpose. Being aware of the capability of each diagnostic modality may take us closer to our target. Therefore, adjunct and appropriate use of multiple imaging modalities and ductoscopy is necessary to evaluate patients with nipple discharge. © 2013 S. Karger GmbH, Freiburg.


Bahat G.,Istanbul University | Tufan A.,Istanbul University | Aydin Y.,Istanbul University | Tufan F.,Istanbul University | And 5 more authors.
Aging Clinical and Experimental Research | Year: 2015

Objectives: The relationship of body mass index (BMI) with functional status differs in diversified geriatric population and various settings. In this study, we aimed to investigate whether BMI is related to functional status independent of age, nutritional status, multimorbidity, and polypharmacy in a group of Turkish community-dwelling female elderly.Design: This study was conducted using a cross-sectional study design.Setting: Geriatric outpatient clinic of a university hospital.Participants: There were 438 female patients aged 60 years or older included in the analysis.Measurements: Body mass indexes were calculated from weight (kg) divided by the square of height (m). Functional status was assessed with the evaluation of activities of daily living (ADL) and instrumental activities of daily living (IADL) scales. Diseases and drugs were determined after the evaluation of the patients with comprehensive geriatric assessment, physical examination, first-line biochemical tests, and using the patients’ self-report and current medication lists.Results: In total, 438 subjects comprised our study cohort. Mean age was 73.3 ± 6.9 years. Mean BMI was 27.8 ± 5.2 kg/m2. Linear regression analysis revealed significant and independent association of lower BMI with higher ADL and IADL scores (p = 0.02, B = −0.10; p < 0.001, B = −0.17, respectively). ADL and IADL were significantly negatively correlated with BMI in subjects with normal nutrition (p = 0.03, r = −0.122; p = 0.001, r = −0.183) but not in subjects with malnutrition risk or malnutrition. We suggest that lower BMI is associated with better functional status in Turkish community-dwelling female older people. This association is prominent in the subjects with normal nutritional status.Conclusions: Our study recommends the need for further studies accounting for the nutritional status on the relationship between BMI and functionality in different populations and in different settings. It represents an important example for diversity in BMI-functionality relationship. © 2014, Springer International Publishing Switzerland.


Iscan Y.,Batman State Hospital | Coskun C.,Bakirkoy Education and Research Hospital | Oner V.,Recep Tayyip Erdoğan University | Turkcu F.M.,Batman State Hospital | And 2 more authors.
Middle East African Journal of Ophthalmology | Year: 2013

In this case report, we document a 54-year-old woman with total bilateral optic nerve atrophy after local application of methanol containing spirit. Almost all the reported cases of methanol intoxication in the literature are caused by oral ingestion. In this rare case, we present transdermal absorption of methanol that may cause irreversible blindness in addition to intracerebral lesions.


Arica S.G.,Mustafa Kemal University | Arica V.,Mustafa Kemal University | Onur H.,Bakirkoy Education and Research Hospital | Gulbayzar S.,Bakirkoy Education and Research Hospital | And 2 more authors.
Emergency Medicine Journal | Year: 2012

Aim: This study was conducted to determine mothers'knowledge about fever, and their attitudes and responses to fever in children, along with the influence of demographic characteristics on the level of knowledge, and to identify occurrences of fear of fever. Materials and Methods: The study consisted of 4500 mothers with children 0-12 years of age who were referred to the pediatric health and disease polyclinic and primary care polyclinic over a period of 24 months. Data were collected using a questionnaire containing 32 openended, multichoice questions, and assessed using number, percentage and χ2 analyses. Results: In this study, 36% of mothers regarded body temperatures lower than 378C as fever; 83% believed that fever was harmful for their children, and 92.3% experienced fear and concern due to their child's fever. The most significant reason for fear was the belief that the child may have a seizure. Moreover, 12% of mothers feared that their child would die due to fever. The level of fear triggered by fever was lower as the education level of the mothers increased. Meanwhile, when their child had a fever, 28.9% of mothers used antifebrile drugs without consulting a physician, while 19% applied cold water and 7.7% applied water with alcohol or vinegar, among other inappropriate practices. Conclusion: Increased information about fevers geared towards the caregivers of children, particularly mothers, would prevent the unnecessary treatment of children, as well as minimising delayed and insufficient responses to fever.


Sarica O.,Taksim Education and Research Hospital | Zeybek E.,Taksim Education and Research Hospital | Ozturk E.,Bakirkoy Education and Research Hospital
Journal of Computer Assisted Tomography | Year: 2010

Because both benign and malignant nipple periareolar region lesions may present with similar clinical findings such as nipple discharge and retraction, they require a diagnostically specific imaging workup. Despite multidisciplinary clinical approaches, malignancy cannot be excluded without diagnostic modalities.Because of the intricacy of the anatomical structures and their superficial position, the diagnostic techniques routinely used to evaluate the different sides of the breast may often be inadequate. Adjunct use of multiple imaging modalities is necessary to evaluate this region. © 2010 by Lippincott Williams & Wilkins.


PubMed | Bakirkoy Education and Research Hospital
Type: | Journal: Case reports in medicine | Year: 2011

Kounis syndrome, also named as allergic angina syndrome, is a diagnosis in which exposure to an allergen causes mostly coronary spasm and rarely plaque rupture, resulting in ischemic myocardial events. Myocardial bridging is defined as an intramural segment of a coronary artery and its systolic compression by overlying fibers. Myocardial bridging generally has a benign prognosis and mostly affects the mid portion of left anterior descending coronary artery. However, some cases with myocardial ischemia, infarction, and sudden death have also been reported. A 17-year-old boy presented to the clinic with acute anterolateral myocardial infarction after having first dose of clindamycin and diagnosed as Kounis syndrome. Further diagnostic workup of the patient showed myocardial bridging at the mid left anterior descending artery. In this report, we present the combination of Kounis syndrome and myocardial bridging leading to myocardial infarction at young age.


PubMed | Bakirkoy Education and Research Hospital
Type: Journal Article | Journal: World journal of gastrointestinal oncology | Year: 2016

Colorectal cancer (CRC) ranked third in cancer related death and its incidence has been increasing worldwide. In recent decades important therapeutic advances have been developed in treatment of metastatic CRC (mCRC), such as monoclonal antibodies against epidermal growth factor receptor (anti-EGFR), which provided additional clinical benefits in mCRC. However, anti-EGFR therapies have limited usage due to approximately 95% of patients with KRAS mutated mCRC do not response to anti-EGFR treatment. Thus, KRAS mutation is predictive of nonresponse to anti-EGFR therapies but it alone is not a sufficient basis to decide who should not be received such therapies because; approximately fifty percent (40%-60%) of CRC patients with wild-type KRAS mutation also have poor response to anti-EGFR based treatment. This fact leads us to suspect that there must be other molecular determinants of response to anti-EGFR therapies which have not been identified yet. Current article summarizes the clinical efficacy of anti-EGFR therapies and also evaluates its resistance mechanisms.

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