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Ozde C.,Gaziosmanpasa Taksim Education and Research Hospital | Dogru M.,Zeynep Kamil Woman and Child Diseases Education and Research Hospital | Erdogan F.,Istanbul University | Ipek I.O.,Istanbul University | And 2 more authors.
Asian Pacific Journal of Allergy and Immunology | Year: 2015

Background: There is an association between adiponectin (APN) and asthma. However, the mechanisms underlying this association is unclear. APN is a predominantly antiinflammatory protein with possible signalling activity in the lung that can be secreted by Epicardial Adipose Tissue (EAT). Our hypothesis is that serum APN levels may be directly and simply related to the amount of EAT accumulation, particularly when it is expressed as thickness in children with asthma. Objective: The aim of this study was to investigate whether serum adiponectin (APN) and epicardial adipose tissue thickness (EATT) have an effect in non-obese children with asthma and in healthy non-asthmatic children, and analyze their relationships with clinical outcomes. Methods: 68 childrens diagnosed with asthma (20 girls/48 boys) who had applied at the pediatric allergy and clinical immunology clinic of the hospital were included in this cross-sectional, observational study. The age-matched control group included 39 healthy children (18 girls/21 boys). EATT was measured by transthoracic echocardiography. The serum APN levels were also checked. Statistical analysis was performed by using independent sample t-test and Spearman correlation analyses. Results: The mean age of the asthma group was 10.2 ± 2.7 years, and the average EATT was found to be 5.7±1.1 mm. The mean age of the control group was 10.5 ± 2.8 years, and the average EATT was found to be 5.1 ± 0.7 mm. The EATT of the asthma group was found to be significantly higher (p < 0.001) in study group. In the asthma group the APN was 10.0 ± 5.3 mg/L, and in the control group the APN was 15.8 ± 10.5 mg/L (p < 0.001). We found that APN was significantly negatively correlated with EATT (r = -0.266, p = 0.006) in asthma and control groups. Conclusion: EATT is associated with non-obese asthmatic childrens. High EATT may be related with high release of pro-inflammatory cytokine and low release of APN. Low levels of APN may be related to low anti-inflammatory effects. Therefore, high EATT and low levels of APN may indicate pro-inflammantory profiles in nonobese asthmatic childrens. © 2009 is a Digital Portal of health science journals in Thailand.

PubMed | Gaziosmanpasa Taksim Education and Research Hospital, Zeynep Kamil Woman and Child Diseases Education and Research Hospital and Bakrkoy Dr Sadi Konuk Education And Research Hospital
Type: Journal Article | Journal: Pregnancy hypertension | Year: 2016

Preeclampsia (PE) is a multisystemic disorder characterized by hypertension and proteinuria that is specific to pregnancy and associated with maternal and fetal morbidity-mortality.To assess right heart structure and function in PE by echocardiography using conventional and tissue Doppler techniques.In total, 67 women with untreated PE and 46 matched healthy pregnant women were included. PE was defined according to the ACOG (2002) criteria. Right and left heart functions were evaluated using transthoracic two-dimensional (2D) echocardiography with color Doppler and tissue Doppler imaging techniques.Right ventricular basal and outflow tract diameters and free wall thickness, right atrial end-systolic maximum diameter, and area were significantly higher in the PE group than the control group (p<0.05). Tricuspid annular plane systolic excursion, isovolumic acceleration time, tissue Doppler-derived tricuspid lateral annular systolic velocity (S), right ventricle fractional area change, and myocardial performance index (Tei) were significantly lower in the PE group than the controls (p<0.05).PE does not only affect the left side of the heart but also the right side. This finding may open new scenarios, because right ventricular dysfunction may also be responsible for PE-related morbidity.

Tarakcoglu M.C.,Bakrkoy Dr Sadi Konuk Education And Research Hospital | Cakn Memik N.,Kocaeli University | Olgun N.N.,Kocaeli University | Aydemir O.,Adnan Menderes University | Weiss M.D.,Weiss Clinic for ADHD Care
ADHD Attention Deficit and Hyperactivity Disorders | Year: 2015

Attention deficit hyperactivity disorder (ADHD) is seen frequently in childhood and leads to marked impairment in functioning. There is no scale in Turkey with documented validity and reliability that assesses ADHD-specific functional impairment (FI). This study aimed at adapting the Weiss Functional Impairment Rating Scale-Parent Report (WFIRS-P), which assesses ADHD-related FI, for use in Turkey, and examining psychometric aspects of the scale. The study included 250 children diagnosed with ADHD and 250 healthy children and their parents. Internal consistency and test–retest methods were used to test the reliability of the scale. Validity was tested with exploratory and confirmatory factor analyses and convergent and discriminant validity analyses. Since all six questions of the WFIRS-P were scored 0, analyses were conducted for the original scale questionnaire consisting of 50 items and the questionnaire consisting of 44 items where the six questions scored 0 were not included. The Cronbach’s alpha coefficient was 0.93 for the whole scale. The Spearman’s correlation coefficient was 0.93 for test–retest reliability. The exploratory factor analysis run on the 44-item questionnaire showed that the scale items were best represented in a 7-factor structure, but some items were placed in different subdomains than those of the original scale. In the confirmatory factor analysis, the root mean square error of approximation was 0.061, and the comparative fit index was 0.95 for the whole model. Therefore, the Turkish WFIRS-P is valid and reliable in testing functional impairment in children with ADHD. © 2014, Springer-Verlag Wien.

PubMed | International Hospital, Bakrkoy Dr Sadi Konuk Education And Research Hospital, Hacettepe University and Sisli Etfal Education and Research Hospital
Type: | Journal: Allergologia et immunopathologia | Year: 2016

Influenza is an infectious disease, dangerous for all people, especially for some risk groups such as patients with chronic diseases and health care workers. But most of the people under the risk of influenza, including health care workers are not immunised because of misinformation. In this study, we aimed to determine the knowledge, beliefs and attitudes of patients with allergic rhinitis and asthma and parents of such children related to influenza vaccination. Attitudes and beliefs of physicians treating these patients about influenza vaccination were also investigated.Two different questionnaires consisting of various items related to influenza vaccine were distributed to physicians and patients and parents of children with asthma and allergic disease.The physicians group consisted of 189 physicians from various branches. About one third of physicians from various branches reported that they did not believe the vaccines effectiveness. Most of the participating physicians did not immunise themselves with influenza vaccination despite the fact that any patient of theirs had died due to influenza infection. Although nearly half of the 183 patients had been vaccinated with influenza vaccine, only 27% of adults and 11.7% of children had been vaccinated annually.Asthmatic patients are not immunised regularly with influenza vaccine due to misperceptions about vaccine effectiveness and fear of adverse effects. Another important reason of this is that most the physicians caring for these patients neither immunise themselves nor recommend the vaccine to their patients.

PubMed | Muǧla University, Tepecik Education and Research Hospital and Bakrkoy Dr Sadi Konuk Education and Research Hospital
Type: | Journal: American journal of obstetrics and gynecology | Year: 2016

Paralytic ileus that develops after elective surgery is a common and uncomfortable complication and is considered inevitable after an intraperitoneal operation.The purpose of this study was to investigate whether coffee consumption accelerates the recovery of bowel function after complete staging surgery of gynecologic cancers.In this randomized controlled trial, 114 patients were allocated preoperatively to either postoperative coffee consumption with 3 times daily (n=58) or routine postoperative care without coffee consumption (n=56). Total abdominal hysterectomy and bilateral salpingo-oophorectomy with systematic pelvic and paraaortic lymphadenectomy were performed on all patients as part of complete staging surgery for endometrial, ovarian, cervical, or tubal cancer. The primary outcome measure was the time to the first passage of flatus after surgery. Secondary outcomes were the time to first defecation, time to first bowel movement, and time to tolerance of a solid diet.The mean time to flatus (30.28.0 vs 40.212.1 hours; P<.001), mean time to defecation (43.19.4 vs 58.517.0 hours; P<.001), and mean time to the ability to tolerate food (3.41.2 vs 4.71.6 days; P<.001) were reduced significantly in patients who consumed coffee compared with control subjects. Mild ileus symptoms were observed in 17 patients (30.4%) in the control group compared with 6 patients (10.3%) in the coffee group (P=.01). Coffee consumption was well-tolerated and well-accepted by patients, and no intervention-related side-effects were observed.Coffee consumption after total abdominal hysterectomy and systematic paraaortic lymphadenectomy expedites the time to bowel motility and the ability to tolerate food. This simple, cheap, and well-tolerated treatment should be added as an adjunct to the postoperative care of gynecologic oncology patients.

PubMed | Kafkas University, Tepecik Education and Research Hospital and Bakrkoy Dr Sadi Konuk Education And Research Hospital
Type: | Journal: European journal of obstetrics, gynecology, and reproductive biology | Year: 2014

The purpose of this retrospective study was to compare our umbilical stalk elevation (USE) technique with the classic Veress needle (VN) technique in obese patients.The USE technique was performed on 40 patients. One control per case was randomly selected from among those undergoing the classic VN technique using a random number table. In USE technique, a 12 mm skin incision was created at the superior crease of the umbilical fold, and the underlying subcutaneous adipose tissue was bluntly dissected using the tip of a fine clamp until the umbilical stalk was isolated at the inferior and central part of the incision. Next, the umbilical stalk was covered and held by a towel clip, and the abdominal wall was elevated by upward traction. The VN was then inserted nearly perpendicular to the incision and turned toward the pelvis immediately after resistance to the needle had been lost. A post-hoc power analysis was performed.The number of attempts was significantly lower in the USE laparoscopy group than in the classic laparoscopy group (1.2 0.4 vs. 2.1 0.7, respectively; P<0.001). The USE technique group had a slightly shorter abdominal entry time than did the classic technique group (328.52 63.71 vs. 434.95 124.10s; P<0.001). Six (7.5%) failed insufflations occurred in our study (5 patients in the classic group vs. 1 patient in the USE group (P=0.10).Our novel USE technique can be an effective means of establishing pneumoperitoneum in obese patients undergoing gynecologic laparoscopic procedures.

PubMed | Bakrkoy Drsadi Konuk Training And Research Hospital and Bakrkoy Dr Sadi Konuk Education And Research Hospital
Type: Journal Article | Journal: Otolaryngologia polska = The Polish otolaryngology | Year: 2016

In this study, our aim was to investigate whether Monocyte/HDL ratio is a marker of the prognosis of the idiopathic sudden hearing loss (ISHL).Retrospective, case-control clinical trial.45 patients, who were diagnosed with idiopathic sudden hearing loss and were treated with the same therapy regime and 47 healthy volunteers, who applied to the hospital for routine controls and had audiological and laboratory examination between March 2014 and December 2015, were included in the study. Monocyte/HDL ratios of the patients in the study and control groups were calculated from the results of the blood counts and biochemical analysis. Additionally, the study group was divided into two sub-groups regarding their responses (responders and non-responders) to the treatment determined by the audiological examination, which was carried out after 3 months according to the Siegel criteria. The Monocyte/HDL ratios between the groups were statistically evaluated.There was no statistically significant difference between the MHRs of the study and control groups (p=0.574). However, the MHR was significantly higher in the non-responders? group compared with the responders? group, although they were treated with the same therapy regimen (p=0.005).There was no difference in MHRs between study and control groups. However, as MHR was higher in the patients with good prognosis compared with the patients with bad prognosis, we believe that regarding the ISHL, MHR is not a predictive value but might have prognostic marker.

PubMed | Istanbul Education and Research Hospital, Bülent Ecevit University, Izmir Tepecik Education and Research Hospital, Muǧla University and 7 more.
Type: Journal Article | Journal: Journal of ovarian research | Year: 2016

The optimal surgical management and staging of borderline ovarian tumors (BOTs) are controversial. Institutions have different surgical approaches for the treatment of BOTs. Here, we performed a retrospective review of clinical characteristics, surgical management and surgical outcomes, and sought to identify variables affecting disease-free survival (DFS) and overall survival (OS) in patients with BOTs.A retrospective review of ten gynecological oncology department databases in Turkey was conducted to identify patients diagnosed with BOTs. The effects of type of surgery, age, stage, surgical staging, complete versus incomplete staging, and adjuvant chemotherapy were examined on DFS and OS.In total, 733 patients with BOTs were included in the analysis. Most of the staged cases were in stage IA (70.4%). In total, 345 patients underwent conservative surgeries. Recurrence rates were similar between the conservative and radical surgery groups (10.5% vs. 8.7%). Furthermore we did not find any difference between DFS (HR=0.96; 95% confidence interval, CI=0.7-1.2; p=0.576) or OS (HR=0.9; 95% CI=0.8-1.1; p=0.328) between patients who underwent conservative versus radical surgeries. There was also no difference in DFS (HR=0.74; 95% CI=0.8-1.1; p=0.080) or OS (HR=0.8; 95% CI=0.7-1.0; p=0.091) between complete, incomplete, and unstaged patients. Furthermore, receiving adjuvant chemotherapy (CT) for tumor stage IC was not an independent prognostic factor for DFS or OS.Patients undergoing conservative surgery did not show higher recurrence rates; furthermore, survival time was not shortened. Detailed surgical staging, including lymph node sampling or dissection, appendectomy, and hysterectomy, were not beneficial in the surgical management oF BOTs.

PubMed | Istinye State Hospital, Cerrahpasa Medical Faculty and Bakrkoy Dr Sadi Konuk Education and Research Hospital
Type: Journal Article | Journal: Angiology | Year: 2016

We compared Turkish patients with cardiac syndrome X (CSX) and controls with respect to serum pro- and anti-inflammatory cytokine levels, as well as the single-nucleotide polymorphisms located in the promoter regions of their related genes. This study included 111 consecutive patients angiographically diagnosed with CSX and 111 healthy controls with similar demographic characteristics. Serum interleukin (IL) 6, tumor necrosis factor (TNF-), and IL-10 levels were measured, and the genotypes of the patients and controls were determined using standard methods. Serum IL-6 and IL-10 levels were significantly higher in the CSX group than in the control group (P < .01, respectively). Serum TNF- level was lower in the CSX group than in the control group (P < .001). On the other hand, participants with CSX and healthy controls were not significantly different with respect to the genotype distributions of IL-6, TNF-, and IL-10 genes. As a result of our study, both pro-inflammatory and anti-inflammatory cytokines may play a role in the pathogenesis of CSX. In contrast, the studied gene polymorphisms did not influence CSX pathogenesis.

PubMed | Cankiri State Hospital, Tokat Erbaa State Hospital, University of Miami, Dumlupinar University and Bakrkoy Dr Sadi Konuk Education And Research Hospital
Type: Journal Article | Journal: The Laryngoscope | Year: 2015

To assess the diagnostic value of a novel device, the endoilluminator, in patients who can or cannot attain effective speech after application of voice prosthesis.Prospective clinical study.Thirty-four patients who underwent total laryngectomy and whose insufflation test was positive were included. As a result of efforts to develop an insufflation test that includes a light apparatus, we attained a device that we call an endoilluminator. We found that the area it illuminated when a patient achieved effective speech was a predictive factor for the test result. That is, patients for whom the upper part of the tracheostomy (where the standard tracheoesophageal fistula will be opened) was illuminated were categorized as the positive test group, whereas those for whom the neck skin above this region was illuminated were categorized as the negative test group.In 27 of the 34 patients, appropriate localization was determined using the endoilluminator, and these patients achieved effective speech. In the remaining seven patients, localization was inappropriate and they did not achieve effective speech during the first week, first month, or third month postpuncture. In further investigations of these seven patients, a pharyngoesophageal spasm was detected in five, and a pharyngoesophageal stricture was detected in two.Endoilluminator increases the success rate of the insufflation test by accurately predicting a patients ability to achieve effective speech after application of voice prosthesis.

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