Unluer E.E.,Izmir Ataturk Research and Training Hospital |
Yavasi O.,Izmir Ataturk Research and Training Hospital |
Eroglu O.,Izmir Ataturk Research and Training Hospital |
Yilmaz C.,Bozyaka Research and Training Hospital |
Akarca F.K.,Izmir Ataturk Research and Training Hospital
European Journal of Emergency Medicine | Year: 2010
OBJECTIVE: Our objective was to study the accuracy of emergency medicine [(EM) bedside ultrasonography (BUS)] and radiology residents performed ultrasonography (RUS) in patients with suspected mechanical small bowel obstruction (SBO). METHODS: After a 6-h training program, from January to June 2009, four EM residents used BUS to prospectively evaluate the patients presenting to the emergency department with suspected SBO. Then, patients underwent RUS. Outcome was determined by surgical findings if they were operated upon or self-reported the condition upon telephone follow-up at 1-month. BUS and RUS results were compared with χ testing. RESULTS: Of the 174 enrolled patients, 90 patients were BUS-positive. Of these, surgical findings agreed with the BUS findings in 84 patients. In 78 cases, BUS was negative, and 76 of these patients had benign clinical courses. Six patients were excluded from the study. The sensitivity, specificity, positive predictive value, negative predictive value, and likelihood ratio for BUS were 97.7, 92.7, 93.3, 97.4, and 13.4%, respectively. Sensitivity, specificity, positive predictive value, and negative predictive value for RUS were 88.4, 100, 100, and 89.1%, respectively. The diagnostic accuracy of BUS and RUS were not statistically different from each other (κ=0.81). The presence of dilated small bowel loops (>25 mm in jejunum or >15 mm in ileum) was the most sensitive (94%) and specific (94%) sonographic finding for SBO. CONCLUSION: Abdominal sonography for the diagnosis of SBO is a new application of BUS in the emergency department. EM residents can diagnose SBO using BUS with a high-degree of accuracy, comparable with that of radiology residents. © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins.
Cingi C.,Eskiehir Osmangazi University |
Catli T.,Bozyaka Research and Training Hospital
Current Allergy and Asthma Reports | Year: 2012
Allergic rhinitis (AR) is characterized by immunemediated inflammation of the nasal mucosal lining. Although this chronic disease is not fatal, it is associated with many debilitating symptoms. Like many other chronic diseases, AR has a wide range of clinical aspects, and comorbidities such as asthma, rhinosinusitis, dermatitis, and conjunctivitis may accompany the disease to different degrees. These comorbidities and features determine the clinical phenotypes of AR. Different phenotypes and other characteristics of AR are discussed in this review. It is important for clinicians to be aware of these variable clinical phenotypes of AR to diagnose and treat the disease properly. © Springer Science+Business Media, LLC 2012.
Arslan M.,Izmir University |
Tuncel A.,Ankara Numune Research and Training Hospital |
Aslan Y.,Ankara Numune Research and Training Hospital |
Kozacioglu Z.,Bozyaka Research and Training Hospital |
And 2 more authors.
Archivio Italiano di Urologia e Andrologia | Year: 2014
Objective: We compared polyglecaprone (Monocryl®) and bidirectional barbed (V-Loc® 180) running sutures during urethrovesial anastomosis (UVA) in laparoscopic radical prostatectomy (LRP). Materials and methods: A total of 92 consecutive patients underwent extraperitoneal LRP for prostate cancer. In the first 47 patients, the running UVA was performed using 3-0 monofilament polyglecaprone (Monocryl ®) suture (Group 1). In the subsequent 45 patients, the running UVA was performed with the 3-0 barbed suture (V-Loc® 180) (Group 2). Rhabdosphincter reconstruction was performed in all the patients. Results: The mean prostatectomy time was 196 and 179 minutes in Group 1 and 2, respectively (p < 0.001). Moreover, the mean UVA time was 40 and 24 minutes in Group 1 and 2, respectively (p < 0.001). Also, catheterization time, lenght of hospital stay and the number of the patients with urine leakage were significantly lower in Group 2 than the other (p < 0.001). No patients in V-Loc® 180 suture group and 5 patients in Monocryl ® suture group experienced postoperative drain leakage in the present study. Overall pad usage at 6th month was higher in group 1 than the other group. In group 1 and 2, 78.7% and 93.3% of the patients reported 0 to 1 pads daily, whereas 21.3% and 6.7% reported ≥ 2 pads daily (p = 0.002). Conclusions: We therefore consider that use of barbed suture running UVA during LRP is associated with a significantly shorter operative time maintaining a proper suturing tension compared with standard suture and it is not associated with a higher incidence of adverse events with no postoperative complications.
PubMed | Tepecik Research and Training Hospital and Bozyaka Research and Training Hospital
Type: Journal Article | Journal: Journal of endocrinological investigation | Year: 2016
Acromegaly is associated with increased cardiovascular morbidity and mortality. The data about the evaluation of coagulation and fibrinolysis in acromegalic patients are very limited and to our knowledge, platelet function analysis has never been investigated. So, we aimed to investigate the levels of protein C, protein S, fibrinogen, antithrombin 3 and platelet function analysis in patients with acromegaly.Thirty-nine patients with active acromegaly and 35 healthy subjects were included in the study. Plasma glucose and lipid profile, fibrinogen levels, GH and IGF-1 levels and protein C, protein S and antithrombin III activities were measured in all study subjects. Also, platelet function analysis was evaluated with collagen/ADP and collagen-epinephrine-closure times.Demographic characteristics of the patient and the control were similar. As expected, fasting blood glucose levels and serum GH and IGF-1 levels were significantly higher in the patient group compared with the control group (pglc: 0.002, pGH: 0.006, pIGF-1: 0.001, respectively). But lipid parameters were similar between the two groups. While serum fibrinogen and antithrombin III levels were found to be significantly higher in acromegaly group (p fibrinogen: 0.005 and pantithrombin III: 0.001), protein S and protein C activity values were significantly lower in the patient group (p protein S: 0.001, p protein C: 0.001). Also significantly enhanced platelet function (measured by collagen/ADP- and collagen/epinephrine-closure times) was demonstrated in acromegaly (p col-ADP: 0.002, p col-epinephrine: 0.002). The results did not change, when we excluded six patients with type 2 diabetes in the acromegaly group. There was a negative correlation between serum GH levels and protein S (r: -0.25, p: 0.04)) and protein C (r: -0.26, p: 0.04) values. Likewise, there was a negative correlation between IGF-1 levels and protein C values (r: -0.39, p: 0.002), protein S values (r: -0.39, p: 0.001), collagen/ADP-closure times (r: -0.28, p: 0.02) and collagen/epinephrine-closure times (r:-0.26, p: 0.04). Also, we observed a positive correlation between IGF-1 levels and fibrinogen levels (r: 0.31, p: 0.01).Acromegaly was found to be associated with increased tendency to coagulation and enhanced platelet activity. This hypercoagulable state might increase the risk for cardiovascular and cerebrovascular events in acromegaly.
Sarfakolu B.,Namik Kemal University |
Afsar S.I.,Baskent University |
Yalbuzda S.A.,Bozyaka Research and Training Hospital |
Ustaomer K.,Ozel Optimed Hospital |
Ayas S.,Baskent University
Spinal Cord | Year: 2014
Study design:Retrospective review of medical notes.Objective:To describe clinical, laboratory and examination findings of acute abdominal emergencies (AAE) in Turkish patients with spinal cord injury (SCI) and to examine diagnosis and management of AAE in early stages.Setting:Inpatient rehabilitation unit of tertiary research hospital.Methods:The medical records of 237 SCI patients were reviewed. The SCI patients who were recruited in the study had been diagnosed with AAE and treated medically or surgically while they were inpatients at the rehabilitation clinic.Results:Nine out of 237 SCI patients had been diagnosed with one of the AAE. Three patients were AIS A, three patients were AIS B and three patients were AIS C. The most common AAE was acute cholecystitis; three patients were diagnosed with this. The others were single cases of intra-abdominal hemorrhage, intra-abdominal abscess, tuba-ovarian abscess, subileus, Crohn's disease and cholangitis. Three of the patients were treated with surgery and six were treated medically. The most common symptoms in patients were fever, abdominal pain and abdominal discomfort (four of AAE). Three patients had abdominal tenderness and abdominal distension. The expected findings of AAE, rebound and defense, were positive only in two patients.Conclusion:Gall bladder disease is a common cause of AAE. The classic symptoms and examination findings will usually not facilitate acute abdomen diagnosis in the SCI group, so we should be aware of patients' subjective complaints and when necessary use advanced imaging techniques immediately. © 2014 International Spinal Cord Society All rights reserved.
PubMed | Ozel Optimed Hospital, Baskent University, Namik Kemal University and Bozyaka Research and Training Hospital
Type: Journal Article | Journal: Spinal cord | Year: 2014
Retrospective review of medical notes.To describe clinical, laboratory and examination findings of acute abdominal emergencies (AAE) in Turkish patients with spinal cord injury (SCI) and to examine diagnosis and management of AAE in early stages.Inpatient rehabilitation unit of tertiary research hospital.The medical records of 237 SCI patients were reviewed. The SCI patients who were recruited in the study had been diagnosed with AAE and treated medically or surgically while they were inpatients at the rehabilitation clinic.Nine out of 237 SCI patients had been diagnosed with one of the AAE. Three patients were AIS A, three patients were AIS B and three patients were AIS C. The most common AAE was acute cholecystitis; three patients were diagnosed with this. The others were single cases of intra-abdominal hemorrhage, intra-abdominal abscess, tuba-ovarian abscess, subileus, Crohns disease and cholangitis. Three of the patients were treated with surgery and six were treated medically. The most common symptoms in patients were fever, abdominal pain and abdominal discomfort (four of AAE). Three patients had abdominal tenderness and abdominal distension. The expected findings of AAE, rebound and defense, were positive only in two patients.Gall bladder disease is a common cause of AAE. The classic symptoms and examination findings will usually not facilitate acute abdomen diagnosis in the SCI group, so we should be aware of patients subjective complaints and when necessary use advanced imaging techniques immediately.
Ebru Salman A.,Ataturk Research and Training Hospital |
Yetisir F.,Ataturk Research and Training Hospital |
Yurekli B.,Bozyaka Research and Training Hospital |
Aksoy M.,Ataturk Research and Training Hospital |
And 2 more authors.
Local and Regional Anesthesia | Year: 2013
Purpose: In this prospective, randomized, double-blind study, our aim was to compare the analgesic efficacy of the semi-blind approach of transversus abdominis plane (TAP) block with a placebo block in patients undergoing unilateral inguinal hernia repair. Methods: After receiving hospital ethical committee approval and informed patient consents, American Society of Anesthesiologists (ASA) I-III patients aged 18-80 were enrolled in the study. Standard anesthesia monitoring was applied to all patients. After premedication, spinal anesthesia was administered to all patients with 3.5 mL heavy bupivacaine at the L3-L4 subarachnoid space. Patients were randomly allocated into 2 groups. Group I (n = 32) received a placebo block with 20 mL saline, Group II (n = 32) received semi-blind TAP block with 0.25% bupivacaine in 20 mL with a blunt regional anesthesia needle into the neurofascial plane via the lumbar triangle of Petit near the midaxillary line before fascial closure. At the end of the operation, intravenous (IV) dexketoprofen was given to all patients. The verbal analog scale (VAS) was recorded at 2, 4, 6, 12, and 24 hours postoperatively. Paracetamol IV was given to patients if their VAS score. 3. A rescue analgesic of 0.05 mg/kg morphine IV was applied if VAS. 3. Total analgesic consumption and morphine requirement in 24 hours were recorded. Results: TAP block reduced VAS scores at all postoperative time points (P, 0.001). Postoperative analgesic and morphine requirement in 24 hours was significantly lower in group II (P, 0.01). Conclusion: Semi-blind TAP block provided effective analgesia, reducing total 24-hour postoperative analgesic consumption and morphine requirement in patients undergoing elective unilateral inguinal hernia repair. © 2013 Salman et al, publisher and licensee Dove Medical Press Ltd.
PubMed | Bozyaka Research and Training Hospital
Type: Journal Article | Journal: Clinical & experimental optometry | Year: 2016
Antidepressant drugs may have an effect on tear film stability. This study aimed to determine the influence of selective serotonin reuptake inhibitors, which are mostly prescribed antidepressants, on ocular surface and tear film stability.Thirty-six patients (Group 1) and 36 healthy volunteers (Group 2) were enrolled. Group 1 comprised of depression and/or anxiety disorder patients using selective serotonin reuptake inhibitors, who were in clinical remission according to psychiatric history and questionnaires (Hamilton depression rating scale and Hamilton anxiety rating scale). All subjects underwent a detailed ophthalmological examination and the following tests were performed: corneal and conjunctival fluorescein staining and Oxford scoring, tear break-up time, Schirmer 1 test, ocular surface disease index score assessment.The mean age was 36.64 (18 to 61) years in Group 1 and 31.84 (18 to 48) years in Group 2 (p > 0.05). Male to female ratio was 0.38 in Group 1 and 0.89 in Group 2 (p > 0.05). In Group 1, 19 patients (52.8 per cent) had depression, 16 patients (44.4 per cent) had anxiety disorder and one patient (2.8 per cent) had a combination of depression and anxiety disorder. The mean tear break-up times in Groups 1 and 2 were 7.05 4.86 and 12.53 4.75 seconds, respectively (p < 0.001). The mean Schirmer 1 test results in Groups 1 and 2 were 14.44 10.81 and 17.69 10.46 mm, respectively (p > 0.05). The mean superficial punctate staining according to Oxford scale in Groups 1 and 2 were grade 0.78 0.76 and grade 0.11 0.32, respectively (p < 0.001). The mean ocular surface disease index scores in Groups 1 and 2 were 32.07 (zero to 75.00) and 16.31 (zero to 58.33), respectively (p < 0.001).Selective serotonin reuptake inhibitor usage might affect ocular surface by affecting tear film stability and such an association should be kept in mind by both psychiatrists and ophthalmologists in clinical practice.
Yavuzsen T.,Dokuz Eylül University |
Alacacioglu A.,Bozyaka Research and Training Hospital |
Dirioz M.,Dokuz Eylül University |
Yilmaz U.,Dokuz Eylül University
Journal of B.U.ON. | Year: 2011
Purpose: The objective of this study was to determine possible differences in the perception of quality of life (QoL) between physicians and nurses working in an oncology clinic in Turkey. Methods: Seventy-seven physicians and 67 nurses participated in this study. All participants provided information such as the working hours per day and the number of years working in an oncology clinic. The European Organization for Research and Treatment of Cancer (EORTC) QLQC30 questionnaire was used during face-to-face interviews by trained interviewers. Results: The mean age of physicians and nurses were 32±0.8 and 29,9±0.9 years, respectively (p>0.05). Forty-four percent of physicians and all nurses were women. Fifty-three percent of physicians and 57% of nurses were single. Mean working hours per day and number of working years were similar between physicians and nurses. The physical, emotional, and cognitive function scales of physicians were better and statistically significant compared with nurses (p<0.0001,p<0.0006, andp<0.0127, respectively). Global health score was also better in physicians but without statistical significance. In physicians, a significant negative correlation with working hours and emotional, cognitive, role, and social function scales was found. A significant positive correlation with the number of working years and emotional function scale and also with age and role, emotional, cognitive, and social scales was found. Global health showed significant negative correlation with working hours, and positive correlation with age, number of working years, physical, role, emotional, cognitive, and social function scales. Conclusion: It is important to recognize that oncology workers, particularly nurses, have poor QoL. There are many factors adversely affecting the QoL of oncology workers in Turkey, therefore systems should be developed to provide better support and conditions for them. © 2011 Zerbinis Medical Publications.
PubMed | Bozyaka Research and Training Hospital
Type: Journal Article | Journal: Journal of B.U.ON. : official journal of the Balkan Union of Oncology | Year: 2013
The present study was undertaken to evaluate the effects of adjuvant anthracycline-based chemotherapy on thiobarbituric acid reactive substances (TBARS) and superoxide dismutase (SOD) levels in patients with breast cancer who had undergone surgery.Body mass index (BMI), serum lipids (total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides), serum TBARS and SOD values were assessed in 30 patients with stage III breast cancer receiving adjuvant anthracycline- based chemotherapy.Anthracycline-based chemotherapy had no effect on BMI, blood pressure and lipid profile. A significant elevation was noted in TBARS (5.50.6 vs 5.90.9 mol/L; p=0.038) and a significant reduction to baseline values in SOD levels (226.561.0 vs 203.148.3 U/mL; p=0.03) in patients following 6 cycles of adjuvant chemotherapy.The TBARS levels increased, whereas the SOD levels descreased after anthracycline-based chemotherapy. We suggest that oxidative stress is not always detrimental, as it can be beneficial in cancer treatment.