Diskapi Education and Research Hospital

Ankara, Turkey

Diskapi Education and Research Hospital

Ankara, Turkey
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Topal E.,Gazi University | Gucenmez O.A.,Gazi University | Harmanci K.,DIskapI Education and Research Hospital | Arga M.,Gulhane Military Medical Academy and Medical School | And 2 more authors.
Annals of Allergy, Asthma and Immunology | Year: 2014

Background Knowledge of factors that affect relapse will allow close monitoring of patients at risk, resulting in a decreased rate of readmission to the emergency department. Objective To determine risk factors associated with relapse within 7 days after treatment of asthma exacerbations in children. Methods This was a multicenter, prospective study of children with asthma attacks. Patients between the ages of 6 months and 17 years who met the criteria between June 2009 and September 2012 were considered. Results The study included 1177 patients (775 males [65.8%]) with a mean (SD) age of 70.72 (48.24) months. Of them, 199 (16.9%) had a relapse within 1 week after being discharged from the hospital. Factors independently associated with relapse identified by a logistic regression model for the 1,177 study visits were having taken a short-acting inhaled β2-agonist within 6 hours before admission (odds ratio [OR], 2.43; 95% confidence interval [CI], 1.728-3.426; P =.001), presence of retraction on physical examination (OR, 1.76; 95% CI, 1.123-2.774; P =.01), no prescription for high-dose inhaled steroids on release (OR, 2.02; 95% CI, 1.370-3.002; P <.001), and not being given a written instructional plan (OR, 1.55; 95% CI, 1.080-2.226; P =.02). Conclusion Whereas having taken short-acting β2-agonists within 6 hours before admission and the presence of retractions on physical examination increased the risk of relapse after treatment of the acute attack, being given high-dose inhaled steroids and a written instructional plan when being sent home reduced the risk. © 2014 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Sari E.,Kirikkale University | Eryilmaz T.,Diskapi Education and Research Hospital | Tetik G.,Diskapi Education and Research Hospital | Ozakpinar H.R.,Diskapi Education and Research Hospital | Eker E.,Doctor Nafiz Korez Hospital
International Wound Journal | Year: 2014

Epidermolysis bullosa (EB) is a progressive familial disorder composed of dermal mucosal blisters, flexion contractures and pseudosyndactylies. Flexion contractures and pseudosyndactyly can be treated with surgery but usually require skin grafting. Because of poor wound healing, skin graft harvesting is a challenge in these patients. In order to prevent donor-site morbidities due to skin graft harvesting some alloplastic materials were introduced. In this study, we focused on Suprathel® as a new allograft material for covering the skin defects of a patient with dystrophic EB. © 2014 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Tok D.,Turkish Armed Forces Health Command | Ekiz F.,Hatay Antakya State Hospital | Basar O.,Hacettepe University | Coban S.,Diskapi Education and Research Hospital | Ozturk G.,Diskapi Education and Research Hospital
International Journal of Clinical and Experimental Medicine | Year: 2014

Background and Aim: Early detection of fibrosis should be the main goal of treatment in liver cirrhosis. Endocan, previously called endothelial cell specific molecule-1, is expressed by endothelial cells, primarily in the lung, liver and kidney. In this study, we aimed to examine the correlation of liver fibrosis stage, histological activity and grade of steatosis between serum levels of endocan in patients with chronic hepatitis B (CHB), chronic hepatitis C (CHC) and non-alcoholic fatty liver disease (NAFLD). Patients and Methods: This cross-sectional study includes a total of 146 subjects. 55 CHB patients, 19 CHC patients, 38 NAFLD patients and 34 healthy controls were enrolled consecutively. Liver biopsies were performed in all patients with chronic viral hepatitis. NAFLD patients had either grade 2 or grade 3 steatosis on ultrasonography and elevated liver enzymes above the upper normal limits. Serum endocan levels were assessed from blood samples obtained at admission. Results: Gender distribution was similar among the groups (p=0.056). The mean age of the CHB patients was 45.8±12.1, CHC patients was 55.0±12.8 years, NAFLD patients was 42.8±10.8, while control group was 39.4±13.6 years old. Patients with CHC were older than all the others (p=0.001). Serum endocan levels were statistically significantly lower in CHB, CHC and NAFLD groups when compared with controls. Although levels of endocan were lower in CHB and CHC groups when compared with NAFLD group, the difference was not statistically significant. Conclusion: Serum endocan concentrations decrease in patients with liver disease. Unlike previous studies, we showed a negative correlation between endocan levels and inflammation stage of chronic hepatitis. However, further studies are needed to establish the association between endocan levels, liver fibrosis and hepatic inflammation.

Avci S.,DIskapI Education and Research Hospital | Sarikaya R.,DIskapI Education and Research Hospital | Buyukcam F.,DIskapI Education and Research Hospital
American Journal of Emergency Medicine | Year: 2013

A 28-year-old-man admitted to emergency department with ventricular tachycardia. Patient had drunk 3 cans of 250-mL energy drink 5 hours before the basketball match; he had palpitation and nausea before the match. After 30 minutes of the match, during the break, patient lost his consciousness. On admission, normal cardiac rhythm was achieved by cardioversion, and the patient was hospitalized and died on the third day. Energy drinks generally contain caffeine, taurine, various vitamins, glucose, and herbal extracts such as guarana and ginseng. Especially in high doses, caffeine can cause palpitations and supraventricular and ventricular arrhythmia. Energy drink consumers should be informed about their severe adverse effects in case of overuse. © 2013 Elsevier Inc. All rights reserved.

Bagriacik E.U.,Gazi University | Yaman M.,Gazi University | Haznedar R.,Gazi University | Sucak G.,Gazi University | Delibasi T.,Diskapi Education and Research Hospital
Journal of Endocrinology | Year: 2012

Bone marrow-derived mesenchymal stem cells are pluripotent cells that are capable of differentiating into a variety of cell types including neuronal cells, osteoblasts, chondrocytes, myocytes, and adipocytes. Despite recent advances in stem cell biology, neuroendocrine relations, particularly TSH interactions remain elusive. In this study, we investigated expression and biological consequence of TSH receptor (TSHR) interactions in mesenchymal stem cells of cultured human bone marrow. To the best of our knowledge, we demonstrated for the first time that human bone marrow-derived mesenchymal stem cells expressed a functional thyrotropin receptor thatwas capable of transducing signals through cAMP. We extended this study to explore possible pathways that could be associated directly or indirectly with the TSHR function in mesenchymal stem cells. Expression of 80 genes was studied by real-time PCRarray profiles.Our investigation indicated involvements of interactions between TSH and its receptor in novel regulatory pathways, which could be the important mediators of self-renewal, maintenance, development, and differentiation in bone marrow-derived mesenchymal stem cells. TSH enhanced differentiation to the chondrogenic cell lineage; however, further work is required to determine whether osteoblastic differentiation is also promoted. Our results presented in this study have opened an era of regulatory events associated with novel neuroendocrine interactions of hypothalamic-pituitary axis in mesenchymal stem cell biology and differentiation. © 2012 Society for Endocrinology.

Purnak T.,Ankara Numune Education and Research Hospital | Olmez S.,Ankara Numune Education and Research Hospital | Torun S.,Yuksek Ihtisas Education and Research Hospital | Efe C.,Hacettepe University | And 6 more authors.
Clinics and Research in Hepatology and Gastroenterology | Year: 2013

Background and aims: Liver biopsy is the gold standard procedure for documenting liver damage in chronic hepatitis C (CHC), as for many other chronic liver diseases. Mean platelet volume (MPV) is a laboratory marker obtained from complete blood count (CBC) analysers in routine clinical practice. The goal of the present study was to evaluate whether MPV would be useful in predicting liver histologic severity in CHC. Patients and methods: A total of 59 patients with CHC and 25 control subjects were recruited into the present study. There were 26 men and 33 women in the CHC group and 12 men and 13 women in the control group. MPV was recorded at the time of admission. The clinical characteristics of CHC patients, including demographics, laboratory and liver biopsy findings, were reviewed. Results: A statistically significant increase in MPV values was observed in CHC patients (8.54±0.63 fL) compared to healthy controls (7.65±0.42 fL) (P<0.001). Moreover, MPV values were significantly higher among patients with advanced fibrosis as compared to those with mild fibrosis (8.99±0.57 fL vs8.19±0.50 fL P<0.001). Receiver operator characteristic (ROC) curve analysis suggested that the optimum cut-off point for MPV value in advanced fibrosis was 8.75 fL. (Sensitivity: 80.8%, specificity: 81.8%, positive predictive value [PPV] 77.8%, negative predictive value [NPV] 84.4%, accuracy 81.3%, AUC: 0.98 P<0.001). Conclusion: The current study showed that MPV is increased in CHC with advanced fibrosis. Calculation of MPV along with the use of other markers may give further information about liver fibrosis severity in CHC. © 2012 Elsevier Masson SAS.

Coban S.,Diskapi Education and Research Hospital | Idilman R.,Ankara University | Erden E.,Ankara University | Tuzun A.,Ankara University
Hepato-Gastroenterology | Year: 2011

Background/Aims: Serum gamma-glutamyl-transpeptidase (GGT) levels often increase in chronic hepatitis C. We aimed to identify whether GGT levels can predict sustained virological response (SVR) in patients with chronic hepatitis C and to investigate other potential predictive factors associated with SVR in patients with chronic hepatitis C treated with pegylated interferon and ribavirin at a single center. Methodology: We evaluated 112 consecutive patients with histologically proven chronic hepatitis C who were treated with pegylated interferon and ribavirin. As potential predictors of SVR to combination therapy, we analyzed age, gender, body mass index, pretreatment GGT and alanine transaminase levels, diabetes mellitus, receiving of anti-viral therapy before beginning combination therapy, viral load, and liver histology by use of a multivariate logistic regression model. Results: SVR to combination therapy was seen in 57.2% of the patients. Variables associated with lower rates of sustained response were liver steatosis (p=0.026), diabetes mellitus (p=0.027), receiving anti-viral therapy before beginning combination therapy (p=0.016), higher GGT levels before therapy (>50IU/mL, p<0.001), and advanced fibrosis stage (p=0.017). On logistic regression analysis, the only independent predictor of SVR was the GGT level before therapy (p=0.003). Conclusions: Low serum levels of GGT before treatment are associated with higher rates of SVR in patients with chronic hepatitis C treated with pegylated interferon and ribavirin. © H.G.E. Update Medical Publishing S.A.

Bilgic O.,Diskapi Education and Research Hospital | Bilgic A.,Ankara Education and Research Hospital | Akais H.K.,Diskapi Education and Research Hospital | Eskioaglu F.,Diskapi Education and Research Hospital | Kilic E.Z.,Yeditepe University
Pediatric Dermatology | Year: 2010

Information about the relationship between psoriasis and psychiatric morbidity and quality of life in children and adolescents is limited. We aimed to examine the symptoms of depression and anxiety and health-related quality of life levels in children and adolescents with psoriasis. Forty-eight outpatients with psoriasis aged 8 to18 years are included in this study. Child Depression Inventory (CDI), State-Trait Anxiety Inventories for Children (STAI-C) and Pediatric Quality of Life Inventory Parent and Child Versions (PedQL-P and C) were applied to both patient and control groups. Psoriasis symptom severity was measured by the Psoriasis Area Severity Index (PASI). Both study and control groups were divided into two age groups, child (8-12 yrs) and adolescent (13-18 yrs), to exclude the effect of puberty on psychological condition. The mean CDI score was higher, and PedQL-C psychosocial and total scores were lower in the children compared with controls. Duration of psoriasis had an increasing effect on physical-health and total scores of PedQL-C in the child group and all PedQL-C scores in the entire sample. Psoriasis severity showed a negative correlation with psychosocial and total scores of PedQL-P in the adolescent group and PedQL-P physical-health scores in the entire sample. Psoriasis is related to depression and impaired quality of life in children. The depressive symptoms in children with psoriasis should not be overlooked and psychiatric assessment of these children should be provided. © 2010 Wiley Periodicals, Inc.

PubMed | Diskapi Education and Research Hospital
Type: Journal Article | Journal: Journal of B.U.ON. : official journal of the Balkan Union of Oncology | Year: 2016

Development of metastasis in patients with breast cancer (BC) is the most important negative prognostic factor and this process mainly begins with lymphatic involvement. Therefore, axillary, subclavicular, internal mammary or supraclavicular nodal involvement is a crucial step before metastasis. Anatomical differences between the right and left lymphatic drainages of the breasts may significantly affect the rate, site and time to development of distant metastasis. The purpose of this study was to investigate if laterality is an independent prognostic factor for metastasis in N3 breast cancer patients.From a total of 4215 BC patients diagnosed between 1994 and 2015 in our center, 305 non-metastatic women with pathological N3 (pN3) nodal status at presentation were enrolled in this study. Patients were divided into two groups: left and right BC. Analysis of overall survival (OS) and time to first metastasis (TTM) was performed according to Kaplan-Meier method with log-rank test.The median number of lymph node involvement and lymph node ratio (number of positive lymph nodes / total number of excised lymph nodes) between the two groups was equal (14 and 0,66 respectively). Recurrence was observed in 123 patients [53 (35%) right vs 70 (44%) left group]. Patients with left BC had significantly higher rate of axial bone metastases compared with the right BC group (55.7 vs 35.8%, p<0.02, respectively). TTM was significantly shorter in the left BC group [49.1 months (95% CI 36.5-61.8) vs 103.6 months (95% CI 47.0-160); p7equals;0.03, respectively]. Median OS did not differ between the groups, however, there was a trend towards lower OS in patients with left BC (p=0.68).Left laterality in patients with pN3 non-metastatic BC is an independent prognostic factor associated with shorter TTM, increased risk of distant metastases and axial bone involvement compared with right laterality.

PubMed | Diskapi Education and Research Hospital and Cumhuriyet University
Type: Journal Article | Journal: Journal of medical virology | Year: 2016

Members of triggering receptor expressed on myeloid cells (TREM) family are known as immunmodulators in several infectious or noninfectious inflammatory disorders. The information about their role in viral infections is very limited. To enlighten if there is a relation between soluble TREM-1(sTREM-1) and a viral infection, Crimean Congo Haemorrhagic Fever (CCHF), we investigated the levels of sTREM-1 in the sera of 39 CCHF patients both at admission and at recovery and compared with 40 healthy controls by using microELISA technique. Statistical analysis was made by using Statistical Package for Social Sciences (SPSS) for Windows 20 programme. Value of P<0.05 was accepted as significant for statistical analyses. Median sTREM-1 level was higher in CCHF group when compared to the control group (1,961 vs. 151.1pg/ml, respectively; P<0.001). In CCHF patients, sTREM-1 levels were significantly decreased at recovery compared to initial level measured at hospital admission (1,961 vs. 948pg/ml, respectively; P=0.019). sTREM-1 is correlated with CRP, WBC, and Plt. We found that serum levels of sTREM-1 higher than 405.9pg/ml existed as a cut off point for differentiating CCHF patients and control group with a sensitivity of 94.9% and specifity of 87.5%. It is proved that sTREM-1 is increased and correlates with the clinical and laboratory findings in CCHF, a viral infection characterized by activation of inflammation. This finding may lead new studies to enlighten the pathogenesis of infections developing by activation of inflammatory cascades and high level cytokine releases, especially. J. Med. Virol. 88:1473-1478, 2016. 2016 Wiley Periodicals, Inc.

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