Guven Hospital

Ankara, Turkey

Guven Hospital

Ankara, Turkey
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Gur G.,Hacettepe University | Turgut E.,Hacettepe University | Ayhan C.,Hacettepe University | Baltaci G.,Guven Hospital | Yakut Y.,Hasan Kalyoncu University
Clinical Biomechanics | Year: 2017

Background Bracing is the most common nonsurgical treatment for adolescent idiopathic scoliosis. Spinal braces affect glenohumeral and scapulothoracic motion because they restrict trunk movements. However, the potential spinal-bracing effects on scapular kinematics are unknown. The present study aimed to investigate the acute effects of spinal bracing on scapular kinematics in adolescent idiopathic scoliosis. Methods Scapular kinematics, including scapular internal/external rotation, posterior/anterior tilting, and downward/upward rotation during scapular plane elevation, were evaluated in 27 in-brace and out-of-brace adolescent idiopathic scoliosis patients with a three-dimensional electromagnetic tracking system. Data on the position and orientation of the scapula at 30°, 60°, 90°, and 120° humerothoracic elevation were used for statistical comparisons. The paired t-test was used to assess the differences between the mean values of in-brace and out-of-brace conditions. Findings The in-brace condition showed significantly increased (P < 0.05) scapular anterior tilting and decreased internal rotation in the resting position on the convex and concave sides; increased scapular downward rotation at 120° humerothoracic elevation on the convex side and at 30°, 60°, 90°, and 120° humerothoracic elevation on the concave side; increased scapular anterior tilt at 30°, 60°, 90°, and 120° humerothoracic elevation on the convex and concave sides; and decreased (P < 0.05) maximal humerothoracic elevation of the arm. Interpretation Spinal bracing affects scapular kinematics. Observed changes in scapular kinematics with brace may also affect upper extremity function for adolescents with idiopathic scoliosis. Therefore, clinicians should include assessments of the glenohumeral and scapulothoracic joints when designing rehabilitation protocols for patients with adolescent idiopathic scoliosis. © 2017 Elsevier Ltd


Turgut E.,Hacettepe University | Ayhan C.,Hacettepe University | Baltaci G.,Guven Hospital
Journal of Hand Therapy | Year: 2017

Study Design: Cross-sectional and controlled laboratory study using pretest-posttest design. Introduction: Patients with distal radius fracture (DRfx) report proximal segment problems. Taping is commonly recommended because it provides improved posture and function. Purpose of the Study: This study aimed to investigate the 3-dimensional scapular kinematics and the effect of taping on the kinematics in participants with DRfx. Methods: Twenty participants with a unilateral history of DRfx and 20 healthy controls participated. Scapular kinematics was assessed using an electromagnetic system. Three separate strips of elastic taping were applied for participants with DRfx over the arm, scapula, and middle and lower trapezius muscles through the paravertebral muscles. Afterward, the scapular kinematics was reassessed in taped condition. Results: When participants with DRfx and healthy controls compared, the scapula was more downwardly rotated at 120° of humerothoracic elevation (mean difference [MD], 9.06°) and at 120° (MD, 9.04°), 90° (MD, 5.6°) of humerothoracic lowering, more upwardly rotated at 30° of humerothoracic lowering (MD, 5.1°). Taping showed a significant effect on kinematics; specifically, the scapula was more externally rotated (38.9° untaped vs 31.1° taped) and posteriorly tilted (-9.2° untaped vs -4.8° taped) during humerothoracic elevation and lowering for participants with DRfx. Discussion: Participants with DRfx showed different scapular kinematics and taping resulted in changes on tested kinematic parameters during humeral movements. Differences in scapular motion during elevation with taping showed a specific pattern. Conclusions: Overall, taping maintained a position likely to produce optimal rotator cuff function during early rehabilitation of patients with DRfx. Level of Evidence: N/A. © 2017 Hanley & Belfus.


Bozbas S.S.,Baskent University | Bozbas H.,Guven Hospital
World Journal of Gastroenterology | Year: 2016

Pulmonary vascular disorders including portopulmonary hypertension (PoPHT) are among the common complications of liver disease and are prognostically significant. Survival is very low without medical treatment and liver transplantation. With advances in medical therapy for elevated pulmonary artery pressure (PAP) and liver transplant surgery, survival of patients with PoPHT and advanced liver disease is significantly improved. Because of the prognostic significance of PoPHT and the limited donor pool, a comprehensive preoperative cardio-pulmonary assessment is of great importance in cirrhotic patients prior to transplant surgery. Therefore, a detailed transthoracic Doppler echocardiographic examination must be an essential component of this evaluation. Patients with mild PoPHT can safely undergo liver transplant surgery. In cases of moderate to severe PoPHT, right heart catheterization (RHC) should be performed. In patients with moderate to severe PoPHT on RHC (mean PAP 35-45 mmHg), vasodilator therapy should be attempted. Liver transplantation should be encouraged in cases that demonstrate a positive response. Bridging therapy with specific pulmonary arterial hypertension treatment agents should be considered until the transplant surgery and should be continued during the peri-and post-operative periods as needed. © The Author(s) 2016.


Arpaci E.,Sakarya University | Tokluoglu S.,Guven Hospital | Yetigyigit T.,Namik Kemal University | Alkis N.,Ankara Oncology Training and Research Hospital
Asian Pacific Journal of Cancer Prevention | Year: 2013

Background: A literature review on 1,104,269 cancer patients concluded that the prevalence of multiple primary malignancies (MPM) is between 0.73% and 11.7%. MPMs seem to have higher incidence than that influenced by hazard only. The purpose of this study was to investigate clinically useful information for effective screening for synchronous and metachronous second primary cancers and to identify a potential surveillance protocol. Materials and Methods: Using statistical and epidemiological indicators we evaluated the patients with MPMs (double locations) admitted to Dr. Abdurrahman Yurtarslan Ankara Oncology Education and Research Hospital between 1981 and 2010. Results: Out of the 130 cases, 24 (18.4%) were synchronous while 106 cases (81.6%) were metachronous tumours. Mean interval time from first to second primary cancers was 4.65 years (0-27 years). The most frequent malignant associations were breast-breast, breast-endometrium and breast-ovary. Both primary and secondary tumors tended to be in an advanced stage explained by the low compliance of the patients to follow-up. Conclusions: The possibility that MPMs exist must always be considered during pretreatment evaluation. Screening procedures are especially useful for the early detection of associated tumors, whereas careful monitoring of patients treated for primary cancer and a good communication between patients and medical care teams should ensure early detection of secondary tumors, and subsequent appropriate management.


Ertek S.,Ufuk University | Cicero A.F.,University of Bologna | Cesur M.,Guven Hospital | Akcil M.,Baskent University | And 3 more authors.
Acta Diabetologica | Year: 2011

Our aim in this study was to evaluate the relationship between metabolic syndrome (MS) as defined by different criteria and the severity of coronary lesions in a sample of diabetic and non-diabetic patients undergoing elective coronary angiography. All patients had blood and urine tests, physical examinations were performed before angiography, and finally they were classified based on three criteria (World Health Organisation-WHO, Adult Treatment Panel-ATP III and International Diabetes Federation-IDF). Eighty-eight patients were diabetic, and 96 patients were non-diabetic. Among all patients, diabetics had significantly higher Gensini scores (P < 0.001). According to WHO criteria (P = 0.005) and IDF criteria (P = 0.015) metabolic syndrome patients had higher Gensini scores, but for ATP III criteria difference was not significant. When we evaluated diabetics and non-diabetics separately, non-diabetic patients with MS had significantly higher scores with WHO definition (P = 0.015) and mildly higher but not significant values with other MS criteria (P = 0.057 for both IDF and ATP III). Neither any one of MS components nor gender revealed significant relationship with coronary disease severity. In our study with a cohort of Turkish patients undergoing elective coronary angiography; we concluded that MS should be taken into consideration, especially in non-diabetic patients. © 2010 Springer-Verlag.


Randall J.,Patient and Health Professional Services | Keven K.,Ankara University | Atli T.,Guven Hospital | Ustun C.,University of Minnesota
Bone Marrow Transplantation | Year: 2016

Allogeneic hematopoietic cell transplantation (alloHCT) may be the only curative option for some older adults with hematologic malignancies, and its associated risks of significant morbidity and mortality warrant a clear, informed decision-making process. As older adults have not been transplanted routinely until recent years, younger people have been the prototypical group around whom the current process has developed. Yet, this process is applied to older adults who have different considerations than younger patients when making their transplant decision. Older adults do not have the open-ended lives of younger patients and are entitled to consider how to spend their remaining time. They also possess maturity and experience, and with proper knowledge, they can make informed choices rather than moving forward in the transplant process unaware. Notably, older patients face similar problems with the informed decision-making process in nephrology. Strategies such as providing education about alloHCT gradually and repeatedly during induction, presenting recent knowledge from the literature in plain language, and utilizing a team approach to patient education may help older adults make the best decision about transplant in light of their situation and values. Understanding when and how older adults decide on alloHCT is an important first step to further exploring this problem. © 2016 Macmillan Publishers Limited.


Uzun M.,Cag Medical Center | Akkan K.,Cag Medical Center | Coskun B.,Guven Hospital
Diagnostic and Interventional Radiology | Year: 2010

Round ligament varicosities are easily misdiagnosed as an obstructed hernia in a gravid patient. When this condition is diagnosed correctly, unnecessary intervention may be prevented. We aimed to determine the significance of round ligament varicosities in pregnancy and to describe their clinical presentation and sonographic appearance. © Turkish Society of Radiology 2010.


Han S.,Guven Hospital
Chirurgia | Year: 2010

Various pathologies leading to dyspnea have been described. There is limited information on dyspnea associated with pathology of the xiphoid process. In this pathology, malposition or chondritis may develop due to trauma or abdominal obesity. All of these may lead to sensitivity and/or pain in the xiphoid area of the patient, which results in difficulty in breathing deeply and discomfort in breathing. Dyspnea is more pronounced during physical activity. Four patients with dyspnea associated with xiphoid pathologies were evaluated in our clinic. In these patients, xiphoid resection was performed. In early postoperative period and afterwards, the conditions of the patients significantly improved. Here, the patients with dyspnea associated with xiphoid pathologies whose conditions improved after surgery have been presented.


Sari T.,Ankara Nuclear Research And Training Center | Tulek N.,Ankara Nuclear Research And Training Center | Bulut C.,Ankara Nuclear Research And Training Center | Oral B.,Guven Hospital | Tuncer Ertem G.,Ankara Nuclear Research And Training Center
Travel Medicine and Infectious Disease | Year: 2014

Objective Due to lack of effective treatment for rabies, post-exposure prophylaxis becomes very important. In this study, we investigated side effects developed in patients following administration of rabies post-exposure prophylaxis.Methods A total of 1685 patients were vaccinated. 265 patients (15.7%) administered the Essen regimen with equine rabies immunoglobulin and 1420 patients (84.2%) administered Zagreb regimen. 761 (45.2%) patients were vaccinated with a verocell vaccine; Verorab and 924 patients (54.8%) were vaccinated with Abhayrab.Results All side effects were higher in female patients than those of males. The patients with chronic illness also had significantly, increased side effects; headache (12.4%), pain at site of administration (11.3%), and arthralgia (10.5%) compared to the patients without chronic illness. We grouped the patients in three as; 0-15years, 15-60 years, and 60 years and above. In the first group; fever (21.2%), vomiting (2.4%) and coughing (2.1%); in the second group (15-60 years), headache (8.8%), arthralgia (6.7%) were significantly increased compared to the other groups. Side effects are significantly higher with schema of 2-1-1 and Abhayrab trade mark vaccine, particularly following the first doses. Discussion Second generation rabies vaccines are safe, effective and cheaper than HDCV. When fatality of rabies disease is considered, occurring side effects can be tolerated. © 2014 Elsevier Ltd.


Cekmen N.,Guven Hospital | Aydimathn A.,Guven Hospital | Erdemli O.,Guven Hospital
e-SPEN | Year: 2011

Background & aims: Glutamine supplementation has beneficial effects on morbidity and mortality in critically ill patients. We investigated the effect of L-alanyl-L-glutamine dipeptide supplemented TPN on biochemical parameters, length of stay (LOS) and mortality in 30 critically patients. Methods: Randomized, prospective, controlled, double-blind study in general intensive care ünit (ICU) in Guven hospital, Turkey. 30 patients admitted to the ICU and requiring TPN for more than 5 days. The patients were randomized and analyzed in two groups; Patients received either Gln-supplemented TPN (containing L-alanyl-L-glutamine dipeptide; 0.5 g/kg per day; n = 15) or standart Gln-free TPN (control group n = 15). Demographics, time of TPN, APACHE II score, type of diagnosis, biochemistry, nutritional, immune parameters, ICU LOS, ICU mortality, and in-hospital mortality were analyzed and compared. Results: There were no difference between groups according to the demographics, APACHE II score, the duration of TPN, diagnosis, the biochemistry except albumin, nutritional and inflammatory parameters, ICU LOS, ICU mortality, and in-hospital mortality. After 2 weeks of treatment, in Gln-supplemented TPN group exhibited significant increases in serum albumin levels (P = 0.006). Conclusion: We found no biochemical and clinical difference between the two groups. Much trials will be necessary to identify a difference in our patient population. © 2011.

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