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Ankara, Turkey

Tuna V.,Nizip Government Hospital | Alkis I.,Medical Park Hospital | Safiye A.S.,Guven Hospital | Imamoglu N.,Hayat Hospital | And 2 more authors.
Australian and New Zealand Journal of Obstetrics and Gynaecology | Year: 2010

In this study, comparing four different parameters in women with surgical menopause because of ovariectomy in reproductive age and in women with natural menopause, the effect of withdrawal of ovarian hormones on both groups was investigated. The patient groups in this study were constituted of 100 women in reproductive age who had undergone total abdominal hysterectomy + bilateral salpingo-oophorectomy and 50 women with natural menopause referred to out-patient's clinic within the same period. The findings for four different parameters were recorded one day before the surgery and at 3rd month post-operatively in surgical menopause group and at the day of referral to outpatient clinic in natural menopause group. The parameters planned to be recorded were blood lipid profile, thrombotic system, arterial elasticity and psychosexual variations. Post-operative high-density lipoprotein level in surgical menopause group was found lower than that of natural menopause group (47.08 vs 52.44 mg/dL, P < 0.05). Post-operative very low density lipoprotein level in surgical menopause group was increased more than that in natural menopause group (27.74 vs 23.58 mg/dL, P < 0.05). An increase was observed in post-operative carotid artery Pulsality Index and Resistive Index levels of surgical menopause group compared with natural menopause group (1.44 vs 1.33, P < 0.001 and 0.73 vs 0.68, P < 0.001 respectively). In surgical menopause group, the differences between pre- and post-operative values of bleeding time (1.15 vs 1.24, P < 0.0001), clotting time (5.9 vs 6.08, P < 0.0001) and fibrinogen level (422 vs 395, P < 0.0001) were found statistically significant. While bleeding time and clotting time were increased post-operatively, fibrinogen level was decreased. A significant increase was observed in post-operative mean Kupperman Index levels of surgical menopause group compared with that of natural menopause group (23.89 vs 9.94, P < 0.001). It was concluded that the ovaries should be considered as important organs impacting women's quality of life with their hormones produced also in the period of menopause; that disadvantages of oophorectomy during hysterectomy should be considered and that an attempt to conserve ovaries during surgery except pre-cancerous events would benefit women. © 2010 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Source


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. Source


Bakar B.,Kirikkale University | Sumer M.M.,Guven Hospital | Bulut S.,TOBB University of Economics and Technology
Brain Injury | Year: 2011

Background: Pheochromocytoma may rarely cause arterial dissection. Here the authors report a patient with pheochromocytoma complicated with vertebral artery dissection (VAD) and stroke. Case history: A 48-year-old man presented with probable diagnosis of myocardial infarction. Following premedication with methylprednisolone for coronary artery angiography, he had unstable hypertension. Three days later, he had right cerebellar and left occipital lobe infarction in association with VAD. Urinary cathecolamines and MR scan of the abdomen suggested a diagnosis of phaeochromocytoma, which was later histopathologically confirmed. Conclusion: This case is interesting in that there is no previous report of the combination of pheochromocytoma, VAD, and stroke. Awareness of the atypical clinical presentations of this tumor is important for definitive treatment. © 2011 Informa UK Ltd All rights reserved. Source


Randall J.,National Marrow Donor Program Be the Match | 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. Source


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. Source

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