Haseki Educational and Research Hospital

İstanbul, Turkey

Haseki Educational and Research Hospital

İstanbul, Turkey

Time filter

Source Type

Kotil K.,Istanbul Educational and Research Hospital | Savas Y.,Haseki Educational and Research Hospital
Journal of Spinal Disorders and Techniques | Year: 2013

STUDY DESIGN:: Prospective cohort data by merging data from comparative studies. OBJECTIVE:: This study aimed to compare clinical and radiologic outcomes of the transforaminal lumbar interbody fusion (TLIF) procedure with or without pedicle screw support in stable patients with a degenerative disease. SUMMARY OF BACKGROUND DATA:: The unilateral lumbar interbody fusion technique has gained popularity in the management of many lumbar degenerative conditions requiring fusion. TLIF is routinely performed with the support of pedicle screws. The use of the TLIF procedure without pedicle screw support has not yet been reported. METHODS:: Between February 2006 and May 2009, surgical decompression and fusion was performed in patients with lumbar degenerative conditions using the TLIF technique either with (n=30, group A) or without pedicle screw support (n=30, group B). The 2 groups had similar age, sex distribution, pain level, and pain history. In this prospective study, patients were followed for a mean period of 31 months (range, 22 to 38 mo). The mean age was 45.5 years (range, 29 to 78 y), and all patients had a disease involving a single intervertebral space. RESULTS:: The female to male ratio was 19:11 and 18:12 in groups A and B, respectively. Pain and function were evaluated by the Oswestry disability index and visual analog scale. Pseudoarthrosis developed in 2 patients from group A and in 3 patients from group B. Although these 5 patients had insufficient fusion, they did show a clinical improvement. The mean duration of the operation was 110 and 73 minutes in groups A and B, respectively. The mean total amount of bleeding was 410 and 220 mL in groups A and B, respectively. Cage loosening did not occur in group A, but 1 patient in group B developed asymptomatic cage loosening limited to the endplates. Four patients in group A suffered sciatic pain because of the malposition of the screw, and 1 patient in group B had contralateral sciatic pain lasting for 2 months. The visual analog scale and Oswestry disability index scores were higher in group A than in group B 1 month after the operation (P<0.005), but the groups did not significantly differ at 3 months (P<0.89). The cost of the procedure was 3-fold higher in group A compared with group B. CONCLUSIONS:: This study showed that the TLIF procedure without pedicle screw support would be sufficient in the management of preoperatively stable patients with lumbar degenerative spinal disease requiring fusion after single-level decompression. This technique is minimally invasive, requires only unilateral intervention, allows magnetic resonance imaging during the postoperative period and is associated with less costs and complications when compared with pedicle screwing. This study represents the first prospective comparative report on this technique showing several of its advantages. © 2012 Lippincott Williams and Wilkins.


Meydan E.A.,Haseki Educational and Research Hospital | Civilibal M.,Haseki Educational and Research Hospital | Elevli M.,Haseki Educational and Research Hospital | Duru N.S.,Haseki Educational and Research Hospital | Civilibal N.,Istanbul University
International Urology and Nephrology | Year: 2012

Background The purpose of this study was to assess the effect of monosymptomatic nocturnal enuresis (MNE) on the quality of life of the mothers. Methods Mothers who have a child with MNE (n = 60) and mothers who have a child without any health problems (n = 90) were included in the study. Groups were similar for background variables (child's age, gender, and number of siblings; mother's age and marital status; and economic status of families and presence of health insurance). The key question was to determine whether or not the difference between the two groups in terms of the quality of life. All mothers underwent Short-Form Health Survey (SF-36) Questionnaire, Spielberg's State-Trait Anxiety Inventory (STAI), and the Beck Depression Inventory (BDI). Results All SF-36 subscales except social functioning were significantly lower in mothers of enuretic children. The trait-anxiety score, the subcomponent of the STAI, was higher in mothers who have a child with enuresis nocturna (P<0.001). The mean BDI score was higher in enuretic group (P<0.001). There was no significant correlation between SF-36, STAI, and BDI scores and child's age, gender, number of siblings, and mother's age. Conclusion This study shows that the quality of life of the mothers was negatively affected by having a child with MNE. © Springer Science+Business Media, B.V. 2011.


Civilibal M.,Haseki Educational and Research Hospital | Duru N.S.,Haseki Educational and Research Hospital | Elevli M.,Haseki Educational and Research Hospital
Pediatric Nephrology | Year: 2014

Results: We found a significantly higher cIMT in children with MS than in healthy children, but carotid DC and flow-mediated EDD were lower in the former. Multivariate analysis revealed that a higher cIMT was independently associated with a higher nighttime systolic blood pressure (SBP) and lower high-density lipoprotein-cholesterol (β = 0.386, p = 0.011 and β = 0.248, p = 0.042, respectively). Also, higher nighttime SBP remained an independent predictor of lower DC (β = 0.495, p = 0.009), and higher 24-h SBP was the only independent predictor for a lower EDD (β = 0.532, p = 0.004).Background: The metabolic syndrome (MS) has reached epidemic proportions worldwide. This syndrome is associated with cardiovascular risk factors, including functional and structural cardiac and vascular changes. The aim of our study was to evaluate subclinical atherosclerosis and its associated risk factors in children with MS.Methods: The study cohort comprised 52 children with MS and 38 age- and sex-matched healthy children. The diagnosis of MS was made according to criteria adopted by the World Health Organization. Blood pressure based on 24-h ambulatory blood pressure monitoring (ABPM), carotid intima-media thickness (cIMT), carotid distensibility coefficient (DC) and flow-mediated endothelium-dependent dilation (EDD) were assessed in all children.Conclusions: Atherosclerotic vascular changes were common among our pediatric patients with MS and easily determined by high-resolution ultrasound imaging. In particular, subclinical atherosclerosis was clearly associated with nocturnal or 24-h systolic hypertension as measured by ABPM. We therefore recommend that subclinical vascular changes and AMBP measurements should be used as diagnostic markers to predict atherosclerotic risks in this pediatric patient group. © 2014, IPNA.


Cakir E.,Bezmialem Foundation University | Buyukpinarbasili N.,Bezmialem Foundation University | Ziyade S.,Bezmialem Foundation University | Selcuk-Duru H.N.,Haseki Educational and Research Hospital | And 2 more authors.
Pediatric Pulmonology | Year: 2013

Pulmonary nocardiosis is a rare infection and overwhelmingly limited to immunocompromised individuals. Endobronchial nocardiosis is even more rare. Nocardiosis is rarely seen in immunocompetent hosts mostly as cutaneous infection. Here we report an immunocompetent child with endobronchial nocardiosis presenting as nonresolving pneumonia and lung abscess. To our knowledge, this is the first case reported in the literature of endobronchial nocardiosis in a child. Pediatr Pulmonol. 2013; 48:1144-1147. © 2012 Wiley Periodicals, Inc. © 2012 Wiley Periodicals, Inc.


Bostanci B.K.,Haseki Educational and Research Hospital | Civilibal M.,Haseki Educational and Research Hospital | Elevli M.,Haseki Educational and Research Hospital | Duru N.S.,Haseki Educational and Research Hospital
Pediatric Nephrology | Year: 2012

Background: The metabolic syndrome (MS), a cluster of potent risk factors for cardiovascular disease, is composed of insulin resistance, obesity, hypertension and hyperlipidemia. The aim of our study was to investigated the relationships between MS and left ventricular mass index (LVMI) in childhood MS. This study included 50 children and adolescents with MS aged between 7-18 years. Methods: Thirty age- and sex-matched healthy children served as a control group. The diagnosis of MS was made according to the criteria adapted from the World Health Organization. They underwent clinical examination with causal blood pressure (BP) measurements, 24-hour ambulatory blood pressure monitoring (ABPM) and echocardiogram. Patients underwent echocardiography to detect left ventricular hypertrophy (LVH). LVMI was calculated as left ventricular mass/height2.7. Results: The mean age of MS group was 12.0±3.1 years. The mean value of LVMI was 46.5±11.5 g/m2.7 in the MS group and it was significantly higher than those in the healthy children. The prevalence of severe LVH was 12% using adult criteria (LVM>51 g/m2.7) and 44 % using pediatric criteria (LVM>95th percentile). The mean daytime systolic BP load (β=0.315, p=0.003) and HOMA-IR (β=0.368, p=0.006) were found as the independent predictors of LVMI. Conclusions: In conclusion, LVH occurs commonly in pediatric MS and is associated with systolic hypertension and insulin resistance. LVMI should be measured routinely for the predicting of cardiovascular risks in these patients. © IPNA 2012.


Kotil K.,Istanbul Educational and Research Hospital | Akcetin M.A.,Haseki Educational and Research Hospital | Savas Y.,Istanbul Educational and Research Hospital
Journal of Clinical Neuroscience | Year: 2012

We rarely use the cervical transpedicular fixation (CPF) technique in the neurosurgery departments of the authors' institutions because the pedicle is thin and there is a risk of neurovascular damage. In this study we investigated postoperative neurovascular injury caused by the transpedicular screws of 210 pedicles in 45 patients on whom we performed CPF for various cervical pathologies. Fixation was performed between C3 and C7, and the iliac crest and lamina were used as autografts for fusion. In 205 of 210 pedicles (97.6%), the screws were in the correct position, while a non-critical lateral orientation was detected in three pedicles (1.4%). Two screws (one in each of two patients) were positioned inappropriately (0.9%, Grade 3), unilaterally and directly in the vertebral foramen, as shown on postoperative CT scans; blood circulation was normal on angiography. The fusion rate was 100%. The average screw length used for C3 to C7 was 32 mm. The patients were followed up for an average of 35.7 months (range: 17-60 months). There was no morbidity or mortality in our study. We concluded that CPF provides very strong cervical spine fixation but also carries a risk of pedicle perforation without neurovascular injury. However, a free-hand technique performed by an experienced surgeon is acceptable for CPF for various cervical pathologies. © 2011 Elsevier Ltd. All rights reserved.


Elevli M.,Haseki Educational and Research Hospital | Civilibal M.,Haseki Educational and Research Hospital | Ersoy O.,Haseki Educational and Research Hospital | Demirkol D.,Bezmialem Foundation University | Gedik A.H.,Bezmialem Foundation University
Indian Journal of Pediatrics | Year: 2014

Paraphenylene daimine (PPD) is a kind of aromatic amine that is widely used in several industrial products. Women also use PPD added to henna (Lawasonia alba) as a hair dye. Though rare in Western countries, PPD poisoning is quite common in East Africa, India and Middle Eastern countries because it is a traditional product at these countries. Different pathologies were described as caused by PPD ingestion including angioedema of head and neck, rhabdomyolysis, and acute renal failure. The authors report a case of systemic poisoning with PPD that lead to angioedema resulting in tracheostomy and rhabdomyolysis. © Dr. K C Chaudhuri Foundation 2013.


Keskin N.,Haseki Educational and Research Hospital | Civilibal M.,Haseki Educational and Research Hospital | Elevli M.,Haseki Educational and Research Hospital | Koldas M.,Haseki Educational and Research Hospital | And 2 more authors.
Pediatric Nephrology | Year: 2011

Henoch-Schonlein purpura (HSP) is a systemic vasculitis characterized by involvement of skin, joints, gastrointestinal tract (GIT), and kidney; its pathogenesis is still controversial. The aim of our study was to investigate the role of oxidative stress in the pathogenesis of HSP. Plasma advanced oxidation protein products (AOPP) level was measured in 29 children with HSP at the onset of the disease and during remission in comparison with 30 healthy subjects. Patients at the active stage had significantly higher AOPP levels than those at the remission stage of HSP and the controls (42.9±25.7, 30.6±11.8, 27.9±11.2 mmol/l; P= 0.027 and P=0.023 respectively). The mean AOPP levels of the patients with arthritis and/or arthralgia were significantly higher those than without joint involvement (48.3±26.0 and 22.3±9.3, P=0.036 respectively). However, AOPP levels were similar in patients with and without gastrointestinal involvement. Plasma AOPP levels were positively correlated with leukocyte and thrombocyte count at disease onset, whereas they were found to be negatively correlated with serum glucose and sodium levels. The mean thrombocyte count was the only independent predictor of increased level of AOPP in regression analysis (β=0.407; P=0.029). In conclusion, this study showed that increased oxidative stress may play an important role in the pathogenesis of HSP. Also, we suggest that higher platelet count might be an indirect indicator of oxidative stress in these patients. Further research is required to identify the potential association between oxidative stress and increased thrombocyte count in children with HSP. © 2011 IPNA.


PubMed | Istanbul University and Haseki Educational and Research Hospital
Type: Journal Article | Journal: Journal of pediatric urology | Year: 2014

The aim of this study was to measure the 24 h urinary calcium content in children with monosymptomatic nocturnal enuresis (MNE) and compare with those in healthy children to investigate whether there is any relation with enuresis and hypercalciuria.This study included 120 children and adolescents with MNE aged between 7 and 14 years. Eighty age- and sex-matched healthy children served as a control group. To determine urinary calcium excretion, 24 h urine samples were collected. The children with enuresis were divided into two sub-groups as hypercalciuric and normocalciuric groups according to the amount of urinary calcium excretion.Hypercalciuria was found in 27 (23%) of the MNE patients compared with two (4%) of continent children (p<0.001). In addition, the mean 24 h urine calcium/body weight ratio was higher in the enuresis group than in the control group, 2.942.42 versus 1.591.72, respectively (p=0.002). When the children with enuresis were divided into two groups as normokalsiuric and hypercalciuric, the hypercalciuric children were younger and the majority of this group were boys..Our study showed that hypercalciuria is common in children with MNE, so we suggested measuring urine calcium levels in NE patients. However, further studies are needed to clarify the relationship between hypercalciuria and NE in larger series..


PubMed | Haseki Educational and Research Hospital
Type: Case Reports | Journal: Indian journal of pediatrics | Year: 2014

Paraphenylene daimine (PPD) is a kind of aromatic amine that is widely used in several industrial products. Women also use PPD added to henna (Lawasonia alba) as a hair dye. Though rare in Western countries, PPD poisoning is quite common in East Africa, India and Middle Eastern countries because it is a traditional product at these countries. Different pathologies were described as caused by PPD ingestion including angioedema of head and neck, rhabdomyolysis, and acute renal failure. The authors report a case of systemic poisoning with PPD that lead to angioedema resulting in tracheostomy and rhabdomyolysis.

Loading Haseki Educational and Research Hospital collaborators
Loading Haseki Educational and Research Hospital collaborators