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Kayadibi H.,Adana Military Hospital | Yasar B.,Haydarpasa Numune Training Hospital | Ozkara S.,Haydarpasa Numune Training Hospital | Kurdas O.O.,Haydarpasa Numune Training Hospital | Gonen C.,Haydarpasa Numune Training Hospital
Scandinavian Journal of Clinical and Laboratory Investigation | Year: 2014

Aim. To provide a simple fibrosis index combining the routine laboratory markers for predicting significant fibrosis (SF) and cirrhosis in patients with chronic HCV. Methods. Platelet count, ALT, AST, AST to ALT Ratio, AST to Platelet Ratio Index (APRI), Forns index, FIB-4 and Age Platelet Index of 202 liver biopsy performed HCV-infected patients were reviewed. METAVIR classification was used to determine the stage of liver fibrosis. The predictive fibrosis index was constructed by multiple linear regression analysis (- 2.948 + 0.562 × Forns index + 0.288 × APRI + 0.006 × platelet count [109/L]). Results. Median (25th-75th interquartile range) age was 52 (42-59) years, and 61% were male. 65.8% (n = 133) had SF (F2-F4) and 23.3% (n = 47) had cirrhosis (F4). For discrimination of SF, AUROCs were: Fibrosis index = 0.869, Forns index = 0.837, APRI = 0.814, platelet count = 0.764. For cirrhosis, AUROCs were: Fibrosis index = 0.911, Forns index = 0.883, APRI = 0.847, platelet count = 0.827. A cut-off point of ≤ 1.2 for fibrosis index excluded SF in 89% of patients with sensitivity of 96%, while > 2.0 predicted SF in 88% of patients with specificity of 86%. Threshold of ≤ 1.9 excluded cirrhosis in 95% of patients with sensitivity of 94%, while > 2.7 showed cirrhosis in 88% of patients with specificity of 95%. In multivariate logistic regression analysis, OR (95% CI) of fibrosis index was 7.825 (3.682-16.629) for SF (p < 0.001) and was 8.672 (4.179-17.996) for cirrhosis (p < 0.001). Conclusion. SF and cirrhosis were predicted with accuracy of 82% and 89% and were excluded with accuracy of 74% and 82% using this fibrosis index which may potentially decrease the need for liver biopsy in 76% and 83% of patients, respectively. © 2014 Informa Healthcare.


Karaman M.I.,Haydarpasa Numune Training Hospital | Zulfikar B.,Istanbul University | Ozturk M.I.,Haydarpasa Numune Training Hospital | Orhan K.,Haydarpasa Numune Training Hospital | And 2 more authors.
Urology Journal | Year: 2014

Purpose: Circumcision is a very common surgical procedure that has been performed for thousands of years. In this paper, we report the long-term results of circumcision performed by using diathermic knife on patients with bleeding diathesis and the amount of blood factors used. Materials and Methods: A total of 147 patients with bleeding diathesis circumcised under local anesthesia by using diathermic knife between 1996 and 2010 were recruited into this study. Age of the patients, type of the bleeding diathesis and the treatment protocols were recorded. Postsurgical infection and bleeding rates of 2 different factor replacement protocols were recorded. Results: Mean age of the patients was 11.5 years (range, 1.5-37 years). In the group of protocol 1 applied patients, 3 patients (4%) had bleeding and one patient had infection whereas in group of protocol 2, 4 patients (5.4%) had bleeding. The bleeding cases were taken under control after the factor replacement and elastic bandage. Conclusion: Whenever it is necessary for an individual to be circumcised for any reason whatsoever, we think that circumcision can be performed in the patients with bleeding diathesis with lower costs and complication rates by using diathermic knife and the protocol that we used.


Gurbuz M.S.,Emsey Hospital | Berkman M.Z.,Acibadem Hospital | unal E.,Agri Public Hospital | Akpinar E.,Sanliurfa Public Hospital | And 3 more authors.
Asian Spine Journal | Year: 2015

Study Design: Retrospective cohort study. Purpose: To compare surgical results of foramen magnum decompression with and without duraplasty in Chiari malformation type 1 (CM-1) associated syringomyelia (SM). Overview of Literature: The optimal surgical treatment of CM-1 associated with SM is unclear. Methods: Twenty-five cases of CM-1 with SM were included. There were 12 patients (48%) in the non-duraplasty group and 13 patients (52%) in the duraplasty group. The rate of improvement, state of postoperative SM size, amount of tonsillar herniation, preoperative symptom duration, complications and reoperation rates were analysed. Results: The rate of clinical improvement was significantly higher with duraplasty (84.6%) than without (33.3%, p <0.05). The rate of postoperative syrinx regression was significantly higher in the duraplasty group (84.6%) than in the non-duraplasty group (33.3%, p <0.05). One case in the duraplasty group needed a reoperation compared with five cases in the non-duraplasty group (p =0.059). Conclusions: Duraplasty is superior to non-duraplasty in CM-1 associated with SM despite a slightly higher complication rate. © 2015 by Korean Society of Spine Surgery.


PubMed | Emsey Hospital, Haydarpasa Numune Training Hospital, Sanliurfa Public Hospital, Agri Public Hospital and Acibadem Hospital
Type: Journal Article | Journal: Asian spine journal | Year: 2015

Retrospective cohort study.To compare surgical results of foramen magnum decompression with and without duraplasty in Chiari malformation type 1 (CM-1) associated syringomyelia (SM).The optimal surgical treatment of CM-1 associated with SM is unclear.Twenty-five cases of CM-1 with SM were included. There were 12 patients (48%) in the non-duraplasty group and 13 patients (52%) in the duraplasty group. The rate of improvement, state of postoperative SM size, amount of tonsillar herniation, preoperative symptom duration, complications and reoperation rates were analysed.The rate of clinical improvement was significantly higher with duraplasty (84.6%) than without (33.3%, p <0.05). The rate of postoperative syrinx regression was significantly higher in the duraplasty group (84.6%) than in the non-duraplasty group (33.3%, p <0.05). One case in the duraplasty group needed a reoperation compared with five cases in the non-duraplasty group (p =0.059).Duraplasty is superior to non-duraplasty in CM-1 associated with SM despite a slightly higher complication rate.


Beyoglu D.,Marmara University | Ozkozaci T.,Haydarpasa Numune Training Hospital | Akici N.,Haydarpasa Numune Training Hospital | Omurtag G.Z.,Marmara University | And 3 more authors.
International Journal of Hygiene and Environmental Health | Year: 2010

The present study is aimed to evaluate the possible DNA damage in children who are living with smoker parents. The tests were conducted by using alkaline comet assay, measured as a percentage of DNA damage in tail (%DNAT). The children that participated in the study were selected from the pediatric unit of a hospital in Istanbul, Turkey. %DNAT was significantly higher (p<0.01) in children who were exposed to indoor tobacco smoke (10.73±1.38) compared to the children in the control group (8.16±1.29). The number of cigarettes consumed by household members did not seem to affect the severity of the DNA damage. Since children spend most of their time at home and cannot remove themselves from harmful living conditions this important genotoxic finding should be considered by smoker parents for the future health consequences of their children. © 2009 Elsevier GmbH. All rights reserved.


Verim L.,Haydarpasa Numune Training Hospital | Cebeci F.,Haydarpasa Numune Training Hospital | Erdem M.R.,Bezmialem Foundation University | Somay A.,Fatih Sultan Mehmet Research and Teaching Hospital
Archivio Italiano di Urologia e Andrologia | Year: 2013

Henoch-Schönlein purpura (HSP) is the most common systemic vasculitis in children. Typical presentations of HSP are palpable purpura of the small vessels in the hips and lower limbs, abdominal pain, arthritis, and hematuria. Scrotal involvement manifested by the presence of scrotal pain and swelling during the course of the disease is rarely seen. HSP without systemic involvement with acute scrotum mimicking testicular torsion is even rare in the medical literature. In most cases, patients with this disease achieve complete recovery. Herein, we report an interesting HSP case with skin symptoms but without systemic involvement and then progression to acute scrotum resembling torsion of testis.


Verim L.,Haydarpasa Numune Training Hospital | Toptas B.,Istanbul University | Ozkan N.E.,Istanbul University | Cacina C.,Istanbul University | And 3 more authors.
Asian Pacific Journal of Cancer Prevention | Year: 2013

Endothelial nitric oxide synthase (eNOS), encoded by the NOS3 gene, has been suggested to play an important role in uncontrolled cell growth in several cancer types. The objective of this study was to evaluate the role of the NOS3 Glu298Asp polymorphism in bladder cancer susceptibility in a Turkish population. We determined the genotypes of 66 bladder cancer cases and 88 healthy controls. Genotypes were determined by polymerase chain reaction-restriction fragment length polymorphism analysis. A significant association for NOS3 Glu298Asp heterozygotes genotypes and T allele were found between healthy controls and bladder cancer, respectively (p<0.001: p=0.002). There were no significant associations between any genotypes and the stage, grade, and histological type of bladder cancer. Our study suggested an increased risk role of NOS3 GT genotype in bladder cancer susceptibility in our Turkish population.


Verim L.,Haydarpasa Numune Training Hospital
International Journal of Fertility and Sterility | Year: 2014

Disorders of sexual development (DSD) are congenital anomalies due to atypical development of chromosomes, gonads and anatomy. Complete androgen insensitivity syndrome (CAIS), also known as testicular feminization (TF) is a rare DSD disease. The majority of CAIS patients apply to hospital with the complaint of primary amenorrhea or infertility. Given that CAIS patients are all phenotypically female while having 46, XY karyotypes, CAIS diagnosis should be disclosed in an age-appropriate manner preferably by a mental health professional. Cases are reported here for three 46XY siblings consistent with CAIS.


Karaaslan F.,Bozok University | Erdem S.,Haydarpasa Numune Training Hospital | Mermerkaya M.U.,Bozok University
International Medical Case Reports Journal | Year: 2014

Results: The incidence of deep postoperative surgical site infection was six (1.89%) patients (females) out of 317 patients (209 females; 108 males) at 1 year. All patients completed their wound NPWT regimen successfully. An average of 5.1 (range 3-8) irrigation and debridement sessions was performed before definitive wound closure. The mean follow-up period was 13 (range 12-16) months. No patient had a persistent infection requiring partial or total hardware removal. The hospital stay infection parameters normalized within an average of 4.6 weeks.Conclusion: The study illustrates the usefulness of NPWT as an effective adjuvant treatment option for managing complicated deep spinal surgical wound infections.Objective: To evaluate the results of negative-pressure wound therapy (NPWT) in the treatment of surgical spinal site infections.Materials and methods: The use of NPWT in postoperative infections after dorsal spinal surgery (transforaminal lumbar interbody fusion plus posterior instrumentation) was studied retrospectively. From February 2011 to January 2012, six patients (females) out of 317 (209 females; 108 males) were readmitted to our clinic with surgical site infections on postoperative day 14 (range 9-19) and were treated with debridement, NPWT, and antibiotics. We evaluated the clinical and laboratory data, including the ability to retain the spinal hardware and recurrent infections. © 2015 Karaaslan et al.


PubMed | Haydarpasa Numune Training Hospital
Type: Journal Article | Journal: International journal of fertility & sterility | Year: 2014

Disorders of sexual development (DSD) are congenital anomalies due to atypical development of chromosomes, gonads and anatomy. Complete androgen insensitivity syndrome (CAIS), also known as testicular feminization (TF) is a rare DSD disease. The majority of CAIS patients apply to hospital with the complaint of primary amenorrhea or infertility. Given that CAIS patients are all phenotypically female while having 46, XY karyotypes, CAIS diagnosis should be disclosed in an age-appropriate manner preferably by a mental health professional. Cases are reported here for three 46XY siblings consistent with CAIS.

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