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Karaman K.,Sakarya University | Tanoglu A.,GATA Haydarpasa Training Hospital | Beyazit Y.,Canakkale State Hospital | Han I.,Izmir Tepecik Teaching and Research Hospital
BMJ Case Reports | Year: 2015

Acute colonic pseudo-obstruction (ACPO), also known as Ogilvie's syndrome, is a clinical syndrome characterised by gross dilation of the caecum and right hemicolon, which sometimes extends to the sigmoid colon and rectum in the absence of an anatomic lesion in the intestinal lumen. It is characterised by impaired propulsion of contents of the gastrointestinal tract, which results in a clinical picture of intestinal obstruction. A careful examination of the markedly distended colon can exclude several colonic pathologies, including mechanical obstruction and other causes of toxic megacolon. ACPO can sometimes predispose or mimic colonic volvulus, especially in geriatric patients. Copyright © 2015 BMJ Publishing Group. Source

Yavascan O.,Izmir Tepecik Teaching and Research Hospital
Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia | Year: 2011

Peritonitis and catheter exit- site infections (ESI) are important causes of hospitalization and catheter loss in patients undergoing chronic peritoneal dialysis (CPD). The frequency of infection can be reduced by scrupulous exit- site care with or without topical antiseptics. There are no studies showing any benefit in the use of povidone-iodine or normal saline for care of exit- sites in long- term CPD patients. In this study, we aimed to determine the potential effectiveness of the application of povidone-iodine or normal saline at the catheter exit- site in preventing ESI and peritonitis in children on CPD. A total of 98 patients treated with either povidone-iodine or normal saline were included in this study. Group I (34 patients) used povidone-iodine and group II (64 patients) simply cleansed the exit- site with normal saline (0.9% NaCl). Dressings were changed 2 to 3 times in a week. The total cumulative follow- up time was 3233 patient- months. ESIs occurred in 10 (29.4%) of 34 patients using povidone-iodine and in 10 (15.6%) of 64 patients using normal saline. The frequency of ESI was significantly high in group I (povidone-iodine) patients. The mean rate of ESI was 1 episode/60.8 patient- months for group I versus 1 episode/144 patient- months for group II (P < 0.05). The rate of peritonitis was similar in each group (1 episode/21.3 patient- months for group I versus 1 episode/20.17 patient- months for group II) (P > 0.05). In conclusion, exit- site care with normal saline is an effective strategy in reducing the incidence of ESI in children on CPD. It can thus significantly reduce morbidity, catheter loss, and the need to transfer patients on peritoneal dialysis to hemodialysis. Source

Alci E.,Manisa State Hospital | Ustun M.,Izmir Tepecik Teaching and Research Hospital | Sezer T.,Ege University | Yilmaz M.,Ege University | And 6 more authors.
Transplantation Proceedings | Year: 2015

Background Double-J (DJ) stents play an important role in modern urology to prevent undesirable side effects after surgery. We aimed to investigate the relationship of DJ stents with the demographic characteristics, surgical complications, urinary tract infection (UTI), and hematuria in the patients who underwent renal transplantation (Tx). Methods Data of 354 patients who underwent renal Tx between 2008 and 2011 at Ege University were evaluated retrospectively; 331 patients were included in this study. The term DJ (-) represents patients in whom a DJ stent was not placed. "Primary DJ term" represents patients in whom the DJ stent was placed during the first Tx. "Secondary DJ term" represents the patients who had DJ after Tx for any complication. Results Two hundred fifty-four (76.7%) patients were in the DJ (-) group, 52 (15.7%) were in the primary DJ group, and 25 (7.6%) were in the secondary DJ group. There were significant differences between the groups in terms of anastomosis type (P =.000), stay-in-hospital time (P =.000), surgical complication (P =.000), re-operation (P =.000), percutaneous nephrostomy (P =.000), UTI (P =.000), first-time UTI (P =.000), recurrent UTI (P =.000), positive hemoculture (P =.000), hematuria (P =.000), duration of dialysis before Tx (P =.000), live/deceased donor (P =.000), and delayed graft function (P =.009). Conclusions Our choice is to use the DJ stent in selected high-risk patients and to keep the indications for DJ stent wider in deceased donor transplants by considering possible surgical complications. The use of the stent only in selected cases will decrease surgical complications due to stent placement. © 2015 Elsevier Inc. All rights reserved. Source

Mir S.,Ege University | Yavascan O.,Izmir Tepecik Teaching and Research Hospital | Berdeli A.,Ege University | Sozeri B.,Ege University
Nephrology Dialysis Transplantation | Year: 2012

Background.In steroid-resistant nephrotic syndrome (SRNS), a considerable number of patient progress to end-stage renal disease (ESRD), despite aggressive therapy. The latest advance in familial focal segmental glomerulosclerosis (FSGS) has been the discovery of a mutant form of canonical transient receptor potential channel 6 (TRPC6) leading to FSGS through unclear mechanisms. The aim of this study is to screen for TRPC6 mutations in familial and sporadic SRNS patients. Methods.Twenty-five children with SRNS originating from Turkey were included in this study. Nine patients had familial and 16 patients had sporadic SRNS. Mutation analysis was performed in all 13 coding exons of the TRPC6 gene with the direct DNA sequencing method. The control group consisted of 50 normal healthy children originating from Turkey. Results.No mutation was detected in nine children (four familial, five sporadic). A variant (L395A) in one patient, intronic nucleotide substitution (c.171 + 16 A>G and c.171 + 86 G>C) in six patients and previously described missense (A404V; rs36111323) and synonymous (N561N; rs12366144) aminoacid variants in nine patients were found. Among patients with intronic, missense and synonymous aminoacid variants, 5 patients had familial and 11 patients had sporadic SRNS. Their mean age at onset of proteinuria was 2.6 ± 1.7 years. Seven cases (three familial, four sporadic) progressed to ESRD with a mean time of 10.2 ± 2.9 years. Conclusions.In conclusion, analysis of TRPC6 gene mutations in FSGS will provide new insights into the pathogenesis of nephrotic syndrome. Previous works have emphasized that the patients with only hereditary familial FSGS carried a missense mutation in the TRPC6 gene. Our findings suggest that TRPC6 mutations may also have an important role in the pathogenesis of sporadic SRNS. © 2011 The Author. Source

Toz E.,Izmir Tepecik Teaching and Research Hospital | Ozcan A.,Izmir Tepecik Teaching and Research Hospital | Balsak D.,Halic University | Avci M.E.,Kanuni Sultan Suleyman Training and Research Hospital | And 2 more authors.
Menopause | Year: 2016

Objective: This study aimed to assess the effects of hysterectomy and bilateral salpingo-oophorectomy (BSO) - compared with the effects of hysterectomy alone - on skin aging in premenopausal women undergoing hysterectomy for benign conditions. Methods: One hundred thirty-five premenopausal women who underwent hysterectomy with BSO were compared with a control group of women who underwent hysterectomy alone based on skin parameters (including wrinkling, laxity/sagging, and texture/dryness) and Skindex-29 questionnaire scores. The inclusion criteria were as follows: aged between 40 and 50 years, follicle-stimulating hormone level lower than 40mIU/mL, undergoing hysterectomy with or without BSO for benign conditions, and not receiving estrogen or progesterone treatment. The exclusion criteria were as follows: adrenocortical hyperplasia or Cushing's syndrome; use of corticosteroids for autoimmune diseases; malignancy, connective tissue diseases (eg, Ehlers-Danlos syndrome), or dermatological diseases (eg, lichen sclerosus); or regular use of medications known to interfere with the condition of the skin. Results: All skin parameters in the hysterectomy group and the hysterectomy with BSO group worsened on weeks 24 and 48. Laxity/sagging and texture/dryness scores on weeks 24 and 48 were significantly worse in the BSO group; laxity/sagging and texture/dryness scores continued to worsen between 24 and 48 weeks. Scores for the Skindex-29 questionnaire emotion and symptom subscales were significantly higher in the BSO group compared with the non-BSO group. Conclusions: Prophylactic BSO during hysterectomy is a significant independent risk factor for worsening skin laxity/sagging and texture/dryness in premenopausal women undergoing hysterectomy for benign conditions. Prophylactic BSO in the presence of dermatological conditions is also associated with reduced quality of life. © 2015 by The North American Menopause Society. Source

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