Kecioren Education and Research Hospital

Ankara, Turkey

Kecioren Education and Research Hospital

Ankara, Turkey
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Razi C.H.,Ankara Private Hospital | Corut N.,Sami Ulus Pediatrics and Gynecology Education and Research Hospital | Andran N.,Kecioren Education and Research Hospital
Pediatric Pulmonology | Year: 2017

Background: The object of this study was to determine whether high doses of inhaled budesonide provide additional benefits to a standardized treatment regimen that includes systemic steroids and salbutamol in preschool patients presented to the emergency department (ED) with acute wheezing attacks. Methods This randomized, double-blind, placebo-controlled, parallel group trial was conducted in children, 6 months–6 years with moderate or severe acute wheezing epizode, as determined based on a pulmonary index score (PIS) of 7–13 points. We compared the addition of budesonide 3 mg versus placebo to standard acute asthma treatment, which included salbutamol and a single 1 mg/kg dose of methylprednisolone given at the beginning of therapy. The primary outcome was differences in hospitalization rates within 4 hr. Secondary outcome was difference in median PIS between treatment groups at 2 hr. Results One hundred patients were enrolled. Cumulative hospitalization rate at 120, 180, and 240 min were 0.72, 0.62, and 0.58 in placebo group; and 0.44, 0.30, and 0.24 in budesonide group. Discharged rate in budesonide group was significantly higher than the placebo group (log-rank = 12.407 ve P < 0.001). Expected mean discharged times were 200.4 (95%CI = 185.3–215.5) min in placebo group and 164.4 (95%CI = 149.4–179.4) min in budesonide group. Median (25–75%) PIS at the 120th min was significantly lower in budesonide group than the placebo group (5 [4–8] vs. 8 [5–9] respectively, P = 0.006). Conclusions The addition of budesonide nebulization may decrease the admission rate of preschool children who have moderate to severe acute wheezing epizodes. Pediatr Pulmonol. 2017;52:720–728. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.


Razi C.H.,Kecioren Education and Research Hospital | Harmanc K.,Kecioren Education and Research Hospital | Abac A.,Kecioren Education and Research Hospital | Ozdemir O.,Kecioren Education and Research Hospital | And 3 more authors.
Journal of Allergy and Clinical Immunology | Year: 2010

Background: No reagents have been shown to be effective in preventing wheezing attacks provoked by acute respiratory tract illnesses (ARTIs) in preschool children. New therapeutic agents and preventive strategies are needed. Objectives: We assessed the effect of OM-85 BV (Broncho-Vaxom; OM Pharma, Geneva, Switzerland) in preventing ARTI-provoked wheezing attacks in preschool children with recurrent wheezing. Methods: A randomized, double-blind, placebo-controlled, parallel-group study was carried out between August 2007 and September 2008. The study included 75 children with recurrent wheezing who were 1 to 6 years old. Participants were randomly assigned to groups given either OM-85 BV or a placebo (1 capsule per day for 10 days each month for 3 consecutive months) at the start of the trial. Participants were followed for 12 months, which included the administration period of the test article. Results: Subjects given OM-85 BV had a lower rate of wheezing attacks. The cumulative difference in wheezing attacks between the 2 groups was 2.18 wheezing attacks per patient in 12 months; there was a 37.9% reduction in the group given OM-85 BV compared with the group given placebo (P < .001). Stepwise multiple (linear) regression analysis showed that the main difference between the OM-85 BV and placebo groups was a reduction the number of ARTIs (R = -0.805, P < .001). The duration of each wheezing attack was 2 days shorter in the group given OM-85 BV than in the group given placebo (P = .001). Conclusion: Administration of OM-85 BV significantly reduced the rate and duration of wheezing attacks in preschool children with ARTIs. © 2010 American Academy of Allergy, Asthma & Immunology.


Cavkaytar S.,Kecioren Education and Research Hospital | Batioglu S.,Ondokuz Mayis University | Gunel M.,Dr Zekai Tahir Burak Woman Health Education And Research Hospital | Ceylaner S.,Intergen | Karaer A.,Inonu University
Human Fertility | Year: 2012

Objective: To determine the frequency, types of chromosomal abnormalities and Y chromosome microdeletions in patients with severe male factor infertility, and the association between clinical background and genetic abnormality. Study design: A total of 322 infertile men; 136 men with severe oligozoospermia (sperm count <5 million/ml) and 196 with nonobstructive azoospermia were studied between April 2004 and November 2006 at the Dr. Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey. Blood, semen samples, and testicular biopsies of patients were obtained. Hormonal analysis (follicle-stimulating hormone (FSH), luteinizing hormone (LH), and testosterone levels), semen analysis, karyotype analysis, and PCR screening for Y chromosome microdeletions were performed. Result(s): Forty-eight out of 332 (14%) infertile men had a genetic abnormality. Twenty-four (7.2%) cases with karyotype abnormality were detected. The frequencies of karyotype abnormalities were Klinefelter's syndrome 17/24 (71%), translocation 3/24 (12%), mix gonadal dysgenesis 2/24 (8%), XX male 1/24 (4%), and 46XYY 1/24 (4%). Twenty cases (6%) infertile men had only Y chromosome microdeletions. The frequencies of the deleted areas were azoospermia factor (AZF)c 42%, AZFb 25%, AZFa 21%, AZFb, c 8%, and AZFa, c 4%. Four of the cases with Y chromosome microdeletions also had a concurrent karyotype abnormality. Conclusion(s): All patients with nonobstructive azoospermia and severe oligozoospermia (sperm count <5 million/ml) should undergo genetic screening. © 2012 The British Fertility Society.


Demirkale I.,Kecioren Education and Research Hospital | Tecimel O.,Ataturk Education and Research Hospital | Sesen H.,Kecioren Education and Research Hospital | Kilicarslan K.,Ataturk Education and Research Hospital | And 2 more authors.
Journal of Arthroplasty | Year: 2014

This retrospective study enrolled 526 patients undergoing bilateral total knee arthroplasties at our institution. In nondrainage group (Group 1) of 255 patients (510 knees), a disposable elastic sterile exsanguination tourniquet (HemaClear), wound closure in layers and Jones Bandage, without pre-tourniquet removal hemostasis or Hemovac drain were used. In drainage group (Group 2) of 227 patients (454 knees), pneumatic tourniquet, post-deflation hemostasis, a Hemovac drain and Jones bandage were used. The maximal drop in hemoglobin was significantly greater in Group 2 than Group 1 (P<. 0.001). Also infection rate was significantly lower in Group 1 (P= 0.017). The use of sterile tourniquet removed after wound closure without Hemovac drain decreases blood transfusion need, infection rate, tourniquet related pain and postoperative complications. © 2014 Elsevier Inc.


Cali U.,Ataturk Education and Research Hospital | Cavkaytar S.,Kecioren Education and Research Hospital | Sirvan L.,Dr Zekai Tahir Burak Woman Health Education And Research Hospital | Danisman N.,Dr Zekai Tahir Burak Woman Health Education And Research Hospital
Clinical and Experimental Obstetrics and Gynecology | Year: 2013

Objective: To examine the placental expression of caspase-3 and bcl-2 in pregnancies complicated by preeclampsia, IUGR, and HELLP syndrome. Materials and Methods: A prospective case-control study was conducted on 50 pregnant women between December 2006 and August 2007 at Dr. Zekai Tahir Burak Women Health Research and Education Hospital, Ankara, Turkey. Placental tissue samples were obtained from 15 pregnancies complicated by preeclampsia, 15 pregnancies with normotensive IUGR, five pregnancies with HELLP syndrome, and 15 gestational age-matched normotensive pregnancies without intrauterine infection as a control group. The placental expression of caspase-3 and bcl-2 has been investigated by immunohistochemical staining. Results: Caspase-3 immunostaining score was significantly higher in each group when compared with the control group (p = 0.002). However there was no statistically signifant difference with bcl-2 immunostaining in each group when compared with the control group. Conclusions: Apoptotic marker caspase-3 is significantly increased in the villous trophoblasts of patients with preeclampsia, HELLP syndrome, and IUGR indicating increased placental apoptosis.


Yildiz C.,Gulhane Military Medical Academy | Demirkale I.,Kecioren Education and Research Hospital
Current Opinion in Pediatrics | Year: 2014

Purpose of review: Spastic type is the most common form of cerebral palsy. The purpose of this review was to evaluate recent literature for current trends in the surveillance and treatment of spastic hip problems in cerebral palsy. Recent findings: Cerebral palsy is still the most common physical disability in childhood in developed countries. Surveillance programs have had promising results in the detection of 'at risk' patients. However, neither regular radiographic screening nor surgical treatment indications and procedures have shown any progression in the last decade. In addition, recent studies have focused heavily on nonoperative treatment strategies to improve gait. Summary: Cerebral palsy is a static encephalopathy causing myostatic contractures especially in the knee and hip. Unbalanced hip contractures can lead to silent hip dislocation. Surgical and rehabilitative approaches such as soft tissue lengthening and proximal femoral and pelvic osteotomies can help patients maintain function and comfort. Selective dorsal rhizotomy or Intrathecal Baclofen Pump insertion or, recently, noninvasive techniques such as neurodevelopmental therapy may help patients and caregivers cope with what is still a devastating and inexorably progressive disorder. © 2014 Wolters Kluwer Health.


Seval M.M.,Kecioren Education and Research Hospital
BMJ case reports | Year: 2013

Endometriosis of the uterine cervix is a rare lesion that is generally asymptomatic in gynaecological practice. We present a case with postcoital bleeding due to a cervical mass mimicking cervical polyp or fibroma which was histologically proven as cervical endometriosis later. Cervical endometriosis should be considered in the differential diagnosis of cervical masses with postcoital bleeding.


Deveci D.,Firat University | Ozkan Z.S.,Kecioren Education and Research Hospital | Yuce H.,Firat University
European Journal of Obstetrics Gynecology and Reproductive Biology | Year: 2012

Objective: IL-6 gene single nucleotide polymorphisms (SNPs) have been reported to have a protective effect against bone resorption. We aimed to investigate the association between bone mineral density and IL-6 promoter region -174 G>C SNP. Study design: This study included 356 postmenopausal Turkish women, of whom 201 were osteoporotic (lumbar spine T score < -2.5 SD) and 155 non-osteoporotic (lumbar spine T score > -1.5 SD). Bone mineral density (BMD) measures were obtained using dual-energy X-ray absorptiometry. SNP of the IL-6 gene (-174 G>C) was examined by polymerase chain reaction-restriction fragment length polymorphism. Results: The frequencies of the variant C allele (24% vs. 30%, p = 0.074) and mutant CC genotype (12% vs. 20%, p = 0.094) were higher in non-osteoporotic women. Lumbar spine and total hip BMD values were lowest among women with the G/G genotype, intermediate in the heterozygotes, and highest in women with the C/C genotype. The GG (p = 0.022) and GC (p = 0.037) genotypes were covariates which approached statistical significance in the regression model fitting of BMD. Conclusion: IL-6 promoter region SNP showed an association with BMD in this postmenopausal Turkish population and these data suggest that the wild GG genotype influences the phenotype. © 2012 Elsevier Ireland Ltd. All rights reserved.


Altay M.,Kecioren Education and Research Hospital | Demirkale I.,Kecioren Education and Research Hospital | Senturk F.,Kecioren Education and Research Hospital | Firat A.,Kecioren Education and Research Hospital | Kapicioglu S.,Kecioren Education and Research Hospital
Journal of Pediatric Orthopaedics Part B | Year: 2013

This study aimed to evaluate the outcome of medial open reduction for developmental dysplasia of the hip (DDH) in patients before and after walking age. A minimum 5-year radiographic and clinical follow-up compared 29 patients (group 1) before walking age with 38 patients (group 2) after walking age for DDH. The correction ratio of acetabular index was similar in both groups postoperatively (41.8% for group 1 and 44.9% for group 2), and it was statistically not significant (P>0.05). The Kalamchi-MacEwen classification showed no correlation between operative age and the rate of avascular necrosis (P>0.05). This report presents similar complication rates as that of the Severin criteria for medial open reduction of the hip and challenges the conventional belief that a medial open reduction for the treatment of DDH in a walking-age child at short-term to mid-term follow-up has comparable results. © 2012 Wolters Kluwer Health | Lippincott Williams &Wilkins.


Ozkan Z.S.,Kecioren Education and Research Hospital
Genetics and molecular research : GMR | Year: 2010

We investigated the effect of bone morphogenetic protein 2 and 4 (BMP-2 and -4) gene polymorphisms on bone density in postmenopausal Turkish women with osteoporosis. The frequency of single-nucleotide polymorphisms (SNPs) of BMP-2 and -4 genes was analyzed in 101 osteoporotic-postmenopausal women and 52 postmenopausal women with positive bone mineral density scores. We evaluated the frequency of the thymine→cytosine nucleotide variation at position 538 for BMP-4 and the transposition of adenine→thymine at codon 190 for BMP-2, with PCR. The proportions of genotypes observed for the BMP-2 SNP in the osteoporotic group were AA (47.5%), AT (39.6%), TT (12.9%), and in the non-osteoporotic group they were AA (48.1%), AT (40.4%), TT (11.5%). The corresponding frequencies for the BMP-4 SNP in the osteoporotic group were TT (30.7%), TC (45.5%), CC (23.8%), and in the non-osteoporotic group they were TT (26.9%), TC (40.4%), CC (32.7%). There were no significant differences in the frequencies of these genotypes between the patient and control groups. We conclude that genetic variations in BMP-2 and -4 do not substantially contribute to lumbar spine bone mineral density in postmenopausal Turkish women.

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