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Akdemir N.,Kecioren Teaching and Research Hospital | Bilir C.,Zonguldak Karaelmas University
Journal of the Turkish German Gynecology Association | Year: 2011

Objective: In this study we investigate the possible relation of thyroid dysfunction and thyroid antibodies to hyperemesis gravidarum. Material and Methods: Thirty-seven patients with hyperemesis gravidarum and 33 healthy controls have been included in this study. Results: Thyroid dysfunction was significantly more common than in controls (38% vs 6%, p=0.002). Thyroglobulin antibodies were also significantly more common in patients with hyperemesis gravidarum than controls (54 IU/mL vs. 14 IU/mL, p=0.03). Conclusion: Hyperemesis gravidarum can be a risk factor for postpartum thyroid dysfunction. Thyroid antibodies must be checked in the hyperemesis population in an endemic goitre region and/or iodine replacement regions. © 2011 by the Turkish-German Gynecological Education and Research Foundation.

Sen O.,Kecioren Teaching and Research Hospital | Abali G.,Acibadem University | Yavuz B.,Kecioren Teaching and Research Hospital | Batur M.K.,Acibadem University
Echocardiography | Year: 2013

Objectives Arterial hypertension leads to instability and heterogeneity in atrial conduction by these hemodynamic and morphological changes in heart and aorta. These changes can be evaluated by transthoracic echocardiography. The aim of this study was to evaluate the correlation of aortic elastic parameters and atrial electromechanical delay (AEMD) parameters in patients with hypertension. Methods Eighty-one hypertensive patients and 55 control subjects were included in the study. All subjects underwent transthoracic echocardiography for detecting aortic elastic parameters and AEMD parameters. Results There was no difference between HT and control groups regarding age and gender. Aortic strain (8.1 ± 4.3% vs. 10.3 ± 5.1%, P = 0.008) and aortic distensibility (0.35 ± 0.18 cm2/dyn vs. 0.45 ± 0.23 cm 2/dyn, P = 0.003) were decreased in hypertensive patients than in controls. Intra-left AEMD (25.5 ± 7.3 vs. 21.8 ± 9.2 P < 0.009) was significantly higher in hypertensive patients compared to control subjects. No statistically significant difference was found in intra-right AEMD and inter-AEMD between the groups. There was a positive significant moderate correlation between aortic strain and intra-left AEMD (r = 0.501, P < 0.001). Conclusions This study demonstrated that intra-left AEMD was increased in hypertensive patients and aortic elastic parameters was correlated with intra-left AEMD. These findings may be related to similar structural and functional changes in heart and aorta in hypertension. © 2013, Wiley Periodicals, Inc.

Tepeler A.,University of Wisconsin - Madison | Sehgal P.D.,University of Wisconsin - Madison | Akman T.,Bezmialem Foundation University | Unsal A.,Kecioren Teaching and Research Hospital | And 3 more authors.
Urology | Year: 2014

Objective To analyze the patient- and procedure-related factors affecting the outcomes of percutaneous nephrolithotomy (PNL) in horseshoe kidneys (HSKs). Methods A retrospective analysis was done of patients with stones in HSKs treated with PNL in 3 referral centers between 1998 and 2013. Demographics, along with perioperative characteristics, were evaluated in detail as to whether or not they had an effect on the success and complication rates. Results A total of 54 HSKs with calculi in 53 patients were treated with PNL. Mean stone size was 28.4 ± 19.6 mm (range, 10-120 mm). Fifty-three patients were treated through a single tract, and 1 patient required additional access. Access was directed to the upper calyx (n = 27), middle calyx (n = 17), and lower calyx (n = 10) through the intercostal (n = 23) and subcostal (n = 31) areas. Flexible nephroscopy was used in 18.5% of the procedures. Postoperative complications were observed in 9 (16.7%) of the procedures. Success rate was 66.7% after a single session of PNL and increased to 90.7% with additional treatments. Although patient demographics, preoperative imaging, and other operative measures did not have significant effect on the complication rate, stone complexity and multiplicity, in combination with flexible nephroscopy, were found to significantly affect the success rate (P = .026, P = .043, and P = .021, respectively). However, in multivariate analysis stone multiplicity was the only factor that affected success rate (P = .004). Conclusion Stone parameters play an important role in achieving stone-free status in HSKs. Use of flexible nephroscopy positively affects the success rate by allowing reaching the peripherally located calices. © 2014 Elsevier Inc.

Akelma A.Z.,Fatih University | Celik A.,Kecioren Teaching and Research Hospital | Ozdemir O.,Kecioren Teaching and Research Hospital | Kavak Akelma F.,Ankara Zubeyde Hanim Etlik Maternity and Gynecology Teaching and Research Hospital | And 4 more authors.
American Journal of Emergency Medicine | Year: 2013

Introduction: The aim of this study was to evaluate the role of S100B protein and neuron-specific enolase (NSE) in children with carbon monoxide (CO) poisoning. Methods: In this prospective, case-controlled study, children with CO poisoning were recruited. Patient demographics features and Glasgow Coma Scale (GCS) were recorded. Blood samples were collected from all children with CO poisoning at their admission to the hospital and at 3 and 6 hours after admission. Levels of NSE and S100B were measured. The control group consisted of age-matched healthy children. Results: A total of 30 children with CO poisoning (mean age, 7.88 ± 3.75 years; 17 boys) and 30 healthy children (mean age, 8.16 ± 3.05 years; 7 boys) were enrolled in the study. Mean carboxyhemoglobin level (%) measured at admission was 30.05 ± 8.00. Serum NSE levels of the children with CO poisoning were significantly higher than those of children from the control group at 0 hour and also at 3 and 6 hours (P <.001, P =.001, and P =.005, respectively). Serum S100B protein levels were similar between the 2 groups at 0 and 3 and 6 hours (P >.05). Serum NSE levels of patients with CO poisoning demonstrated a negative correlation with the admission GCS scores. No correlation was found between GCS scores and S100B protein levels. Conclusion: We have shown that NSE levels increase in CO-associated hypoxic brain damage in accordance with clinical findings. We have also found that, contrary to the studies conducted on adults, S100B protein levels do not increase in response to hypoxic brain damage. © 2013 Elsevier Inc. All rights reserved.

Ertugrul D.T.,Kecioren Teaching and Research Hospital | Yavuz B.,Kecioren Teaching and Research Hospital | Cil H.,Kecioren Teaching and Research Hospital | Ata N.,Kecioren Teaching and Research Hospital | And 6 more authors.
Cardiovascular Therapeutics | Year: 2011

Several studies have shown that low 25-hydroxyvitamin D levels are associated with higher risk of cardiovascular disease and an increase in 25-hydroxyvitamin D levels protects against cardiovascular disease. In this study, we aimed to compare the effects of rosuvastatin and fluvastatin on vitamin D metabolism. The study population consisted of 134 hyperlipidemic patients who had not previously been treated with lipid lowering medications. Patients were randomized in a 1:1 ratio to rosuvastatin 10 mg or fluvastatin 80 mg XL during the study. Lipid parameters, 25 hydroxyvitamin-D, and bone alkaline phosphatase (BALP) were obtained at baseline and after 8 weeks of rosuvastatin and fluvastatin treatment. Sixty-nine patients were administered rosuvastatin, and 65 patients fluvastatin. Total Cholesterol and LDL cholesterol decreased after 8 weeks of both rosuvastatin and fluvastatin treatments. Rosuvastatin was significantly more effective than fluvastatin on lowering total (P < 0.001) and LDL cholesterol (P < 0.001). There was a significant increase in 25-hydroxyvitamin D with rosuvastatin treatment (P < 0.001), whereas no significant change in 25-hydroxyvitamin D was observed with fluvastatin treatment. Mean BALP fell from 18.5 to 9.6 u/I (P < 0.001) with rosuvastatin and from 17.0 to 12.8 with fluvastatin (P= 0.004). There was no significant difference in BALP levels between rosuvastatin and fluvastatin treatment (P= 0.368). The present study demonstrated that 25-hydroxyvitamin D levels increased with rosuvastatin treatment; whereas fluvastatin treatment had no effect on 25-hydroxyvitamin D. This disparity could be related to the potency or the bioavailability of these two statins. Further studies are needed to clarify the relationship between statins and the vitamin D physiology. © 2010 Blackwell Publishing Ltd.

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