Liv Hospital

İstanbul, Turkey

Liv Hospital

İstanbul, Turkey
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Yldz E.P.,Istanbul University | Ekici B.,Liv Hospital | Tatl B.,Istanbul University
Expert Review of Neurotherapeutics | Year: 2017

Introduction: Hypoxic ischemic encephalopathy (HIE) is the most important reason for morbidity and mortality in term-born infants. Understanding pathophysiology of the brain damage is essential for the early detection of patients with high risk for HIE and development of strategies for their treatments. Areas covered: This review discusses pathophysiology of the neonatal HIE and its treatment options, including hypothermia, melatonin, allopurinol, topiramate, erythropoietin, N-acetylcyctein, magnesium sulphate and xenon. Expert commentary: Several clinical studies have been performed in order to decrease the risk of brain injury due to difficulties in the early diagnosis and treatment, and to develop strategies for better long-term outcomes. Although currently standard treatment methods include therapeutic hypothermia for neonates with moderate to severe HIE, new supportive options are needed to enhance neuroprotective effects of the hypothermia, which should aim to reduce production of the free radicals and to have anti-inflammatory and anti-apoptotic actions. © 2016 Informa UK Limited, trading as Taylor & Francis Group.

Tamay Z.,Istanbul University | Akcay A.,Liv Hospital | Ergin A.,Pamukkale University | Guler N.,Istanbul University
International Journal of Pediatric Otorhinolaryngology | Year: 2013

Background: Allergic rhinitis (AR) is a global health problem affecting many people from childhood to adulthood. The aim of this study was to evaluate the prevalence of AR and related symptoms, and to assess the risk factors, dietary habits and the Mediterranean diet affecting AR. Methods: In a cross-sectional study design, 9991 children, aged 13-14 years in 61 primary schools in 32 districts of Istanbul were evaluated. The prevalence of AR symptoms among the children was evaluated using the ISAAC protocol. Results: In our study, total of 10,984 questionnaires were distributed to 13-14. yr-old schoolchildren to 61 schools in 32 district of Istanbul and 9991 questionnaires were suitable for analysis with an overall response of 91.7%. The rates of lifetime rhinitis, rhinitis in last 12 months and lifetime doctor diagnosed AR prevalence were 53.5%, 38.3% and 4.5%, respectively. The variation among districts in the prevalence of doctor diagnosed AR was very high. The highest prevalence was about 10 times higher than in the district with the lowest prevalence (range: 1.4-14.5) of Istanbul.A family history of atopy, mother with a university degree, presence of cat at home during last 12 months and adenoidectomy were significant for increased doctor diagnosed AR risk. Additionally, although fish and other sea foods, fermented drinks made from millets and various seeds, animal fats and butter were independent risk factors for doctor diagnosed AR, fish oil and hamburger were protective foods for doctor diagnosed AR. The MD was not associated with the prevalence of doctor diagnosed AR. Conclusions: This study shows that that there are wide variations for the prevalence of AR related symptoms in 13-14. yr-old schoolchildren among districts of Istanbul in Turkey. Socio-economical, environmental factors, some dietary habits, but not Mediterranean diet may affect the prevalence of AR. © 2013 Elsevier Ireland Ltd.

Ari S.,Gebze Fatih Devlet Hastanesi | Gokdemir G.,Liv Hospital
Turkderm Deri Hastaliklari ve Frengi Arsivi | Year: 2013

Background and Design: Dermoscopy is an important tool in the diagnosis of pigmented skin lesions. Newly, this method has also been used in the diagnosis and follow-up of hair and scalp disorders. The objective of this study was to investigate dermoscopic findings in a sample of patients diagnosed with cicatricial alopecia based on clinical and histopathological findings. Materials and Methods: Twenty-nine patients with cicatricial alopecia diagnosed according to the clinical and histological findings were examined by dermoscopy. Results: Dermoscopic features were evaluated in 8 patients with folliculitis decalvans, - 7 with pseudopelade of Brocq, - 6 with lichen planopilaris, - 2 with discoid lupus erythematosus, - 1 with dissecting cellulitis, and in 5 patients with secondary cicatricial alopecia. The structures previously examined with naked eye were evaluated by dermoscopy in more detail. Loss of follicular orifices was seen in all patients with cicatricial alopecia. Perifollicular scaling, arborizing red lines, honeycomb pigment pattern, white dots and tufted hairs were the other most obvious findings. Conclusion: The use of dermoscopy in the clinical evaluation of cicatricial alopecia improves diagnostic capability beyond simple clinical inspection. Larger studies correlating dermoscopic findings with histopathology examinations are necessary to improve our understanding of this method.

Altun H.,Yunus Emre Hospital | Hanci D.,Liv Hospital
American Journal of Rhinology and Allergy | Year: 2015

Background: The surgical treatment of nasal septal perforation is known to improve nasal respiratory airflow and, thereby, should be beneficial to the patient's olfactory abilities. However, there are only limited data on the effect of nasal septal perforation repair (NSPR) on olfaction, and most studies reported contradictory results. Objective: The aim of this prospective study was to investigate the change in the olfactory abilities of 42 patients with a primary concern of nasal septal perforation. Methods: NSPR was performed with the "cross-stealing" technique. The inferior-based mucoperichondrial flap in one side and the superior-based mucoperichondrial flap from the other side of the nasal septum were passed to the opposite sides through the perforation. Surgery was completed by placing an interpositional graft between the flaps before suturing. The interpositional grafts were residual cartilage. The olfactory performance of the patients before and at 1, 3, and 6 months after the closure of the nasal septal perforation was measured by using an olfaction test kit. Results: The success rate with complete closure of nasal septal perforation with the "cross-stealing" technique was 92.8%. Analysis of the data indicated statistically significant improvement in olfactory function scored as odor threshold (T), odor discrimination (D), odor identification (I) and TDI at 1, 3, and 6 months after NSPR (p < 0.001 for all). The mean TDI score evaluated 6 months after NSPR was improved by 64%. Analyses of variance indicated statistically significant improvement in olfactory scores within time factors were calculated a reoperative v us 1, 3, and 6 months; 1 versus 3 and 6 months; and 3 versus 6 months (p < 0.001 for all). Analysis of the present data indicates a beneficial effect of NSPR on olfactory abilities of patients with perforation. Conclusion: Our data on the short- and long-term olfactory abilities of 42 patients with nasal septal perforation after NSPR when using an olfaction test kit indicated statistically significant improvement in olfactory function. Copyright © 2015, OceanSide Publications, Inc., U.S.A.

Invited medical book chapters are usually requested of experienced authors who have made significant contributions to the literature in certain fields requested by an editor from an experienced. Before the writing process begins, an agreement between the editor and the author with regard to the title, deadline, specific instructions and content an agreement is crucial. Certain issues concerning a chapter can be negotiated by the parties beforehand, but some issues cannot. As writing a medical book chapter is seen as an honor in its own right, the assignment needs to be treated with sincerity by elucidating the topic in detail, and maximal effort should be made to keep in mind that the chapter will reach a large target audience. The purpose of this review article is to provide guidance to residents and junior specialists in the field of urology to improve their writing skills. © 2013 by Turkish Association of Urology.

Aydin S.,Bezmialem Foundation University | Arioglu Aydin C.,Liv Hospital | Batmaz G.,Bezmialem Foundation University | Dansuk R.,Bezmialem Foundation University
Journal of Sexual Medicine | Year: 2015

Introduction: Female sexual dysfunction (FSD) is a common problem that may be encountered in the interruption of normal sexual functioning in the sexual response cycle. Women with a pelvic floor disorder who scored low on the Female Sexual Function Index (FSFI) showed an improvement in their sexual life following treatment by vaginal electrical stimulation (VES). Aim: The aim of this trial was to evaluate the effectiveness of VES in women with FSD without a predominant pelvic floor disorder or urinary incontinence. Methods: Forty-two women with FSD were randomly allocated to VES and placebo groups. Pelvic floor muscle (PFM) assessment and the FSFI questionnaire were performed at baseline and after the completion of sessions. VES treatment was administered using a vaginal probe. The probe was inserted, and a medium-frequency (50Hz) alternating current was administered for a duty cycle of 5 seconds on followed by a 5-second rest. Main Outcomes Measures: Primary outcome measure was the improvement in FSFI score. PFM assessments were performed according to the PERFECT scheme. Results: Total FSFI scores improved significantly in both the VES group and the control group. Results show that in the VES group, there was an improvement in total score and FSFI domains that improved including arousal, desire, orgasm, and satisfaction. Similarly, control group domains that improved were desire, arousal, and orgasm. But there was no significant increase in satisfaction scores in the placebo group. No significant changes in pain or lubrication domains were seen in either group. Power, endurance, fast contractions, and repetitions were significantly improved in the VES group. Conclusions: The lack of significant differences between the placebo and VES groups, except the satisfaction domain, puts into question the effectiveness of electrical stimulation as a monotherapy in treating primary FSD without pelvic floor disorder. Aydin S, Arioğlu Aydin C, Batmaz G, and Dansuk R. Effect of vaginal electrical stimulation on female sexual functions: A randomized study. J Sex Med 2015;12:463-469. © 2014 International Society for Sexual Medicine.

Ceren E.,Fatih Sultan Mehmet Research and Training Hospital | Gokdemir G.,Liv Hospital | Arikan Y.,Bone Diseases Research and Training Hospital | Purisa S.,Istanbul University
Dermatologic Surgery | Year: 2013

Background The treatment of ingrown toenail is usually bothersome for patients and doctors. Objectives To compare two treatment techniques of ingrown toenails - phenol matricectomy (PM) and nail-splinting using a flexible tube (FT) - in terms of efficacy, postoperative pain, postoperative cosmetic satisfaction, amount of tissue damage, and recurrence. Methods and Materials One hundred twenty ingrown toenails were randomized and divided into PM and FT groups. All cases were evaluated 2 days and 1 and 6 months after treatment. Postoperative pain, cosmetic satisfaction, time to recovery, and recurrence rate were measured. Results Postoperative pain was less and cosmetic satisfaction was good in both groups (p <.001). Our recurrence rate was 8.4%. There were no statistical differences between groups in these measures. Tissue improvement rate was 6% in the PM group and 93% in the FT group 2 days after the procedures (p <.001). Conclusions Although FT provides faster recovery and less postoperative morbidity than PM, the techniques are equally effective in treating ingrown toenails. © 2013 by the American Society for Dermatologic Surgery, Inc.

Alaca R.,Liv Hospital
Turkiye Fiziksel Tip ve Rehabilitasyon Dergisi | Year: 2015

Performing a standardized physical examination for the spinal cord injury patients is mandatory for clinical and scientific purposes. Several attempts have been made since 1960s to have a standard of assessment. This article includes the history, development, and improvement of ASIA classification, the most widely accepted and used assessment in the field. © 2015 by Turkish Society of Physical Medicine and Rehabilitation.

Aydn S.,Bezmialem Foundation University | Aroglu Aydn C.,Liv Hospital
Neurourology and Urodynamics | Year: 2016

Aims: The aim of this study was to assess medium-term outcomes of the single anterior vaginal wall incision technique with concomitant mid-urethral sling (MUS) procedure. Methods: Patients suffering from stress urinary incontinence and who desired surgical correction for their incontinence were divided into two groups according to MUS surgery alone or MUS surgery with anterior vaginal wall surgery. Concomitant surgery was performed via single large anterior vaginal wall incision. Primary outcome was treatment success 12 months after surgery. Urodynamic and baseline factors that may be associated with surgery failure were analyzed. Results: Single incision anterior colporrhaphy with MUS was performed in 180 patients, 62 patients underwent only MUS procedure. Success rate was 87.1% in sling surgery alone and 83.9% in single incision concomitant surgery group (P = 0.5). Detrusor overactivity (DO) was present on UDS in 23 of 37 women (62.2%) with MUS failure, 81 of 205 women (39.7%) with no stress test positivity with the cough stress test (P < 0.05). Total continence rate in patients who underwent vaginal hysterectomy was 60.6% (P < 0.001). Conclusion: Concurrent cystocele repair with MUS operations through a single anterior wall incision is a safe and effective method for SUI. This study demonstrated an increased risk of surgery failure for those who underwent a concurrent hysterectomy for pelvic organ prolapse. Neurourol. Urodynam. 35:995–999, 2016. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

Aydn S.,Bezmialem Foundation University | Aydn C.A.,Liv Hospital
International Urogynecology Journal and Pelvic Floor Dysfunction | Year: 2015

Introduction and hypothesis: The levator hiatus and puborectalis muscle play a critical role in supporting the pelvic organs. Vaginal birth is known to be the main etiological factor for development of levator defects. The aim of this study was to define and evaluate changes in the levator ani immediately and at 3 months after delivery with 3D transperineal ultrasonography. Methods: Of 92 eligible primiparous women who delivered vaginally, 84 were examined within 36 h of delivery (early evaluation) and 3 months after delivery (late evaluation) with 3D transperineal ultrasonography. 3D volumes were evaluated in the supine position after voiding. Levator biometry, levator defect and loss of tenting were determined in the axial plane. Results: The levator defect rate was significantly higher at the early evaluation (71.4 %) than at the late evaluation (39.6 %; p < 0.0001). Levator thickness and transverse hiatal diameters on resting and during maximal Valsalva maneuver were greater at the late evaluation than at the early evaluation. Anteroposterior hiatal dimension, hiatal area on resting and maximal during the Valsalva maneuver were greater at the early evaluation than at the late evaluation. Head circumference and the length of the first stage of labor were associated with levator defects. Conclusions: Changes in the levator hiatus could be transitional or persist over time. There were significant changes in levator hiatus measurements, levator thickness, levator defect incidence and loss of tenting rate between early postpartum and late postpartum. The head circumference of the fetus and the length of the first stage of labor are the shared and consistent factors that can be associated with pelvic floor trauma. © 2015, The International Urogynecological Association.

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