Sifa Hospital

İzmir, Turkey

Sifa Hospital

İzmir, Turkey

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Bakirci E.M.,Bayburt State Hospital | Topcu S.,Atatürk University | Kalkan K.,Atatürk University | Tanboga I.H.,Atatürk University | And 3 more authors.
Clinical and Applied Thrombosis/Hemostasis | Year: 2015

We aimed to investigate the relationship between the extent of venous thromboembolism (VTE) and nonspecific inflammatory markers such as neutrophil to lymphocyte ratio (NLR) and high-sensitivity C-reactive protein (hs-CRP). We retrospectively enrolled 77 patients with VTE (distal deep vein thrombosis [DVT], n = 19; proximal DVT, n = 32; and pulmonary thromboembolism [PTE], n = 26) and 34 healthy controls. In the performed analysis of variance, the levels of white blood cell, NLR, and hs-CRP were clearly different among the groups (control, distal and proximal DVT, and PTE) (P < .001). Especially, a significant increase from the control group to the DVT and PTE was observed in the analysis made for NLR. In the performed receiver-operating characteristic curve analysis, area under curve (AUC) = 0.849 and P < .001 were detected for NLR > 1.84. For this value, the sensitivity and specificity were determined as 88.2% and 67.6%, respectively. The NLR is an inexpensive and a readily available marker that may be effective in determining the extent of VTE, and it is useful for risk stratification in patients with VTE. © The Author(s) 2013


Senol A.,Suleyman Demirel University of Turkey | Akn M.,Akdeniz University | Songur Y.,Memorial Sisli Hospital | Isler M.,Sifa Hospital | Kockar M.C.,Suleyman Demirel University of Turkey
Journal of Clinical and Analytical Medicine | Year: 2016

Aim: Alpha-fetoprotein (AFP) has been widely used as a diagnostic marker for hepatocellular carcinoma. Some patients with hepatitis C show high AFP values, but no evidence of hepatocellular carcinoma. The aim of this study is to assess the influence of antiviral treatment on the serum AFP in pa-tients with chronic hepatitis C without hepatocellular carcinoma. Material and Method: Thirty seven chronic hepatitis C patients (20 females and 17 males) were included in the study. All patients were given a combined treat-ment of pegylated or conventional interferon (IFN) and ribavirin. Serum AFP was measured at baseline and on months 3-6-12 of the therapy. Results: Compared to the pretreatment levels of ALT (88,59 ± 57,22 IU), those at 3, 6 and 12 months were statistically lower (p< 0,001). Mean serum AFP levels gradually decreased from pretreatment level of 6,6 ± 6,05 ng/ml to 5,1 ± 3,7 (p>0,05), to 4,34 ± 4,64 (p>0,05) and to 2,63 ± 2,17 (p<0,001) at month 3, 6 and 12 of the therapy, respectively. Although AFP decrease at month 3 was non significant, a significant decrease of mean serum AFP levels after 6 and 12 months of therapy was demonstrated in the patients with high AFP (>10 ng/ml). In these patients, mean serum AFP levels were decreased from pre-treatment level of 15,09 ± 5,92 ng/ml to 11,39±3,30, to 6,97±2,53 (p<0,001) and to 5,67±3,89 (p=0,009) at month 3, 6 and 12, respectively. Discussion: Serum AFP level significantly decreases during therapy in hepatitis C patients receiving IFN-α plus ribavirin for 48 weeks. © 2016, Journal of Clinical and Analytical Medicine. All rights reserved.


Erdem F.H.,Sifa Hospital | Karatay S.,Atatürk University | Yildirim K.,Atatürk University | Kiziltunc A.,Atatürk University
Clinics | Year: 2010

OBJECTIVES: The aim of this study was to investigate the activities of serum paraoxonase and arylesterase in patients with ankylosing spondylitis with respect to those of healthy controls, to assess whether these enzyme levels are related to disease activity and functional capacity. METHODS: The study included 32 patients with ankylosing spondylitis whose diagnoses were made according to the modified New York criteria as well as 25 healthy controls matched for age and sex. The Bath Ankylosing Spondylitis Disease Activity Index and the Bath Ankylosing Spondylitis Functional Index were applied to the ankylosing spondylitis patients. As laboratory parameters, the erythrocyte sedimentation rate and serum C-reactive protein level were measured in patients and control subjects. Paraoxonase and arylesterase enzyme activities were measured using appropriate methods. RESULTS: No statistically significant differences (p>0.05) were found between the ankylosing spondylitis patients and controls in terms of serum paraoxonase or arylesterase levels. Furthermore, there was no correlation between clinical and laboratory parameters in patients with ankylosing spondylitis. CONCLUSION: Serum paraoxonase and arylesterase levels in ankylosing spondylitis patients may not differ from those of healthy controls, and there is no significant correlation between antioxidant parameters and the Bath Ankylosing Spondylitis Disease Activity Index or Bath Ankylosing Spondylitis Functional Index scores in ankylosing spondylitis patients. Further research is needed to provide deeper understanding of this disease.


Solak A.,Sifa Hospital | Solak I.,Ege University
Turkish Journal of Gastroenterology | Year: 2012

Sclerosing encapsulating peritonitis, or abdominal cocoon syndrome, was described firstly in young adolescent girls. It is characterized by a thick fibrotic peritoneum that wraps the bowel in a concertina-like fashion with some adhesions. We report a man with intermittent intestinal obstruction and an abdominal cocoon encasing the small bowel. Our patient had no history of peritonitis or tuberculosis. We think he had primary abdominal cocoon syndrome. To the best of our knowledge, very few male patients have been reported in the medical literature as developing this condition. We treated the patient with drug therapy, including steroid and mycophenolate mofetil, and a liquid diet program, without surgical operation. He was symptom-free on follow-up over a period of 11 months.


Genc B.,Sifa Hospital | Solak A.,Sifa Hospital | Sahin N.,Sifa Hospital | Gur S.,Sifa Hospital | And 2 more authors.
Diagnostic and Interventional Radiology | Year: 2013

PURPOSE We aimed to investigate the coronary venous system and its variations by using dual source computed tomography (CT). MATERIALS AND METHODS Retrospective assessment was carried out on 339 patients who underwent coronary CT angiography using 128-slice dual source CT for suspected coronary artery disease. The examinations were performed according to routine imaging protocols used to evaluate coronary arteries. The coronary venous system was evaluated in each case using maximum intensity projection and volume rendering technique multiplanar reformation reconstructions. In each patient, the presence and calibration of normal anatomy, as well as the variations of the coronary sinus, middle cardiac vein, small cardiac vein, posterior cardiac vein, great cardiac vein, anterior interventricular vein, posterolateral vein, left marginal vein, and anterolateral vein were recorded. RESULTS The coronary sinus, middle cardiac vein, great cardiac vein, and anterior interventricular vein were visualized in all of the patients. In all cases, one of the lateral or posterolateral veins of appropriate localization and diameter for cardiac resynchronization therapy was detected. The posterior cardiac vein was visualized in 87% of the cases, the left marginal vein in 87.9%, and the small cardiac vein in 20%. There was no ignificant difference in the diameters or visibilities of the coronary veins in terms of age. CONCLUSION The coronary venous system and its tributaries may be examined in detail using CT angiography examination performed according to the routine coronary CT angiography protocol used for dual source CT. Dual source CT may be a valuable tool for evaluation of the coronary veins prior to invasive procedures that are directed at the coronary venous system. © Turkish Society of Radiology 2013.


Tanriverdi H.,Pamukkale University | Evrengul H.,Sifa Hospital | Kilic I.D.,Pamukkale University | Taskoylu O.,Pamukkale University | And 2 more authors.
Cardiology | Year: 2010

Background: Coronary slow flow (CSF) phenomenon is characterized by delayed opacification of coronary vessels in a normal coronary angiogram. Although clinical and pathological features have been previously described, the underlying pathophysiology has not been fully elucidated. In this study, we aimed to evaluate central aortic pressure, aortic stiffness and left ventricular (LV) function in patients with coronary slow flow. Method and Results: The study population consisted of 154 patients who underwent coronary angiography because of typical and quasi-typical symptoms of angina. 81 patients with angiographically proven CSF and 73 cases with normal coronary flow pattern with similar risk profiles were enrolled in the study. Aortic pressures and indexes of elastic properties were evaluated using invasive methods. Aortic pulse pressure (mm Hg) and pulsality index of patients with CSF were found to be significantly higher than those of controls (60.8 ± 13.8 vs. 53.7 ± 14.5, p = 0.002; 0.84 ± 0.22 vs. 0.67 ± 0.18, p = 0.0001, respectively). LV Doppler parameters were deteriorated in patients with CSF. Aortic fractional pulse pressure and pulsality index were significantly correlated with the mean TIMI frame count and LV diastolic parameters in correlation analysis. Conclusion: The present findings allow us to conclude that impaired aortic elasticity in patients with CSF may also be responsible for the impaired LV diastolic parameters. Copyright © 2010 S. Karger AG, Basel.


Evrengul H.,Sifa Hospital | Ozcan E.E.,Sifa Hospital | Turhan H.,Gozde Hospital | Ozturk A.,Sifa Hospital
Experimental and Clinical Cardiology | Year: 2012

A 57-year-old woman with a history of hypertension, hyperlipidemia and stable angina is described. A coronary angiogram revealed the presence of a single coronary artery arising from the right sinus of Valsalva that was providing the left anterior descending (LAD), left circumflex and right coronary artery branches, with noncritical occlusive atherosclerotic plaques at the proximal circumflex artery. A small hypoplastic LAD tapering proximally was found, but no LAD and compensatory collateral circulatory vessels were observed distally. In the present report, the authors discuss this extremely rare combination of congenital coronary anomalies and their clinical implications. © 2012 Pulsus Group Inc.


Cengiz Colak M.,Firat University | Kocaturk H.,Sifa Hospital | Bayram E.,Erzurum Training and Research Hospital
Turkiye Klinikleri Journal of Medical Sciences | Year: 2011

This report describes an unusual case of extensive multiple peripheral embolisms caused by a left atrial myxoma involving cerebral arteries, abdominal aorta and its branches in a 46- year-old patient. Embolism of left atrial myxoma is an uncommon but a well-known cause of peripheral and cerebral ischemia. Distal embolization is often the first presentation in most cases, with the central nervous system being the most common site. Distal embolization generally results from tumor fragmentation, or, less often, from complete tumor detachment, causing syncope, dyspnea, neurologic symptoms, or ischemic limb pain. Myxomas might give rise to embolism large enough to cause vascular occlusion, as in this case. This is the first case experienced initial peripheral embolism followed simultaneously by subsequent cerebral and abdominal/renal arterial embolisms originating from left atrial myxoma. Diagnosis was previously based on the transthroracic echocardiography and confirmed with histopathological evaluation of the resected material. We present a very interesting case of a myxoma leading to multiple embolisms concurrently with a catastrophic consequence despite aggressive attempts. © 2011 by Türkiye Klinikleri.


PubMed | Sifa Hospital, Dokuz Eylül University and Ilyas Cokay Catalca Hospital
Type: Journal Article | Journal: Journal of Korean Neurosurgical Society | Year: 2016

Rod-screw fixation systems are widely used for spinal instrumentation. Although many biomechanical studies on rod-screw systems have been carried out, but the effects of rod contouring on the construct strength is still not very well defined in the literature. This work examines the mechanical impact of straight, 20 kyphotic, and 20 lordotic rod contouring on rod-screw fixation systems, by forming a corpectomy model.The corpectomy groups were prepared using ultra-high molecular weight polyethylene samples. Non-destructive loads were applied during flexion/extension and torsion testing. Spine-loading conditions were simulated by load subjections of 100 N with a velocity of 5 mm min(-1), to ensure 8.4-Nm moment. For torsional loading, the corpectomy models were subjected to rotational displacement of 0.5 s(-1) to an end point of 5.0, in a torsion testing machine.Under both flexion and extension loading conditions the stiffness values for the lordotic rod-screw system were the highest. Under torsional loading conditions, the lordotic rod-screw system exhibited the highest torsional rigidity.We concluded that the lordotic rod-screw system was the most rigid among the systems tested and the risk of rod and screw failure is much higher in the kyphotic rod-screw systems. Further biomechanical studies should be attempted to compare between different rod kyphotic angles to minimize the kyphotic rod failure rate and to offer a more stable and rigid rod-screw construct models for surgical application in the kyphotic vertebrae.


PubMed | Izmir Kâtip Celebi University, Suleyman Demirel University of Turkey and Sifa Hospital
Type: Journal Article | Journal: Oncology letters | Year: 2016

The present study aimed to examine hypoxia-inducible factor (HIF)-1 expression and its association with glucose uptake in invasive breast cancer. In addition, connections between glucose uptake and several other prognostic parameters of breast cancer were studied. Between August 2013 and April 2015, 92 patients with biopsy-diagnosed breast cancer were subjected to

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