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Uzun M.,Acibadem Maslak Hospital | Bulbul M.,Istanbul University | Toker S.,University of Konya | Beksac B.,Acibadem University | Kara A.,Sisli Etfal Education and Training Hospital
Journal of Orthopaedic Surgery and Research | Year: 2014

Background: Medical photography is used clinically for patient evaluation, treatment decisions, and scientific documentation. Although standards for medical photography exist in many branches of medicine, we have not encountered such criteria in publications in the area of orthopedics.Purpose: This study aims to (1) assess the quality of medical images used in an orthopedic publication and (2) to propose standards for medical photography in this area.Methods: Clinical photographs were reviewed from all issues of a journal published between the years 2008 and 2012. A quality of clinical images was developed based on the criteria published for the specialties of dermatology and cosmetic surgery. All images were reviewed on the appropriateness of background, patient preparation, and technique.Results: In this study, only 44.9% of clinical images in an orthopedic publication adhered to the proposed conventions.Conclusions: Standards have not been established for medical photography in orthopedics as in other specialty areas. Our results suggest that photographic clinical information in orthopedic publications may be limited by inadequate presentation. We propose that formal conventions for clinical images should be established. © 2014 Uzun et al.; licensee BioMed Central Ltd.


Karacetin D.,Istanbul Research and Training Hospital | Okten B.,Istanbul Research and Training Hospital | Yalcin B.,Sisli Etfal Education and Training Hospital | Incekara O.,Sisli Etfal Education and Training Hospital
Journal of B.U.ON. | Year: 2011

Purpose: To study the efficacy and safety of radiotherapy (RT) with concomitant and subsequent temozolomide in comparison to RT alone in the treatment of patients with newly diagnosed glioblastoma multiforme (GBM) after brain surgical intervention. Methods: Twenty patients received cranial fractionated RT (60 Gy total dose: 2 Gy/day, 5 days/week, for 6 weeks) with concomitant oral temozolomide (75 mg/m2/day x 7 days/week, for 6 weeks) followed by temozolomide monotherapy (200 mg/m2/day x 5 days every 28 days for 6 cycles). Another 20 patients received only cranial RT (Co-60 teletherapy, 60 Gy in 30 fractions). Results: At the end of the study the median time to progression free survival (PFS) was 13 months in the temozolomide plus RT treatment group and 5 months in the RT-alone group (p=0.0001). Median overall survival (OS) in the temozolomide plus RT and the RT-alone group was 19 and 11.5 months, respectively (p=0.0264). The main side effect in the temozolomide plus RT group was myelosuppression. Concomitant treatment resulted in grade 3 hematologic toxicity in 6 patients. Conclusion: These data show that the combination of temozolomide, concomitant and subsequent to RT seems more effective than RT alone in patients with newly diagnosed GBM and that multimodality treatment is safe and well tolerated. © 2011 Zerbinis Medical Publications.


Boyraz M.,Sisli Etfal Education and Training Hospital | Cekmez F.,Gulhane Military Medical Academy | Karaoglu A.,Gulhane Military Medical Academy | Cinaz P.,Gazi University | And 2 more authors.
Biomarkers in Medicine | Year: 2013

Aim: To investigate the relationship of adiponectin, leptin, resistin and RBP4 levels in obese and metabolic syndrome children with nonalcoholic fatty liver disease (NAFLD). Patients & methods: Group I consisted of 63 obese children with liver steatosis, group II consisted of 12 obese children with elevated serum ALT activity from group I, and group III included 85 obese children without liver steatosis. Results: Leptin levels were higher in the NAFLD children than in the control group. Serum RBP4 levels in obese children with NAFLD were higher than those in obese children without NAFLD and controls. Adiponectin and resistin levels were negatively correlated and RBP4 levels positively correlated with ALT activity and ultrasonographic grading. Conclusion: These data suggest that adiponectin, resistin and RBP4 may have a role in the pathogenesis of NAFLD in obese children. Adiponectin, leptin, resistin and RBP4 may be suitable markers for predicting metabolic syndrome and NAFLD. © 2013 Future Medicine Ltd.


Boyraz M.,Sisli Etfal Education and Training Hospital | Cekmez F.,GATA Medical Faculty | Karaoglu A.,GATA Medical Faculty | Cinaz P.,Gazi University | And 2 more authors.
Biomarkers in Medicine | Year: 2013

Aim: To investigate the relationship between serum adiponectin, resistin and RBP4 levels and the components of metabolic syndrome. Patients & methods: Serum adiponectin, resistin and RBP4 levels were detected and analyzed in 148 8-18-year-old Turkish obese pubertal children with/without metabolic syndrome. Results: Adiponectin and resistin concentrations were significantly inversely correlated with BMI standard deviation score, homeostatic model assessment insulin resistance, waist circumference, triglyceride levels and diastolic and systolic blood pressure, and were directly correlated with high-density lipoprotein cholesterol. RBP4 concentrations were directly correlated with homeostatic model assessment insulin resistance, waist circumference, triglyceride levels and diastolic and systolic blood pressure, and inversely correlated with high-density lipoprotein cholesterol. Conclusion: Adiponectin, RBP4 and, in particular, resistin levels may be used as suitable predictive biomarkers of metabolic syndrome. © 2013 Future Medicine Ltd.


Kurna S.A.,Fatih Sultan Mehmet Education and Training Hospital | Altun A.,Fatih Sultan Mehmet Education and Training Hospital | Aksu B.,Sisli Etfal Education and Training Hospital | Kurna R.,Private Practice | Sengor T.,Nightingale
European Journal of Ophthalmology | Year: 2013

Purpose: To compare 3 surgical treatment options of pterygium: limbal sliding flap transplantation, primary closing, and amniotic membrane grafting methods. Methods: Seventy-five patients with primary pterygium were included in the study. Snellen visual acuity measurement, grading pterygium, slit-lamp examination, keratometry, and anterior segment photography were performed preoperatively. Twenty-eight eyes of 28 patients (group 1) underwent limbal-conjunctival sliding flap transplantation, 22 eyes of 22 patients (group 2) underwent amniotic membrane grafting, and 25 eyes of 25 patients (group 3) underwent primary closing surgery. The patients were followed up on the first day and the first week after surgery and then at months 1, 3, 6, and 12. Results: The mean size of the pterygium preoperatively was 3.58 ± 1.1 mm in group 1, 3.95 ± 0.90 mm in group 2, and 3.5 ± 0.87 mm in group 3. The mean follow-up time was 15.07 ± 13.8 months in group 1, 20.2 ± 6.7 months in group 2, and 28.04 ± 9.9 months in group 3. Grade 4 corneal recurrence rate in follow-up was 7.1% in group 1, 27.3% in group 2, and 56% in group 3 (p = 0.00). Mean recurrence times were 4.0 ± 1.7, 4.4 ± 3.3, and 4.4 ± 3.6 months according to groups 1, 2, and 3 (p = 0.963). After the surgery, corneal astigmatism decreased and keratometric values increased significantly in all the groups with no statistically significant difference between the groups (p>0.05). Conclusi{dotless}ons: Limbal-conjunctival sliding flap transplantation is an efficient method to manage primary pterygium. It may be a safe and effective initial treatment option to reduce risk of recurrence and postoperative complications of pterygium surgery. © 2013 Wichtig Editore.


Temizkan O.,Sisli Etfal Education and Training Hospital | Temizkan S.,Kartal Dr Lutfi Kirdar Education And Training Hospital | Asicioglu O.,Sisli Etfal Education and Training Hospital | Aydin K.,Kartal Dr Lutfi Kirdar Education And Training Hospital | Kucur S.,Sisli Etfal Education and Training Hospital
Gynecological Endocrinology | Year: 2015

Prolactin (PRL) may have stimulatory effects on vascular resistance. We aimed to analyze uterine, spiral, and intraovarian artery blood flow by Doppler ultrasonography in hyperprolactinemic patients prior to and after treatment with cabergoline. The study was conducted in Sisli Etfal Training and Research Hospital gynecology outpatient clinic between 1 March 2010 and 30 September 2011. Twenty-four women with symptomatic hyperprolactinemia in reproduction age were included in the study. All hyperprolactinemic patients were studied prior to and following the suppression of circulating PRL levels by cabergoline. Patients were examined by standard B-mod and color transvaginal ultrasonography. Pulsality index (PI), resistance index (RI), and systolic/diastolic ratio (S/D) were recorded. The median PRL value was 86 (62-120)ng/ml before treatment and 4.0 (2.5-6.4)ng/ml after the treatment (p<0.001). We found a significant association among PRL, uterine, spiral, and intraovarian artery RI with linear regression analysis (p<0.001 for all three arteries). Uterine, spiral, and intraovarian artery PI (p=0.021, p<0.001, and p<0.001, respectively) and RI (p=0.001, p<0.001, and p<0.001, respectively) significantly decreased after cabergoline treatment. In conclusion, this is a pilot study which shows for the first time that PRL increases the uterine, endometrial, and intraovarian vascular resistance and cabergoline reverses this effect. © 2015 Informa UK Ltd.


Demirci G.T.,Sisli Etfal Education and Training Hospital | Altunay I.K.,Sisli Etfal Education and Training Hospital | Mertoglu E.,Sisli Etfal Education and Training Hospital | Kucukunal A.,Sisli Etfal Education and Training Hospital | Sakiz D.,Sisli Etfal Education and Trainig Hospital
Journal of Dermatological Case Reports | Year: 2011

Background: Linear atrophoderma is a rare disease, first described by Moulin in 1992 in 5 patients. It is an acquired unilateral hyperpigmented, depressed band-like areas following the lines of Blaschko. It affects children or adolescents of both genders involving the trunk or the limbs. It is considered to be a rare cutaneous form of mosaicism. Main observation: A 39-year-old woman with a 22 years history of unilateral slightly depressed hyperpigmented lesion on her neck was admitted to us. The skin texture was normal and there were no signs of induration or sclerosis. The histopathological examination revealed a normal epidermis outlined by a hyperpigmented basal layer. In the papillary dermis proliferation of superficial vessels with mild lymphocytic infiltrate and melanin-laden macrophages were present. The collagen fibres and elastic fibres were normal. The clinical and histopathological features confirmed the diagnosis of linear atrophoderma of moulin. We discussed the case according to the other cases reported in the literature. Conclusion: Approximately 28 cases of linear atrophoderma have been reported in literature. The present case has the charecteristic clinical and histopathological features of linear atrophoderma as defined by Moulin, but the localization of the lesion is unusual.


PubMed | Sisli Etfal Education and Training Hospital
Type: Comparative Study | Journal: International urology and nephrology | Year: 2014

We aimed to compare the success rates of the double hydrodistention implantation technique (HIT) and the HIT with a polyacrylate/polyalcohol copolymer (PPC) for the treatment of primary vesicoureteral reflux (VUR) with a new nonbiodegradable tissue-augmenting substance (Vantris, Promedon, Cordoba, Argentina).Between January 2011 and December 2012, fifty-two children who underwent subureteric injection for primary VUR are included. The children were randomly separated into two groups, the HIT and the double HIT groups, according to the type of injection. Success was defined as no reflux on a follow-up voiding cystourethrogram (VCUG) after 6 months. The patients were evaluated according to sex, age, grade of reflux, number of injections, and injected volume, and the radiological success rates were compared.Fifty-two patients underwent an endoscopic injection for primary grade III-V VUR. The HIT group consisted of 26 patients with 33 ureters, and the double HIT group consisted of 26 patients with 35 ureters. There were no significant differences in terms of the sex, ages, VUR grades, bilaterality between the two groups. The mean injected volumes were ml 1.12 (1.02-1.22) in the HIT group and 1.24 ml (95 % CI 1.10-1.38) in the double HIT group. The reflux was resolved in 21/33 (63.6 %) ureters in the HIT group and in 30/35 (85.7 %) ureters in the double HIT group, (p < 0.05). We had only one complication. This patient in the double HIT group, developed bilateral hydronephrosis and oliguric renal failure requiring open reimplantation at the sixth month.We observed successful results double HIT method with PPC in Grade III-V reflux, but the long-term follow-up of patients is needed for hydronephrosis. As the double HIT treatment leads to a higher success rate, its use is preferable.


PubMed | Sisli Etfal Education and Training Hospital
Type: Journal Article | Journal: Journal of dermatological case reports | Year: 2011

Linear atrophoderma is a rare disease, first described by Moulin in 1992 in 5 patients. It is an acquired unilateral hyperpigmented, depressed band-like areas following the lines of Blaschko. It affects children or adolescents of both genders involving the trunk or the limbs. It is considered to be a rare cutaneous form of mosaicism.A 39-year-old woman with a 22 years history of unilateral slightly depressed hyperpigmented lesion on her neck was admitted to us. The skin texture was normal and there were no signs of induration or sclerosis. The histopathological examination revealed a normal epidermis outlined by a hyperpigmented basal layer. In the papillary dermis proliferation of superficial vessels with mild lymphocytic infiltrate and melanin-laden macrophages were present. The collagen fibres and elastic fibres were normal. The clinical and histopathological features confirmed the diagnosis of linear atrophoderma of moulin. We discussed the case according to the other cases reported in the literature.Approximately 28 cases of linear atrophoderma have been reported in literature. The present case has the charecteristic clinical and histopathological features of linear atrophoderma as defined by Moulin, but the localization of the lesion is unusual.


Akin M.,Sisli Etfal Education and Training Hospital | Erginel B.,Sisli Etfal Education and Training Hospital | Karadag C.A.,Sisli Etfal Education and Training Hospital | Yildiz A.,Sisli Etfal Education and Training Hospital | And 4 more authors.
International Urology and Nephrology | Year: 2014

Objectives: We aimed to compare the success rates of the double hydrodistention implantation technique (HIT) and the HIT with a polyacrylate/polyalcohol copolymer (PPC) for the treatment of primary vesicoureteral reflux (VUR) with a new nonbiodegradable tissue-augmenting substance (Vantris, Promedon, Cordoba, Argentina).Methods: Between January 2011 and December 2012, fifty-two children who underwent subureteric injection for primary VUR are included. The children were randomly separated into two groups, the HIT and the double HIT groups, according to the type of injection. Success was defined as no reflux on a follow-up voiding cystourethrogram (VCUG) after 6 months. The patients were evaluated according to sex, age, grade of reflux, number of injections, and injected volume, and the radiological success rates were compared.Results: Fifty-two patients underwent an endoscopic injection for primary grade III–V VUR. The HIT group consisted of 26 patients with 33 ureters, and the double HIT group consisted of 26 patients with 35 ureters. There were no significant differences in terms of the sex, ages, VUR grades, bilaterality between the two groups. The mean injected volumes were ml 1.12 (1.02–1.22) in the HIT group and 1.24 ml (95 % CI 1.10–1.38) in the double HIT group. The reflux was resolved in 21/33 (63.6 %) ureters in the HIT group and in 30/35 (85.7 %) ureters in the double HIT group, (p < 0.05). We had only one complication. This patient in the double HIT group, developed bilateral hydronephrosis and oliguric renal failure requiring open reimplantation at the sixth month.Conclusion: We observed successful results double HIT method with PPC in Grade III–V reflux, but the long-term follow-up of patients is needed for hydronephrosis. As the double HIT treatment leads to a higher success rate, its use is preferable. © 2014, Springer Science+Business Media Dordrecht.

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