Trabzon Numune Education and Research Hospital

Trabzon, Turkey

Trabzon Numune Education and Research Hospital

Trabzon, Turkey

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Bulut M.,Bursa Sevket Yilmaz Education and Research Hospital | Cebicci H.,Kayseri Education and Research Hospital | Sigirli D.,Uludag University | Sak A.,Bursa Sevket Yilmaz Education and Research Hospital | And 4 more authors.
Emergency Medicine Journal | Year: 2014

Objective: There are a few scoring systems in emergency departments (ED) to establish critically ill patients quickly and properly and to predict hospitalisation. We aim to compare the efficacy of Modified Early Warning Score (MEWS) and Rapid Emergency Medicine Score (REMS) on in-hospital mortality, and as predictor of hospitalisation in general medical and surgical patients admitted to ED. Methods: This is a prospective, multicentre and observational cohort study. The study included general medical and surgical patients admitted to the EDs of three education and research hospitals during a period of 6 months. The primary outcome of the study is the admission of the patient to a ward/an intensive care unit (ICU)/high dependency unit (HDU) and in-hospital mortality. Receiver operating characteristics (ROC) curve analysis was performed to evaluate and compare the performances of two scores. Results: Total patients were 2000 (51.95% male, 48.05% female). The mean age was 61.41±18.92. Median MEWS and REMS values of the patients admitted to the ICU/HDU from ED were 1 and 6, respectively; and there was a significant difference in terms of REMS values, compared with patients discharged from ED. REMS (area under the curve (AUC): 0.642) was found to have a better predictive strength than MEWS (AUC: 0.568) in discriminating in-patients and discharged patients. Additionally, REMS (0.707) was superior to MEWS (AUC 0.630) in terms of predicting inhospital mortality of patients presenting to ED. Conclusions: The efficiency of REMS was found to be superior to MEWS as a predictor of in-hospital mortality and hospitalisation in medical and surgical patients admitted to ED.


Hurmuz P.,Trabzon Numune Education and Research Hospital
Thoracic Cancer | Year: 2010

Malignant pleural mesothelioma is a rare neoplasm arising from the surface serosal cells of the pleural cavity. More than 80% of cases of malignant pleural mesothelioma have been attributed to asbestos exposure. In its natural course median survival is 4 to 12 months. If untreated most of patients die due to local complications of the disease. Surgery improves local control but is not sufficient as a single treatment modality. The recommended treatment strategy for a select group of patients is multimodal therapy that includes surgery, radiotherapy and chemotherapy. © Tianjin Lung Cancer Institute and Blackwell Publishing Asia Pty. Ltd.


Ersoy K.,Trabzon Numune Education and Research Hospital | Anaforoglu I.,Trabzon Numune Egitim Ve ArastIrma Hastanesi | Algun E.,Trabzon Numune Education and Research Hospital
Endocrine | Year: 2013

Overt hypothyroidism and subclinical hypothyroidism are thought to be associated with atherosclerosis and a chronic ischemic process. Ischemic modified albumin (IMA) is a novel marker of ischemia. We examined serum IMA levels in patients with subclinical and overt hypothyroidism. We recruited patients who presented to our clinic for thyroid disease control. We compared demographic data, fasting blood sugar, serum lipid levels, and the prevalence of metabolic syndrome by the presence of overt, subclinical, and no hypothyroidism. Cobalt binding to albumin capacity was analyzed using a rapid colorimetric technique and compared among the groups. We assessed 11 men and 74 women with a mean age of 39.9 ± 12 years. Of these, 48 (56.5 %) were euthyroid, 24 (28.2 %) had subclinical hypothyroidism, and 13 (15.3 %) had overt hypothyroidism. The groups did not differ significantly in terms of age; body mass index; waist circumference; systolic and diastolic blood pressures; levels of fasting and nonfasting blood sugar, high- and low-density lipoproteins, and triglycerides; and the presence of metabolic syndrome. Mean serum IMA level also did not differ significantly among the groups: 0.20 ± 0.08 absorbance units (ABSU) in the euthyroid participants, 0.18 ± 0.08 ABSU in those with subclinical hypothyroidism, and 0.20 ± 0.09 ABSU in those with overt hypothyroidism (P = 0.754). Mean IMA values did not differ significantly by sex, cigarette use, the presence of metabolic syndrome, or the presence of thyroid autoantibodies. Serum IMA levels did not differ among patients with overt or subclinical hypothyroidism in this case-control study. © 2012 Springer Science+Business Media, LLC.


Anaforoglu I.,Trabzon Numune Education and Research Hospital | Yildiz B.,Trabzon Numune Education and Research Hospital | Incecayir O.,Trabzon Numune Education and Research Hospital | Algun E.,Trabzon Numune Education and Research Hospital
Neuroendocrinology Letters | Year: 2012

Although hyperthyroidism arising from primary thyroid disease is rare in pregnancy, transient gestational hyperthyroidism is not uncommon. This condition can be associated with hyperemesis gravidarum (HG), and Wernicke's encephalopathy. We present the case of a woman with toxic nodular goiter complicating HG-associated Wernicke's encephalopathy. A 38-year-old Caucasian woman, who had received a diagnosis of hyperthyroidism and HG early in her pregnancy, had intrauterine fetal death at Week 16 of gestation. One day after undergoing therapeutic abortion, she was admitted to our clinic with persistent thyrotoxicosis, nausea, and vomiting. A toxic thyroid nodule was detected. She was given antithyroid medication, total parenteral nutrition. On Day 10 of hospitalization, she developed ataxia, aphasia, and somnolence. Cranial magnetic resonance imaging showed increased bilateral thalamic signalization. She was given a diagnosis of Wernicke's metabolic encephalopathy, for which she received thiamine and multivitamin preparations. She responded dramatically on the second day of thiamine therapy. Her consciousness improved rapidly and she began to speak. Her muscle tone was slightly weak and she had paresthesias in both legs. Absorption of thiamine may be particularly impaired in pregnant women with hyperemesis and hyperthyroid disease. Wernicke's encephalopathy should be considered in hyperthyroid women with HG who develop neurological abnormalities. © 2012 Neuroendocrinology Letters.


Anaforoglu I.,Trabzon Numune Education and Research Hospital | Algun E.,Trabzon Numune Education and Research Hospital | Incecayir O.,Trabzon Numune Education and Research Hospital | Ersoy K.,Trabzon Numune Education and Research Hospital
Metabolic Syndrome and Related Disorders | Year: 2011

Background: Polycystic ovary syndrome (PCOS) is a heterogeneous disease with well-established metabolic abnormalities in women of reproductive age. There are various diagnostic criteria to define and establish PCOS. However, data conflict regarding the optimal diagnostic criteria for PCOS and its metabolic consequences. We have evaluated the clinical, endocrine, and metabolic features between main PCOS phenotypes according to different diagnostic criteria. Methods: In this prospective, case-control study, 175 consecutive women with PCOS, 41 ovulatory women with idiopathic hirsutism, and 109 healthy, nonhirsute, ovulatory controls were enrolled. The following diagnostic criteria were assessed: Hirsutism; ovulatory function; ovarian sonography; gonadotropin, testosterone, dehydroepiandrosterone (DHEA), 17-hydroxyprogesterone, fasting insulin, and lipid levels; oral glucose tolerance test; homeostasis model assessment for insulin resistance (HOMA-IR); body mass index (BMI); waist circumference; and the presence of metabolic syndrome. Results: Of the 175 women meeting the Rotterdam criteria for PCOS, 121 (69%) had both androgen excess and ovulatory dysfunction, thus also meeting the National Institutes of Health (NIH) criteria. The other 54 (31%) had either androgen excess or ovulatory dysfunction. Women meeting the NIH criteria had the largest mean BMI, waist circumference, and HOMA-IR score; the highest mean testosterone, DHEA, triglyceride, and fasting insulin levels; the lowest mean progesterone level; and the greatest prevalence of insulin resistance (HOMA-IR score >3) among the groups. Conclusions: The NIH criteria identify women at high risk for insulin resistance and metabolic syndrome. The Rotterdam criteria include women who have less severe metabolic implications. © Copyright 2011, Mary Ann Liebert, Inc.


Anaforoglu I.,Trabzon Numune Education and Research Hospital | Ramazanogullari I.,Trabzon Numune Education and Research Hospital | Algun E.,Trabzon Numune Education and Research Hospital | Kutanis R.,Trabzon Numune Education and Research Hospital
Medical Principles and Practice | Year: 2012

Objective: It was our aim to investigate the quality of life (QOL) among family caregivers of patients with type 2 diabetes mellitus. Subjects and Methods: The Short Form-36 QOL scale, Beck Depression Inventory and State-Trait Anxiety Inventory Form were used to evaluate the presence and degree of depression and anxiety and their association with sociodemographic features of 50 family caregivers of diabetic patients compared to 54 controls. Results: The groups were similar in terms of age, sex, health insurance, educational status and marital and financial status. Beck Depression Inventory scores were significantly higher in family caregivers (p = 0.001) than in controls. Depression as a categorical variable was significantly more frequent among family caregivers of diabetic patients than among controls (p < 0.001). The social function component of the QOL of controls was better than that of family caregivers (p < 0.005). There was no difference between groups in terms of anxiety. Conclusion: Family caregivers of diabetic patients appeared to be more prone to depression and tended to have a poorer QOL. Copyright © 2011 S. Karger AG.


PubMed | Trabzon Numune Education and Research Hospital
Type: Review | Journal: Thoracic cancer | Year: 2016

Malignant pleural mesothelioma is a rare neoplasm arising from the surface serosal cells of the pleural cavity. More than 80% of cases of malignant pleural mesothelioma have been attributed to asbestos exposure. In its natural course median survival is 4 to 12 months. If untreated most of patients die due to local complications of the disease. Surgery improves local control but is not sufficient as a single treatment modality. The recommended treatment strategy for a select group of patients is multimodal therapy that includes surgery, radiotherapy and chemotherapy.


PubMed | Trabzon Numune Education and Research Hospital
Type: Case Reports | Journal: Neuro endocrinology letters | Year: 2012

Although hyperthyroidism arising from primary thyroid disease is rare in pregnancy, transient gestational hyperthyroidism is not uncommon. This condition can be associated with hyperemesis gravidarum (HG), and Wernickes encephalopathy. We present the case of a woman with toxic nodular goiter complicating HG-associated Wernickes encephalopathy. A 38-year-old Caucasian woman, who had received a diagnosis of hyperthyroidism and HG early in her pregnancy, had intrauterine fetal death at Week 16 of gestation. One day after undergoing therapeutic abortion, she was admitted to our clinic with persistent thyrotoxicosis, nausea, and vomiting. A toxic thyroid nodule was detected. She was given antithyroid medication, total parenteral nutrition. On Day 10 of hospitalization, she developed ataxia, aphasia, and somnolence. Cranial magnetic resonance imaging showed increased bilateral thalamic signalization. She was given a diagnosis of Wernickes metabolic encephalopathy, for which she received thiamine and multivitamin preparations. She responded dramatically on the second day of thiamine therapy. Her consciousness improved rapidly and she began to speak. Her muscle tone was slightly weak and she had paresthesias in both legs. Absorption of thiamine may be particularly impaired in pregnant women with hyperemesis and hyperthyroid disease. Wernickes encephalopathy should be considered in hyperthyroid women with HG who develop neurological abnormalities.


PubMed | Trabzon Numune Education and Research Hospital
Type: Journal Article | Journal: Endocrine | Year: 2013

Overt hypothyroidism and subclinical hypothyroidism are thought to be associated with atherosclerosis and a chronic ischemic process. Ischemic modified albumin (IMA) is a novel marker of ischemia. We examined serum IMA levels in patients with subclinical and overt hypothyroidism. We recruited patients who presented to our clinic for thyroid disease control. We compared demographic data, fasting blood sugar, serum lipid levels, and the prevalence of metabolic syndrome by the presence of overt, subclinical, and no hypothyroidism. Cobalt binding to albumin capacity was analyzed using a rapid colorimetric technique and compared among the groups. We assessed 11 men and 74 women with a mean age of 39.912years. Of these, 48 (56.5%) were euthyroid, 24 (28.2%) had subclinical hypothyroidism, and 13 (15.3%) had overt hypothyroidism. The groups did not differ significantly in terms of age; body mass index; waist circumference; systolic and diastolic blood pressures; levels of fasting and nonfasting blood sugar, high- and low-density lipoproteins, and triglycerides; and the presence of metabolic syndrome. Mean serum IMA level also did not differ significantly among the groups: 0.200.08 absorbance units (ABSU) in the euthyroid participants, 0.180.08 ABSU in those with subclinical hypothyroidism, and 0.200.09 ABSU in those with overt hypothyroidism (P=0.754). Mean IMA values did not differ significantly by sex, cigarette use, the presence of metabolic syndrome, or the presence of thyroid autoantibodies. Serum IMA levels did not differ among patients with overt or subclinical hypothyroidism in this case-control study.


PubMed | Trabzon Numune Education and Research Hospital
Type: | Journal: Case reports in medicine | Year: 2012

A 51-year-old man developed anorexia, dizziness, nausea, vomiting, and weight loss. He had orthostatic hypotension, hyponatremia, hyperkalemia, and hypocortisolemia, and the diagnosis of adrenal insufficiency was made. Magnetic resonance imaging (MRI) showed asymmetrically enlarged adrenal glands. Biopsy of a hypoechoic, enlarged, inguinal lymph node showed caseating granulomas. Lumbar MRI showed vertebral body height loss and abnormal signal in L1 and L2; vertebral biopsy showed chronic, necrotic, caseating granulomatous inflammation consistent with tuberculous osteomyelitis. Clinical improvement occurred with isoniazid, rifampicin, pyrazinamide, and corticosteroids. The differential diagnosis of adrenal insufficiency should include tuberculosis, especially in geographic regions where tuberculosis is endemic.

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