Umraniye Training and Research Hospital

İstanbul, Turkey

Umraniye Training and Research Hospital

İstanbul, Turkey
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Ozgurhan E.B.,Beyoglu Eye Training and Research Hospital | Akcay B.I.S.,Umraniye Training and Research Hospital | Kurt T.,Beyoglu Eye Training and Research Hospital | Yildirim Y.,Beyoglu Eye Training and Research Hospital | Demirok A.,Istanbul Medeniyet University
Journal of Refractive Surgery | Year: 2015

PURPOSE: To report the outcomes of accelerated corneal collagen cross-linking in patients with thin corneas (minimum corneal thickness < 400 μm). METHODS: Thirty-four eyes of 34 patients with a minimum corneal thickness less than 400 μm were included. All patients underwent accelerated corneal collagen cross-linking (irradiance power of 30 mW/cm2 at 3 minutes with a total surface dose of 5.4 J/cm2). Uncorrected (UDVA) and corrected distance visual acuity (CDVA), manifest refraction (diopters [D]), and topography were evaluated at baseline and at the 1-, 6-, and 12-month follow-up visit. Endothelial cell density (cells/mm2) was calculated preoperatively and postoperatively at 12 months. The corneal stromal demarcation line was measured using anterior segment optical coherence tomography at 1 month postoperatively. RESULTS: The mean age of all patients (14 women and 20 men) was 23.08 ± 3.90 years (range: 16 to 29 years). UDVA and CDVA increased but not significantly. UDVA improved from 0.67 ± 0.32 (20/93 ± 20/41 Snellen) to 0.56 ± 0.28 logMAR (20/72 ± 20/38 Snellen) (P = .033) and CDVA improved from 0.49 ± 0.19 (20/61 ± 20/30 Snellen) to 0.42 ± 0.19 logMAR (20/52 ± 20/30 Snellen) (P = .009) at the last follow-up visit. The mean spherical and cylindrical refractions did not significantly change (P = .100 and 0.139, respectively). At the last follow-up visit, the flat keratometry decreased from 47.40 ± 2.52 to 46.95 ± 2.48 D, steep keratometry decreased from 51.04 ± 3.71 to 50.62 ± 3.57 D, and apex keratometry decreased from 57.58 ± 4.49 to 56.26 ± 4.47 D (P = .001, = .0019, = .001, respectively) from baseline. The mean endothelial cell density changed from 2,726.02 ± 230.21 to 2,714.58 ± 218.26 cells/mm2 at 12 months postoperatively (P =.086). CONCLUSION: The results of this study revealed that accelerated corneal collagen cross-linking stabilized the progression of keratoconus without a significant endothelial cell density loss during the 12 months of follow-up. Copyright © SLACK Incorporated.


Erdogan G.,Umraniye Training and Research Hospital
Retina | Year: 2015

PURPOSE:: To evaluate the efficacy and safety of peripheral vitrectomy under air infusion in comparison with fluid infusion in patients undergoing 23-gauge pars plana vitrectomy for primary rhegmatogenous retinal detachment. METHODS:: A total of 80 eyes of 80 patients with primary rhegmatogenous retinal detachment were enrolled into the study. Forty cases underwent peripheral vitrectomy under air infusion (air group), and a control group of equal number underwent peripheral vitrectomy under fluid infusion (fluid group). Peripheral iatrogenic retinal breaks during peripheral vitrectomy, postoperative visual acuities, and retinal redetachment rates were compared. RESULTS:: The number of eyes with peripheral iatrogenic retinal breaks in air group during peripheral vitrectomy was statistically comparable with that in fluid group (1/40 and 4/40, 2.5% and 10%, respectively; P = 0.16). Scleral depression was necessitated in 7 of 40 cases (17.5%) during the operation in the air group. There were no statistically significant differences between the groups in means of postoperative visual acuity and retinal redetachment (P = 0.18 and P = 1.0, respectively). CONCLUSION:: Peripheral vitrectomy under air infusion for primary rhegmatogenous retinal detachment revealed comparable results with fluid infusion in terms of intraoperative and postoperative complications and surgical outcomes. © 2015 by Ophthalmic Communications Society, Inc.


Karaman M.,Umraniye Training and Research Hospital
Kulak burun boǧaz ihtisas dergisi : KBB = Journal of ear, nose, and throat | Year: 2012

In this study, we aimed to determine the possible relationship between the indications for tonsillectomy in adult population and to estimate the incidence of postoperative hemorrhage. Medical records of 200 adult patients who underwent tonsillectomy between January 2003 and October 2008 were retrospectively analyzed. The indications for adult tonsillectomy were chronic infection in 153 patients (76.5%); upper airway obstruction secondary to tonsillar hypertrophy in 37 patients (18.5%) and suspected neoplasms in 10 patients (5%). Sixteen patients (8%) had postoperative hemorrhage. Fourteen patients of 153 patients (9.2%) who underwent surgery with the indication of chronic infection and two of 37 patients (5.4%) who underwent surgery with the indication of upper airway obstruction secondary to tonsillar hypertrophy had also postoperative hemorrhage. None of the 10 patients who operated with the indication of suspected neoplasm had postoperative hemorrhage. Although the incidence of postoperative hemorrhage according to the indications of adult tonsillectomy in descending order was chronic infection (9.2%), upper airway obstruction secondary to tonsillar hypertrophy (5.4%) and suspected neoplasms (0%), it was found that the incidence of postoperative hemorrhage was not statistically significantly related to the indications for tonsillectomy. The incidence of postoperative hemorrhage was not statistically significantly related to the indications for tonsillectomy. In addition, we believe that surgery is a more common cause of postoperative hemorrhage rather than chronic infections.


Kadanali A.,Umraniye Training and Research Hospital
Mikrobiyoloji Bulteni | Year: 2012

Toscana virus which is an arbovirus transmitted to humans by sandflies (Phlebotomus spp.), can cause febrile illness and meningitis mainly during summer. It has a tropism for central nervous system and is a major cause of meningitis and encephalitis in endemic countries. Majority of the clinical and epidemiologic studies on Toscana virus have been reported from Italy, France, Spain, Portugal and other Mediterranean countries. Although Toscana virus infections has been identified, data on virus activity in Turkey are limited. In this review article, the epidemiological, clinical and laboratory features of Toscana virus as a cause of febrile diseases, meningitis and encephalitis during summer in Turkey were discussed.


Eren Cevik S.,Umraniye Training and Research Hospital | Tasyurek T.,Umraniye Training and Research Hospital | Guneysel O.,Dr Lutfi Kirdar Kartal Education and Research Hospital
American Journal of Emergency Medicine | Year: 2014

Intravenous lipid emulsion (ILE) is a lifesaving treatment of lipophilic drug intoxications. Not only does ILE have demonstrable efficacy as an antidote to local anesthetic toxicity, it is also effective in lipophilic drug intoxications. Our case series involved 10 patients with ingestion of different types of lipophilic drugs. Intravenous lipid emulsion treatment improved Glasgow Coma Scale or blood pressure and pulse rate or both according to the drug type. Complications were observed in 2 patients (minimal change pancreatitis and probable ILE treatment-related fat infiltration in lungs). In our case series, ILE was used for different lipophilic drug intoxications to improve cardiovascular and neurologic symptoms. According to the results, it was found that ILE treatment is a lifesaving agent in lipophilic drug intoxications and it can be used in unconscious patients who have cardiac and/or neurologic symptoms but no history of a specific drug ingestion. © 2014 Elsevier Inc. All rights reserved.


Akduman D.,Umraniye Training and Research Hospital
Kulak burun boǧaz ihtisas dergisi : KBB = Journal of ear, nose, and throat | Year: 2010

To make a contribution to the treatment modality of larynx cancer, we evaluated our surgical outcomes of the patients with larynx cancer and their quality of life in the postoperative period. Forty-three patients (38 males, 5 females; mean age 57.6 years; range 34 to 84 years) with larynx cancer were included in this retrospective clinical study. Total laryngectomy/near total laryngectomy (TL/NTL) was performed in 29 patients, supracricoid laryngectomy in 13 patients and supraglottic laryngectomy in one patient. Neck dissection performed in 39 patients. Two patients had preoperative and eleven patients had postoperative radiotherapy (RT). The patients were evaluated with respect to age, sex, smoking, alcohol consumption, localization-differentiation-stage of the tumor, surgery and RT, postoperative complications and survival. QLQ-C30 and QLQ-H and N35 questionnaires were used and the results of 26 patients who were alive and filled in the questionnaires themselves were evaluated. The most frequent postoperative complication was pharyngocutaneous fistula (41.3%), which occurred only in TL/NTL patients. Mean postoperative hospitalization time was 21.2 days. Laryngeal preservation, peristomal recurrence and locoregional recurrence rates were 64.3%, 6.9% and 9.3% respectively. Overall survival rate was 88.8%. Mean survival time was 62.4 months. In quality of life assessment, speech problem (p<0.01) and cough index (p<0.05) were significantly higher in TL/NTL group than SCL group (p<0.05). There were no significant difference in both groups with respect to RT (p>0.05). Our surgical outcomes are compatible with the previous studies. Although the larynx preservation had a positive effect on the speech, it did not affect other quality of life parameters. In addition, having a permanent tracheostomy increased cough index markedly. We emphasize that multi-institutional prospective quality of life studies comparing different treatment methods for similar stage tumors are essential in defining the optimal management strategy in patients with larynx cancer.


Naderi S.,Umraniye Training and Research Hospital
Journal of Neurosurgery: Spine | Year: 2010

Object. The authors reviewed the results of "skip" corpectomy in 29 patients with multilevel cervical spondylotic myelopathy (CSM) and ossified posterior longitudinal ligament (OPLL). Methods. The skip corpectomy technique, which is characterized by C-4 and C-6 corpectomy, C-5 osteophytectomy, and C-5 vertebral body preservation, was used for decompression in patients with multilevel CSM and OPLL. All patients underwent spinal fixation using C4-5 and C5-6 grafts, and anterior cervical plates were fixated at C-3, C-5, and C-7. Results. The mean preoperative Japanese Orthopaedic Association score increased from 13.44 ± 2.81 to 16.16 ± 2.19 after surgery (p < 0.05). The cervical lordosis improved from 1.16 ± 11.74° to 14.36 ± 7.85° after surgery (p < 0.05). The complications included temporary hoarseness in 3 cases, dysphagia in 1 case, C-5 nerve palsy in 1 case, and C-7 screw pullout in 1 case. The mean follow-up was 23.2 months. The final plain radiographs showed improved cervical lordosis and fusion in all cases. Conclusions. The authors conclude that the preservation of the C-5 vertebral body provided an additional screw purchase and strengthened the construct. The results of the current study demonstrated effectiveness and safety of the skip corpectomy in patients with multilevel CSM and OPLL.


Onol F.F.,Umraniye Training and Research Hospital | Guzel R.,Umraniye Training and Research Hospital | Tahra A.,Umraniye Training and Research Hospital | Kaya C.,Umraniye Training and Research Hospital | Boylu U.,Umraniye Training and Research Hospital
Journal of Urology | Year: 2015

Purpose We compared the long-term success of desmopressin sublingual lyophilisate formulation and enuretic alarm therapy in children with primary monosymptomatic nocturnal enuresis, and determined predictive factors for treatment success. Materials and Methods A total of 142 children with primary monosymptomatic nocturnal enuresis were randomized to receive treatment consisting of desmopressin or enuretic alarm for 6 months. Treatment compliance and response were reviewed monthly in each patient using a 30-day bed-wetting diary. Outcomes were assessed according to International Children's Continence Society criteria, and success rates at 6 and 12 months were compared for desmopressin and enuretic alarm. Additional intention to treat analyses were performed, considering cases with missing data as failures. Possible demographic factors predicting success were investigated by logistic regression analysis. Results Overall 4 children (5.2%) in the desmopressin group and 20 (30.7%) in the enuretic alarm group withdrew after randomization. Based on patients who completed 6 months of treatment, success (more than 90% reduction in wet nights per month) was achieved in 76.8% and 61.8% of children in the desmopressin and enuretic alarm groups, respectively. At 12 months 77.8% of those receiving desmopressin and 75% of those treated with enuretic alarm had success. However, long-term success rate was significantly higher with desmopressin (68.8% vs 46.2%) if intention to treat population was considered. Multivariate analysis revealed treatment group, severity of enuresis and monthly income as independent predictors of cure at 6 months. Conclusions In compliant patients desmopressin lyophilisate and enuretic alarm provided equivalent success at the end of treatment and after extended followup. Alarm therapy had a high rate of early withdrawal from therapy and consequently lower rates of success on intention to treat analyses. Severe enuresis (more than 5 wet nights weekly) is an important predictive factor for cure after first-line treatment. © 2015 American Urological Association Education and Research, Inc.


Cevik S.E.,Umraniye Training and Research Hospital | Tasyurek T.,Umraniye Training and Research Hospital | Guneysel O.,Dr Lutfi Kirdar Kartal Education and Research Hospital
American Journal of Emergency Medicine | Year: 2014

Intravenous lipid emulsion (ILE) is a lifesaving treatment of lipophilic drug intoxications. Not only does ILE have demonstrable efficacy as an antidote to local anesthetic toxicity, it is also effective in lipophilic drug intoxications. Our case series involved 10 patients with ingestion of different types of lipophilic drugs. Intravenous lipid emulsion treatment improved Glasgow Coma Scale or blood pressure and pulse rate or both according to the drug type. Complications were observed in 2 patients (minimal change pancreatitis and probable ILE treatment-related fat infiltration in lungs). In our case series, ILE was used for different lipophilic drug intoxications to improve cardiovascular and neurologic symptoms. According to the results, it was found that ILE treatment is a lifesaving agent in lipophilic drug intoxications and it can be used in unconscious patients who have cardiac and/or neurologic symptoms but no history of a specific drug ingestion. © 2014 Elsevier Inc. All rights reserved.


Bozkurt T.K.,Umraniye Training and Research Hospital
Eye and Contact Lens | Year: 2016

OBJECTIVES:: Study aims to evaluate the indications and surgical techniques for corneal transplantation and to report changes in trends for preferred keratoplasty surgical techniques. METHODS:: Clinical records of 815 consecutive corneal transplantations between January 1, 2004 and December 31, 2014 in Haydarpasa Numune Training and Research Hospital Eye Clinic were analyzed and classified into seven broad groups according to indications. Main outcome measures were change of leading indications and trends for surgical techniques. RESULTS:: Leading indications for keratoplasty were keratoconus (KCN) (27.7%), bullous keratopathy (BK) (23%), postinfectious corneal scars (13.5%), regrafts (13.1%), corneal dystrophies (12.1%), and noninfectious corneal scars (5.4%). Regrafts were the only indication with a significantly increasing trend (P<0.01). Since the introduction of lamellar keratoplasty (LK) techniques including deep anterior lamellar keratoplasty (DALK) and Descemet stripping automated endothelial keratoplasty (DSAEK), there was a significant increasing trend in number and percentage of both LK techniques (DALK; P=0.001 and P=0.007, and DSAEK; P<0.001 and P<0.001, respectively) and a significant corresponding decline in the percentage of penetrating keratoplasty (PK) (P<0.01). Similarly, DALK and DSAEK replaced PK as the preferred surgical technique for KCN and BK indications, (P=0.007 and P=0.01, respectively). Although PK was the most common surgical technique over the 11-year period (54.7%), both anterior and posterior LK techniques showed an emerging trend as the procedures of choice when indicated. CONCLUSIONS:: No major shift was observed in the clinical indications for corneal transplantation over the previous 11 years, except for regrafts. Lamellar keratoplasty techniques largely overtook the PK technique, but PK was still the overall preferred technique in the era when both LK techniques were used. © 2016 Contact Lens Association of Ophthalmologists, Inc.

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