Van Yuksek Ihtisas Egitim Ve Arastirma Hastanesi

Van, Turkey

Van Yuksek Ihtisas Egitim Ve Arastirma Hastanesi

Van, Turkey
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Gulcu E.,Van Yuksek Ihtisas Egitim ve Arastirma Hastanesi | Saglam E.,Van Yuksek Ihtisas Egitim ve Arastirma Hastanesi | Gulcu E.,Yuzuncu Yil University | Emiroglu M.Y.,Van Yuksek Ihtisas Egitim ve Arastirma Hastanesi
Turk Kardiyoloji Dernegi Arsivi | Year: 2011

A 52-year-old men with rheumatoid arthritis of 12-year history presented with severe chest pain. The electrocardiogram was consistent with acute inferior myocardial infarction. Transthoracic echocardiography showed increased left ventricular dimensions and hypokinesia in the inferolateral wall. Coronary angiography performed for percutaneous coronary intervention showed aneurysmatic dilatation (15-16 mm) and total occlusion of the right coronary artery by a large thrombus. As there was no stent available for dilated right coronary artery and due to the large thrombus burden, medical therapy was decided and tissue plasminogen activator infusion was started. The patient's chest pain progressively decreased. Coronary angiography performed on the fifth day of admission showed TIMI 3 flow in the right coronary artery. Warfarin was added to standard anti-ischemic treatment with a target INR of 2.5-3.0. Our literature search yielded no reported case of such aneurysmatic dilatation associated with rheumatoid arthritis. © 2011 Türk Kardiyoloji Derneǧi.

Background: Patient groups with secondary arteriovenous fistula (AVF) management with saphenous vein (SV) graft and polytetrafluoroethylene (PTFE) graft for hemodialysis (HD) were reviewed in terms of patency and complication rate. Methods: Forty HD access procedures were performed in 40 consecutive patients between January 2006 and January 2010. All access procedures were planned on the basis of preoperative duplex ultrasonography (USG) scans of arm and forearm veins. Functional patency was defined as ability to cannulate for HD successfully for the patient. Primary and secondary cumulative functional patency of SV and PTFE grafts were determined with Kaplan Meier test; differences in patency rates were analyzed with Log Rank test and differences in revision rates including thrombolysis, thrombectomies and operative revisions were analyzed with the Z test and the Fisher's exact t-test. Results: Mean follow-up was 48 months (range 43-54 months). Risk factors were similar between the two groups. Saphenous vein graft had better patency rates. The HD access complications were higher in SV graft group, while infection and thrombosis were higher in PTFE group. Conclusion: Our data strongly support the necessity that SV graft should be considered initially, compared to PTFE graft, for the patient who is a candidate for an upper arm secondary AVF creation based on anatomical criteria.

Inan B.,Bezmialem Foundation University | Aydin U.,Bezmialem Foundation University | Erkalp K.,Bezmialem Foundation University | Yasar T.,Bezmialem Foundation University | Basel H.,Van Yuksek Ihtisas Egitim ve Arastirma Hastanesi
Turkish Journal of Thoracic and Cardiovascular Surgery | Year: 2011

Background: In this study, surgical treatments performed by using autologous materials and other methods along with their results of these treatments were investigated. Methods: T wenty-two p atients (18 m ales, 4 f emales; mean age 34.2 years; range 24 to 61 years) who had undergone surgery with the diagnosis of inferior vena cava (IVC) injury in our clinic between May 2002 and July 2008, were analyzed. The surgical procedures and their results were retrospectively evaluated. The injuries were classified as penetrating traumas (n=17, 77%), blunt traumas (n=3, 13%), and gunshot injuries (n=2, 9%). Emergent laparotomy was performed for all patients. The surgical procedures performed included four methods: primary venoraphy (n=15, 68%), prosthetic graft interposition (n=1, 4%), repair with autogenous vein graft (n=4, 18%), and ligation (n=2, 9%). Results: Of the 22 patients, only one patient died as a of consequence of hemodynamic instability in perioperative period. Reoperation was performed in six patients in the postoperative period. The mean duration of intensive care unit stay was 3.1±1.9 days, and the mean duration of hospital stay was 26.5 days. The patients were evaluated with Doppler ultrasonography in the postoperative period. Conclusion: Inferior vena cava injuries caused by traumas can lead to life-threatening clinical pictures. The treatment method should be determined according to the pathological features and the degree of urgency of the case, and the use of synthetic materials should be avoided as much as possible.

Eren Z.,Yeditepe University | Bakir E.A.,Van Yuksek Ihtisas Egitim Ve Arastirma Hastanesi | Kaspar E.C.,Yeditepe University | Bakir S.,Van Yuksek Ihtisas Egitim Ve Arastirma Hastanesi | And 2 more authors.
Turkish Nephrology, Dialysis and Transplantation Journal | Year: 2012

OBJECTIVE: To share the results of the project funded by the European Union, entitled "providing poor hemodialysis patients with transportation, food service and subsistence" within the scope of the Eastern Anatolia Development Project conducted at the Hemodialysis Unit of Van Highly Specialized Training and Research Hospital. MATERIAL and METHODS: For eleven months, 66 patients were regularly transported to the hemodialysis unit and were given a meal. The anthropometric measurements, quality of life, anxiety, depression and hopelessness scales of patients were evaluated RESULTS: The evaluation included 66 patients (26 women, 40 men). A signifi cant increase was found in BMI (p = 0.01) and waist circumference (p = 0.00) together with elevated values of albumin (p = 0.02) and ferritin at the end of the project (p = 0.01). In women, there was a signifi cant increase in waist circumference (p = 0.00) and upper arm circumference (p = 0.03). From subscales of the SF-36 test, an increase in (p = 0.00) general health perception (p = 0.01) and the social function scores (p = 0.03) was observed in men. Beck Depression, Beck Hopelessness and Beck Anxiety Scale results showed that the anxiety and depression scores of the male patients had decreased signifi cantly. CONCLUSION: It was observed that regular transportation, adequate and conscious nutrition had positive effects on the treatment. We believe that social programs may have a benefi cial effect on the quality of life of hemodialysis patients in this region.

Gulcu E.,Van Yuksek Ihtisas Egitim ve Arastirma Hastanesi | Saglam E.,Van Yuksek Ihtisas Egitim ve Arastirma Hastanesi
Turk Kardiyoloji Dernegi Arsivi | Year: 2010

A 25-year-old male patient underwent primary femoral artery repair following a gunshot injury. Postoperative examination showed a thrill and bruit in the right femoral region. Peripheral angiography performed under right femoral Doppler ultrasound guidance revealed an arterio-venous fistula between the right superficial femoral artery and femoral vein. Through selective angiography from the left femoral artery, an endovascular stent was implanted in the right femoral artery. Control contrast injection showed near-total closure of the fistula and Doppler ultrasonography on the following day showed total closure.

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