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- Uzun, Sevda(79)
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Yayınlar
- MakaleAçık Erişim2013Evaluation of protein tyrosine phosphatase activity in patients with acute leukemia
Akdogan, Elif; Cengiz, Sevil; YIlmaz, Mustafa; Sönmez, Mehmet; Durmus, Ahmet; Oval, Ercüment; Omay, Serdar Bedii
Protein tyrosine phosphatases regulate physiological processes including growth, differentiation, metabolism and the cell cycle. Together with tyrosine kinases, they control the phosphorylation state of tyrosine residues of signaling proteins. An increased level of protein phosphorylation results in abnormal proliferation and many cancer types show a mutation or deletion of a protein tyrosine phosphatase gene. In this study we evaluated the protein tyrosine phosphatase activity in acute leukemia patients. Tyrosine phosphatase activity in bone marrow mononuclear cells of acute leukemia patients was measured using a tyrosine phosphatase assay system kit and compared with a control group. We found that tyrosine phosphatase activity in acute leukemia patients was high compared to the controls. According to subgroups of acute leukemia, tyrosine phosphatase activity in the AML-M2 subgroup was high compared to the controls. The effect of increased level of protein tyrosine phosphatase activity on leukemogenesis needs further evaluation. Studies in a large group of patients are needed to emphasize the importance of tyrosine phosphatase activity in acute leukemia patients.
- MakaleYayıncıda açık erişim2013Serum anti-carbonic anhydrase I and II antibodies and polycystic ovary syndrome; [Serum anti-karbonik anhidraz I ve II antikorları ve polikistik over sendromu]
Menteşe, Ahmet; Güven, Süleyman; Sümer, Ayşegül; Turan, Ibrahim; Demir, Selim; Karahan, Süleyman Caner; Alver, Ahmet
Aim: The aim of this study is to investigate anti-carbonic anhydrase antibodies (anti-CA I and CA II antibodies) in the sera of women with polycystic ovary syndrome (PCOS). Methods: In this study serum anti-CA I and II antibody levels of age and BMI matching fifty women with PCOS and fifty women without PCOS on day three of menstrual cycle were assessed with an ELISA method previously developed by Hosoda and modified by Alver et al. Results: The mean serum anti-CA I antibody levels were significantly higher in women with PCOS and anti-CA II antibody levels were not significantly different in women with PCOS compared with control subjects. For serum anti-CA I antibody, the absorbance higher than 0.484 (mean + 3SD of control subjects) was taken as positive, Anti-CA I antibody was detected in 13 of 50 patients with PCOS (26%). Considering serum anti-CA II antibody, the absorbance higher than 0.654 (mean + 3SD of control subjects) was taken as positive. Anti--CA II antibody was detected in 2 of 50 patients with PCOS (4%). All patients with positive anti-CA II antibody also had positive anti-CA I antibody. Autoantibodies specifically reactive to CA I were found to be present at a higher frequency than CA II in the serum of subjects with PCOS in the present study. Conclusion: The results may suggest that autoimmune responses against CA I may be involved in the pathogenesis of PCOS.
- MakaleAçık Erişim2013Detection of class 1 integron in Acinetobacter baumannii isolates collected from nine hospitals in Turkey
ÇIÇek, Ayşegül Çopur; Düzgün, Azer Özad; Saral, Ayşegül; Kayman, Tuba; ÇIzmecI, Zeynep; Balci, Pervin Özlem; Dal, Tuba; Firat, Mehmet; Tosun, Ismail; Alitntop, Yasemin Ay
Objective: To investigate the antibiotic resistance genes inserted into class 1 and class 2 integrons in Acinetobacter baumannii (A. baumannii) isolates obtained from nine different cities in Turkey. Methods: A collection of 281 A. baumannii clinical isolates were collected from nine diferent state hospitals in Turkey and were confirmed as A. baumannii by conventional biochemical, API testing and bla-OXA-51 specific PCR. The isolates were examined by PCR for existence of class 1 and 2 integron gene cassettes. Results: They were characterized by antimicrobial susceptibility testing and the highest resistance rates were determined for piperacillin (90.03%), ciprofloxacin (87.54%), cefepime and trimethoprim/sulfamethoxazole (81.13%). The lowest resistance rates was for cefotaxime (3.55%). class I integrons were detected in 6.4% (18/281) of A. baumannii strains and no class 2 integron was detected. The gene cassettes of class 1 integrons AacC1-AAC(3) I-aadA1, AacC1-aadA1, AAC(3)-I, AAC(3)-I -AAC(3)-I -aadA1, TEM-1, AAC(3)-I-aadA1 - AAC(3)-I -AAC(3)-I, AAC(3)-I -AAC(3)-I -AAC(3)-I -aadA1, AAC(3)-I - aadA1, AAC(3)-I-AAC(3)-I, AAC(3)-I-aadA1-AAC(3)-I-aadA1, AAC(3)-I-AAC(3)-I-aadA1-AAC(3)-I-aadA1 were detected in eighteen strains. The aac genes family were most frequently found integrated into the class 1 integrons and it was followed by aadA genes and TEM-1 genes. Conclusions: This is an extensive study on the distribution of class 1 integron among A. baumannii in Turkey. In addition to these, two new alleles were observed. Their percentage rates of similarity to other cassettes are 95% aadA1 (TKA18) and 89% aadA1 (ANKA3).
- MakaleAçık Erişim2012Basic Disaster Consciousness and Preparation Levels
Inal, Ebru; Kocagöz, Semanur; Turan, Meliksah
Objectives The behaviors of individuals during disasters are determined by their level of disaster readiness and their knowledge of disaster threats. The aim of this research was to determine the basic disaster consciousness levels of individuals between the ages of 18 and 23. Methods The study included 291 students from Kelkit Aydin Dogan vocational school at the University of Gumushane. Each student completed a questionnaire with 10 informative questions about disaster consciousness. The data were evaluated using the chi-square test and the t-test. Results Not all 291 students answered each question. Of 285 students, 74.0% had not received any education on disaster preparedness. Of 249 students, 85.9% did not have a disaster preparedness plan. Of 266 students, 88.7% did not have an emergency kit. Out of 10 possible points, participants received 3.00 +/- 1.58 points on average for disaster preparedness. Conclusions The point average for student participants was quite low. Previous disaster training significantly increased the number of points received by participants. Disaster training should be extended to a wider range of individuals.
- MakaleAçık Erişim2012Traumatic diaphragmatic ruptures: diagnostic and therapeutic approaches
Çobanoglu, Ufuk; Kara, Volkan; Yalçinkaya, Irfan; Er, Metin; Isik, Ahmet Feridun; Sayir, Fuat; Mergan, Duygu
Background: This study aims to evaluate the characteristics of patients with traumatic rupture of diaphragm (TDR), the diagnostic and therapeutic approaches used in these cases and and the outcomes of the patients. Methods: Forty-one patients (31 males, 10 females; mean age 41.9 years; range 7 to 71 years) with thoracoabdominal trauma and diagnosis of TDR who were treated in our clinic between January 2000 and January 2010 were analyzed retrospectively. The patients were statistically compared in terms of age, gender, the time of diagnosis (early or late), the diagnostic procedures that were performed, whether the diagnosis of rupture was made during or after the operation, the localization of the rupture, the diameter of the rupture, accompanying injuries, the surgery performed, mortality and morbidity and the trauma injury severity score. Results: The etiology for the diaphragmatic rupture was blunt trauma in 43.9% and penetrating trauma in 56.10% of the patients. 85.36% of the patients were diagnosed in early stage and 14.64% in late stage. Herniation dignosis was made radiologically in 118 (43.9%) patients and diaphragmatic rupture was detected during the operation in 23 patients (56.1%). Twenty-nine (70.73%) patients had thoracotomy, seven (17.02%) patients had laparatomy and five (12.19%) patients had thoracotomy plus laparatomy. The overall mortality rate was 14.63% (n=6). Conclusion: Traumatic diaphragmatic ruptures may have a fatal course depending on the strangulation of the herniating abdominal viscera. Traumatic diaphgram rupture should be suspected in all multitraumatic patients and these cases shuld be seriously evaluated for the definitive diagnosis and treatment plan.
- MakaleAçık Erişim2012Clinical effects of enhanced external counterpulsation treatment in patients with ischemic heart failure
Kozdag, Guliz; Ertas, Gokhan; Aygün, Fatih; Emre, Ender; Kirbas, Ahu; Ural, Dilek; Soran, Ozlem
Objective: Enhanced external counterpulsation (EECP) is a noninvasive treatment that is proven safe and effective in patients with coronary artery disease (CAD) and heart failure (HF). The aims of this study are to investigate the clinical effects of EECP therapy in patients with symptomatic CAD and chronic HF, and to find out an answer to the question: Does EECP therapy have any effect on the prognostic markers of HF? Methods: This study was designed as a prospective cohort study. A total of 68 consecutive patients with symptomatic CAD and chronic HF referred to EECP therapy were enrolled in this study between November 2007 and December 2010; 47 patients (39 males and 8 females, 65 +/- 7, years), have undergone EECP treatment, and 21 patients (20 males and 1 female, 62 +/- 10 years), who did not want to participate in the EECP program comprised the control group. Statistical analysis was performed using t tests for dependent and independent samples, Mann-Whitney U test, Chi-square and Fischer exact tests. Results: EECP therapy resulted in significant improvement in post-intervention New York Heart Association functional class (p<0.001), left ventricular ejection fraction (p<0.001), B-type natriuretic peptide levels (p<0.003), uric acid levels (p<0.05), free-T3/free-T4 ratio (p<0.034) and mitral annular E (p<0.05) velocity, compared with baseline, a finding not evident in the control group. Conclusion: EECP treatment significantly improved clinical and some biochemical parameters, which are mostly prognostic markers in patients with symptomatic CAD and chronic HE (Anadolu Kardiyol Derg 2012; 12:214-21)
- MakaleYalnız künye2012Effect of enhanced external counterpulsation treatment on mean platelet volume in patients affected by ischemic chronic heart failure
Ertas, Gokhan; Kozdag, Guliz; Emre, Ender; Akay, Yasar; Ural, Dilek; Hebert, Kathy
Mean platelet volume (MPV) is increased in chronic heart failure (CHF) and is an independent predictor of mortality in CHF patients. It is not known whether enhanced external counterpulsation (EECP) therapy leads to decreased MPV values or not. The purpose of this study was to examine the effects of EECP on platelet count and MPV values and to assess the influence of MPV on the risk of death and recurrent ischemic events in ischemic CHF patients. A total of 68 ischemic heart failure patients with CHF symptoms and refractory angina pectoris were included in the study, 47 consecutive patients (39 males and eight females) aged 44-82 years. Although follow-up period started after completion of EECP in treated patients, control group follow-up started at the end of 7-week treatment without EECP. All patients were monitored for a mean duration of 13 +/- 8 months (range, 1-36 months). The primary endpoints of the study were effects of EECP treatment on platelets after treatment period (7 weeks) and the recurrence of ischemic events. Secondary endpoint was cardiovascular death during the follow-up period. We observed a significant increase in platelet count and decrease in MPV levels (P=0.044 and P=0.004, respectively) in the control group. There were no significant differences in platelet count and MPV levels in the EECP group (P>0.05). After the treatment period, New York Heart Association functional classification (2.60 +/- 0.75 vs. 1.72 +/- 0.68, P<0.001) and Canadian Cardiovascular Society functional classification of angina (2.50 +/- 0.90 vs. 1.60 +/- 0.74, P<0.001) improved in patients with EECP treatment. In our study, we found that EECP therapy had a neutral effect on MPV values and platelet count Blood Coagul Fibrinolysis 23:127-131 (C) 2012 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.
- MakaleAçık Erişim2012An unusual clinical state: true ulnar artery aneurysm in a five-year old girl
Memetoglu, Mehmet Erdem; Memetoglu, Mehmet Erdal; Erbasan, Ozan
We report the case of a 5-year old girl, who presented with a true ulnar artery aneurysm, and the aetiology, clinical presentation and treatment of the disease.
- MakaleYalnız künye2012Isolated Hemothorax Following Thoracic Trauma: Analysis of 57 Cases
Çobanoglu, Ufuk; Melek, Mehmet; Kara, Volkan; Mergan, Duygu
Aim: The aim of this study was to review cases with isolated hemothorax after thoracic trauma, to assess the diagnostic and treatment methods, and to discuss the determining factors of morbidity and mortality. Material and Method: A total of 57 patients were examined retrospectively. All patients underwent tube thoracostomy and underwater seal as the initial treatment approach. Emergency thoracotomy was performed on cases with continuing drainage from the chest tube, expanding hemothorax on the posteroanterior (PA) chest x-ray, and with hemodynamic instability. Result: Hemothorax occurred as a result of penetrating trauma in 31 (54.38%) and due to blunt trauma in 26 (45.61%) cases. Of the cases, 49 (85.96%) underwent tube thoracostomy drainage. All the 8 cases (14.03%) that underwent emergency thoracotomy had penetrating trauma. Mortality occurred in one patient (1.75%) who had penetrating trauma and who underwent emergency thoracotomy. The morbidity rate in patients with blunt trauma was significantly higher than those with penetrating trauma (p<0.0001). Discussion: Accurate diagnosis and appropriate surgical intervention in cases with traumatic hemothorax is essential for reducing the morbidity and mortality. Chest tube insertion and underwater seal application should be the initial treatment modality and successful in most cases. Emergency thoracotomy is life-saving in indicated patients. The need for thoracotomy is higher in isolated hemothorax due to penetrating chest trauma.
- EditoryalYalnız künye2012An unusual clinical state: atrial fibrillation due to mad-honey intoxication
Kalkan, Asim; Gökçe, Mustafa; Memetoglu, Mehmet Erdem
- MakaleAçık Erişim2012Behcet's disease with aneurysm of internal iliac artery and percutaneous treatment
Memetoglu, Mehmet Erdem; Kalkan, Asim
Behcet's disease (BD), described in 1937 by Hulusi Behcet, is a multisystemic inflammatory disorder. In this paper, we report a large pseudoaneurysm of the internal iliac artery in a patient who had BD, and was admitted to emergency service complaining of leg pain and the percutaneous treatment of the pathology which followed.
- MakaleYalnız künye2012Endovenous ablation with a 940 nm laser for the treatment of great saphenous vein insufficiency: short- to mid-term results
Memetoglu, Mehmet Erdem; Kurtcan, Serpil; Erbasan, Ozan; Özel, Deniz
PURPOSE We aimed to present the short- to mid-term results of endovenous laser ablation (EVLA) procedures that were used to treat great saphenous vein (GSV) insufficiency. MATERIALS AND METHODS This prospective study was conducted between December 2009 and January 2011. A total of 112 incompetent GSVs were treated using EVLA with a 940 nm wavelength laser. Ninety patients were treated for varicose veins with saphenous reflux, including 36 females (40%) and 54 males (60%). These patients' ages ranged from 17 to 79 years (median, 48 years). After the EVLA, the patients were monitored using duplex ultrasonography and were assessed clinically at 1 week and 1, 3, 6, and 12 months after the surgery. The patients were scheduled for a three-day examination after the EVLA to assess the level of pain that each patient was experiencing in each limb. RESULTS At the end of a one-year follow-up period, the postprocedural duplex scans revealed a total occlusion of the treated GSVs in 88 (97%) patients and a sub-total occlusion in two (2%) patients. The average modified clinical, etiological, anatomical, and pathological score was significantly decreased at 12 months. The following complications were observed in the present study: hypoesthesia (11%), swelling and induration (5%), skin pigmentation (5%), deep vein thrombosis (1%), erythema (1%), and bleeding (1%). The mean visual analog pain score for the entire procedure was 3.14 +/- 1.06. CONCLUSION Our short- and mid-term results of the EVLA procedure were satisfactory, and the results of this study reaffirmed the safety and effectiveness of an EVLA using a 940 nm wavelength for the treatment of GSV insufficiency.
- MakaleYalnız künye2012Safety and effectiveness of 5-mm and 10-mm electrothermal bipolar vessel sealers (LigaSure) in laparoscopic resections for sigmoid colon and rectal cancers
Gezen, Cem; Kement, Metin; Altuntas, Yunus E.; Aksakal, Nihat; Okkabaz, Nuri; Civil, Osman; Vural, Selahattin; Oncel, Mustafa
Background: LigaSure™ (Covidien, Mansfield, MA) has been used in cases undergoing laparoscopic colon and rectal resections. This study aims to analyze the efficacy and safety of the 5-mm and 10-mm devices. Subjects and Methods: Patients who received a laparoscopic or hand-assisted laparoscopic operation for a tumor located in the sigmoid colon or rectum since 2006 were abstracted from a prospectively designed database, and findings were analyzed in two groups based on size of the device used during the procedure. The videotapes of the procedures were watched, and operation reports were read to obtain further information on specific intra- and postoperative complications. Demographics, tumor and operation-related information, and postoperative data were compared. Results: Among 215 (128 [59.5%] males; median age, 59.5±13.8 years) patients, data obtained from the 5-mm (n=32) and 10-mm (n=183) groups were identical regarding demographics and data related to tumor (localization and stage) and operation (number of harvested lymph nodes, conversion rates, operation time, intraoperative bleeding, transfusion requirement, reoperation rates, complications, 30-day mortality, and length of hospital stay). However, more patients underwent an anterior resection in the 10-mm group than in the 5-mm group (31.7% versus 15.6%, P<.05). Further analyses found device-related bleeding in 8 (3.7%) cases (2 [6.3%] versus 6 [3.3%] in the 5-mm versus 10-mm group, respectively, P>.05), requiring further attempts for hemorrhage control (n=6), conversion to open surgery (n=1), or relaparotomy (n=1). Conclusions: The 5-mm and 10-mm LigaSure devices are similarly effective and safe during laparoscopic sigmoid colon and rectal resections. Severe bleeding from larger vessels may be observed, requiring conversion to open surgery or relaparotomy.
- MakaleYalnız künye2012Aspirin, clopidogrel, and warfarin use and outcomes in a cohort of 580 patients discharged after hospitalization for decompensated heart failure
Kozdaǧ, Güliz; Yaymaci, Mehmet; Ertaş, Gökhan; Çelikyurt, Umut; Şahin, Tayfun; Kiliç, Teoman; Ural, Dilek
The benefits of taking of aspirin, clopidogrel, and warfarin in relation to cardiovascular mortality and re-hospitalization in chronic heart failure (HF) patients have been called into question. We examined the outcomes (cardiac mortality and/or HF re-hospitalization) in patients discharged from our hospital between January 2003 and July 2009 after hospitalization for chronic decompensated HF. Of 580 HF patients (mean age, 63 ± 13 years; mean ejection fraction, 26 ± 9%, 63% with coronary disease and 37% without coronary disease), 207 patients (36%) died due to cardiovascular reasons, and 313 (54%) required HF re-hospitalization for decompensated HF during a 39 ± 14 month follow-up period. 101 (17%) patients were taking clopidogrel during enrollment in the study. When comparing patients who were on clopidogrel treatment with those who were not, clopidogrel was found to have a beneficial effect on cardiac mortality (27 vs. 38%, P = 0.04). In conclusion, in this observational prospective study, patients who used clopidogrel showed decreased cardiac mortality [HR, 0.566 (95% CI 0.332-0.964), P = 0.036] compared to patients who did not take clopidogrel. Clopidogrel had a beneficial effect on the survival of chronic HF patients in the long term.
- MakaleAçık Erişim2012Metabolic syndrome in collection and disposal of solid waste sector
Eker, Hasan Huseyin; Bayraktarli, Recep Yilmaz; Issever, Halim; Ulas, Tumer; Erelel, Mustafa; Eser, Ali; Ozdilli, Kuraat; Ozder, Aclan
Objectives: This study aims to assess the frequency and factors relevant to metabolic syndrome in workers employed in the collection and disposal of solid waste sector. Materials and Methods: This cross-sectional study was conducted in the major solid waste collecting and disposal company named ISTAC AS (Istanbul Environmental Protection and Waste Processing Corporation) in Istanbul, Turkey. All 715 male employees of the company were included in the study without sampling. The study was completed with 619 subjects. Since it was a small group, female workers were not taken into ac-count in the study. Metabolic syndrome frequency was investigated according to the NCEP-ATP III criteria including the levels of systolic and diastolic blood pressure, waist perimeter, HDL, triglyceride, fasting blood glucose values. Results: Metabolic syndrome was present in 40.9% of participating employees. Metabolic syndrome was more common in those working in the excavation field (54.0%), such as caterpillar operators (56.5%), and less common in employees working in administrative offices, such as office staff or managers, who were under 35 years old and who had been working for less than 10 years (p < 0.05). Employees working in work stations other than administrative offices had a 2.60 times higher risk compared to those working in administrative offices. Conclusions: Metabolic syndrome may be related to work sta-tion, job, age and period worked by the subjects.
- MakaleYalnız künye2012Complete versus partial mobilization of splenic flexure during laparoscopic low anterior resection for rectal tumors: A comparative study
Gezen, Cem; Altuntas, Yunus E.; Kement, Metin; Vural, Selahattin; Civil, Osman; Okkabaz, Nuri; Aksakal, Nihat; Oncel, Mustafa
Background: The aim of the current study is to compare the results after partial and complete splenic flexure mobilization (SFM). Subjects and Methods: The records of laparoscopic and hand-assisted laparoscopic procedures for primary rectal tumor patients were abstracted from a prospectively designed database. The phrenicocolic and splenocolic ligaments were divided via a four-trocar technique in the partial SFM group, and dissection was continued with the separation of gastrocolic and pancreaticomesocolic attachments via a five-trocar procedure in the complete SFM group. The following data were compared between the groups: Demographics, intra- and postoperative information, and pathological features. Results: In total, 122 cases (77 [63.1%] male, 58.2±13.2 years old) who underwent a partial (n=36, 29.5%) or a complete (n=86, 70.5%) SFM were included. Reservoir creation (48.8% versus 19.4%, P=.003) was more common and conversion (8.1% versus 22.2%, P=.039) was less frequent in the complete SFM group, but there were significantly more T4 tumors in the partial group (16.7% versus 2.3%, P=.008). Demographics, other intra- and postoperative parameters, and pathological features were identical. Conclusions: In our study, complete SFM decreased conversion rates, but this finding may be related to the higher rate of T4 tumors in the partial SFM group. Complete SFM assures an increase in reservoir creation in patients receiving a low anterior resection. Because other parameters are identical, the decision for the level of SFM is better left to the surgeon in cases undergoing a low anterior resection, but complete SFM may be preferred in cases who are candidates for a reservoir formation.
- MakaleYalnız künye2012Laparoscopic and conventional resections for low rectal cancers: A retrospective analysis on perioperative outcomes, sphincter preservation, and oncological results
Gezen, Cem; Altuntas, Yunus E.; Kement, Metin; Aksakal, Nihat; Okkabaz, Nuri; Vural, Selahattin; Oncel, Mustafa
Background: This study aims to compare the results of laparoscopic and conventional techniques in patients with low rectal cancers. Subjects and Methods: A retrospective data analysis was initiated in patients underwent laparoscopic or conventional surgery for cancers located in the low (<6 cm) rectum. Patient and tumor-related information, outcomes of operations, and survival were compared between the groups. Results: Among 142 patietns (91 men [64.1%]; mean±standard deviation age, 57.7±14.6 years) who had tumors located <6 cm from the dentate line, 92 (64.8%) were operated on with the laparoscopic technique. Demographics, tumor stage, and localization (2.9±2.0 versus 2.9±2.1 cm from the dentate line in laparoscopic and conventional arms, respectively; P=.968) were similar. However, there were more patients in the laparoscopic group who received neoadjuvant chemoradiation therapy (92.4% versus 80.0%; P=.03), since there were significantly fewer cases with stage I tumors in this group (3.3% versus 14%; P=.33). The conversion rate was 14.1% (n=13). The amount of bleeding and the requirement for transfusion decreased (P<.05 for both), and the possibility of sphincter-saving procedures (66.3% versus 34.0%; P<.001) increased, in the laparoscopy group. Other parameters were identical. In the laparoscopy group, the number of harvested lymph nodes (10.2±5.4 versus 12.4±6.0; P=.025) and the rate of vascular invasion (27.5% versus 47.8%; P=.021) were less, and Kaplan-Meier analysis revealed an improved survival (P=.042), although the follow-up period was significantly shorter in this group (P<.001). Conclusions: Laparoscopic surgery for low rectal cancers may be technically feasible and oncologically safe. Laparoscopy may increase the possibility of sphincter preservation.
- MakaleYalnız künye2012Analysis of the multi-item dimensionality of patients' perceived value in hospital services
Teke, Abdulkadir; Cengiz, Ekrem; Çetin, Mehmet; Demir, Cesim; Kirkbir, Fazil; Fedai, Turan
The purpose of this research is to analyse the multi-item dimensionality of patients' perceived value in hospital service. A total of 564 patients administered to Gulhane Military Medical Academy were surveyed. Sample population was specified through convenience sampling procedure. A face to face survey was conducted by three interviewers in August 2008. Confirmatory Data Analysis was carried out to reach the final data analysis. A scale of overall perceived value in health service was developed, which was composed of three dimensions and represented by 21 items. These dimensions were: Functional value, emotional value, and social value. The results indicated that perceived value was a multidimensional construct that affects the whole process of service purchasing. If the hospitals managers give importance to the sub-dimensions of the patient value inclined to their own hospitals and they regularly examine the situation of these dimensions, they can move one step ahead in achieving patient satisfaction and loyalty.
- MakaleAçık Erişim2012Results after multivisceral resections of locally advanced colorectal cancers: An analysis on clinical and pathological t4 tumors
Gezen, Cem; Kement, Metin; Altuntas, Yunus E.; Okkabaz, Nuri; Seker, Mesut; Vural, Selahattin; Gumus, Mahmut; Oncel, Mustafa
Background: Locally advanced colorectal cancers are best treated with multivisceral resections. The aim of this study is to evaluate early and late results after multivisceral resections.Methods: All patients operated for primary colorectal cancer between 2001 and 2010 were -reviewed. These were compared within the patients underwent single organ and multivisceral resections: demographics, tumor and procedure related parameters, perioperative results, early oncological outcomes and 5-year survival.Results: A total of 354 patients (59.6 ± 13.8 years old, 210 [59.3%] males) were abstracted. Ninety (25.4%) patients underwent multivisceral resections for clinical T4 tumors and en-bloc R0 resection was achieved in 82 (91.1%). Only 31 (34.4% and 8.8% of clinical T4 and all cancers, respectively) cases had actual adjacent organ invasions (pT4). Males (20%) had lower risk for locally advanced tumors than females (33.3%) (p < 0.05). PT4 cancers were more common, if the clinical T4 tumor is located in the colon (48.8% vs 21.3%; p < 0.01). Laparoscopy was seldom initiated and the risk of conversion was higher in clinical T4 tumors (p < 0.05). The rates of sphincter-saving procedures were not different. Operation time, bleeding and transfusion requirements increased when multivisceral resections were necessitated (p < 0.05), but hospital stay, complications and 30-day mortality rates were similar. The 5-year survival rates were identical (p > 0.05).Conclusions: Clinical T4 tumors are not rare and more common in women. An actual invasion (pT4) may be observed in one third of all clinical T4 tumors, and more frequent in colon cancers. An en-bloc, R0, multivisceral resection may be achieved in most cases. Multivisceral resections do not alter the rates of sphincter-saving procedures, morbidity and 30-day mortality; do not worsen survival but increase operation time, intraoperative bleeding and perioperative transfusion requirements.
- MakaleYalnız künye2012The role of group education on quality of life in patients with a stoma
Altuntas, Y.E.; Kement, M.; Gezen, C.; Eker, H.H.; Aydin, H.; Sahin, F.; Okkabaz, N.; Oncel, M.
Stoma education has been traditionally given in a one-to-one setting. Since 2007, daily group education programmes were organised for stoma patients and their relatives by our stoma therapy unit. The programmes included lectures on stoma and stoma care, and social activities in which patients shared their experiences with each other. Patients were also encouraged to expand interaction with each other and organise future social events. A total of 72 patients [44 (61.1%) male with a mean (±SD) age of 56.8 ± 13.6 years] with an ileostomy (n= 51, 70.8%), a colostomy (n= 18, 25.0%) or a urostomy (n= 3, 4.2%) were included in the study. Patients were asked to answer a survey (SF-36) face-to-face before the initiation of the programme, which was repeated 3 months later via telephone call. The comparison of pre-education and post-education SF-36 scores revealed a statistically significant improvement in all 8-scale profiles, but not in vitality scale, and both psychometrically-based and mental health summary measures. Analyses disclosed that married patients and those who were living at rural districts seem to have the most improvement in life quality particularly in bodily pain, general health and role-emotional scales and mental health summary measure. In our opinion, group educations may be beneficial for stoma patients, and stoma therapy units may consider organising similar activities.
