Hatice Gümüş - Academia.edu (original) (raw)
Papers by Hatice Gümüş
Electronic Journal of General Medicine, 2012
Bochdalek hernia is a congenital disease characterized by protrusion of the abdominal organs into... more Bochdalek hernia is a congenital disease characterized by protrusion of the abdominal organs into the thorax through the posterior defect in the diaphragma. The detection of incidental bochdalek hernia has increased because of the widespread use of the multidedector computed tomography. It is very rare in adult population. Intrathoracic kidney in bochdalek hernia is uncommon. In this paper, a 78 year-old man who had bochdalek hernia with a kidney in the left side of the thoracic region is presented.
Electronic Journal of General Medicine, 2013
Cecal diverticulitis is an unusual condition that presents clinically similar to appendicitis. Al... more Cecal diverticulitis is an unusual condition that presents clinically similar to appendicitis. Although it is usually asymptomatic, it may cause inflammation, bleeding, or perforation. The diagnosis is not always easy and in the majority of cases, the diagnosis is usually made at laparotomy. There have been various controversies in the literature regarding the optimal management of cecal diverticulitis. The aim of this study is a detailed description of this rare cause of acute abdomen. A 40-year-old female patient presenting with acute onset pain in the right lower abdominal quadrant, nausea and fever had mild leukocytosis. Abdominal ultrasonography and computed tomography revealed findings suggestive of plastron appendicitis. The diagnosis of cecal diverticulitis was established during the surgery. The patient underwent diverticulectomy and appendectomy operations. Cecal diverticulitis is rare clinical entity that should be considered in the differential diagnosis of emergency patients admitted with the complaint of pain in the right lower abdominal quadrant.
Journal of Breast Health, 2016
Objective: Due to a lack of sufficient data, the treatment protocols for male breast cancer are u... more Objective: Due to a lack of sufficient data, the treatment protocols for male breast cancer are usually the same as those used for female breast cancer. The aim of the current study was to present our clinical experience with male breast cancer. Materials and Methods: The records of 37 patients who were treated for male breast cancer in our hospital between 2004 and 2014 were reviewed retrospectively. The data of patients were recorded and analyzed. Results: The mean age of the patients was 63.03±12.36 years. Thirty-three patients (89.2%) had invasive ductal carcinoma, two (5.4%) had ductal carcinoma in situ, and two had invasive lobular carcinoma (5.4%). The most common molecular subtype was luminal A (17 cases, 45.9%). Twentynine patients with male breast cancer underwent mastectomy and two underwent breast conserving surgery. Axillary lymph node dissection was performed in 25 patients. The most common surgical procedure was modified radical mastectomy. Distant metastases were present in 17 (45.9%) patients. Overall, the 5-year survival was 60%. The 5-year survival was 100% for those with stage 0-I disease, 87% for stage II, and 42% for stage III. The 3-year survival was 14% for stage IV. Conclusion: Patients with male breast cancer presented at an older age, a later stage, and with earlier metastasis. Early metastasis and death increases with increasing stage. Poor prognosis correlates with late admission. Data from different centers should be compiled and reviewed in order to determine a specific treatment protocol for male breast cancer; each paper published reveals new data.
Archives of Medical Science, 2017
Introduction: In this study, we aimed to evaluate the effects of the development of aspiration pn... more Introduction: In this study, we aimed to evaluate the effects of the development of aspiration pneumonia (AP) on the intensive care unit (ICU) requirements and in-hospital mortality of patients hospitalised in the neurology ward due to an acute cerebrovascular accident (CVA). Material and methods: Five hundred and three patients hospitalised in the neurology ward following an acute CVA were retrospectively analysed. The patients were divided into two groups: those with AP (group 1) and those without AP (group 2). Demographic characteristics and physical and radiological findings, including the localisation, lateralisation and aetiology of the infarction, in addition to ICU requirements and mortality, were evaluated. Results: Aspiration pneumonia was detected in 80 (15.9%) patients during the in-hospital stay. Transfer to the ICU for any reason was required in 37.5% of the patients in group 1 and 4.7% of those in group 2 (p < 0.001). In-hospital mortality occurred in 7.5% and 1.4% of the patients in group 1 and group 2, respectively (p = 0.006). The incidence of AP was highest in patients with an infarction of the medial cerebral artery (MCA) (p < 0.001). The AP was associated with older age (p < 0.001), hypertension (p = 0.007), echocardiography findings (p = 0.032) and the modified Rankin Scale (mRS) score (p < 0.001). Conclusions: Our findings suggest that the requirement rate for transfer to the ICU and the mortality rate appear to be significantly higher in patients with a diagnosis of AP. Precautions should be taken, starting from the first day of hospitalisation, to decrease the incidence of AP in patients with acute CVA, focusing especially on older patients and those with a severe mRS score.
Journal of Breast Health, 2016
Objective: The most common procedure to prevent seroma formation, a common complication after bre... more Objective: The most common procedure to prevent seroma formation, a common complication after breast and axillary surgery, is to use prophylactic surgical drains. Ongoing discussions continue regarding the ideal time for removing drains after surgical procedures. In this study, we aimed to investigate factors that affect drain indwelling time (DIT). Materials and Methods: From 2014 to 2015, a total of 91 consecutive patients with breast cancer were included in the study. The demographic characteristics of the patients, treatment methods, histopathologic features of the tumor, size of removed breast tissue (BS), tumor size (TS), number of totally removed lymph nodes (TLN), and metastatic lymph nodes (MLN), whether they had neoadjuvant chemotherapy, and the DIT were retrospectively recorded from the hospital database. Results: The mean age of the patients was 48.9 years, and the mean DIT was 4.8 days. The mean size of breast removed was 17.3 cm and tumor size was 4.7 cm, and the mean number of metastatic lymph nodes was 3.3, and mean total number of lymph nodes was 14.1. Patients who had neoadjuvant chemotherahpy had longer DIT. There was a positive correlation between the BS, TS, TLN, MLN, length of hospital stay, and DIT. Linear regresion analysis revealed that the BS, TLN, and history of neoadjuvant chemotherahpy were independent risk factors for DIT. Conclusion: DIT primarily depends on BS, TLN, and history of neoadjuvant chemotherahpy. A policy for the management of removing drains to prevent seroma formation should thus be individualized.
The Turkish Journal of Gastroenterology, 2012
Pankreas kanseri yüksek mortalite ve morbiditeye sahiptir. Genellikle hayat› tehdit edici öneme s... more Pankreas kanseri yüksek mortalite ve morbiditeye sahiptir. Genellikle hayat› tehdit edici öneme sahip olan biliyer obstrüksiyona neden olmaktad›r. En önemli biliyer drenaj metodu endoskopik retrograd kolanjiyopankreatografi'dir. Endoskopik retrograd kolanjiyopankreatografi'nin baflar›l› olamad›¤› durumlarda tercih edilen yöntem perkütan biliyer drenaj'd›r. ‹nvaziv metod olan perkütan biliyer drenaj birtak›m komplikasyonlara neden olabilmektedir. Bizim literatür araflt›rmalar›m›za göre hasta iatrojenitesine ba¤l› komplikasyon rapor edilmemifltir. Bu gibi durumlarda alternatif bir çözüm indirekt biliyer drenajd›r.
Journal of Clinical and Experimental Investigations, 2015
Objective: This survey aims to elucidate patient and health system related factors leading to del... more Objective: This survey aims to elucidate patient and health system related factors leading to delayed diagnosis and treatment of breast cancer in Southeastern Anatolia. Methods: Hundred patients admitted to Department of General Surgery at Dicle University between December 2012 and July 2014, and diagnosed with breast cancer in preceding 6 months were included in the survey after their consent. The survey has 4 chapters (patient and health system related factors, demographic data, and assessment of cancer stage) and 25 questions. Results: Fifty-eight percent of patients visited a physician with a 3 months delay after realization of breast cancer symptoms. Only 8% of patients had regular checkups. Nine percent of patients were suspicious of breast cancer due to the lesion in the breast. 86% of patients did not consider it to be a serious matter. Lack of female physicians cited by 2% as the reason for avoiding doctor's visit. Seven percent cited lack of knowledge and 23% being scared. Seventy-seven percent were able to get a doctor's appointment, 82% to get mammography, 78% underwent biopsy in a week. Women between the ages of 30-50 had higher concern about cancer (p<0.05). Women who were illiterate or housewives regarded doctor's visitation as not a good experience (p<0.05). Conclusion: Patients' age and literacy, and efficiency of health system may be contributing factors on the delay of diagnosis and treatment of breast cancer. Cancer awareness should be increased and fear being diagnosed with cancer should be overcome in women between the ages of 30-50 to decrease the delay of diagnoses.
European review for medical and pharmacological sciences, 2013
The aim of the present study was to evaluate variations in celiac trunk and hepatic artery with m... more The aim of the present study was to evaluate variations in celiac trunk and hepatic artery with multi-detector computed tomography (MDCT). Totally 820 patients who underwent angiography of the abdominal aorta were evaluated. Anatomical findings were grouped according to the Michels classification. Several variations and/or anomalies were noted in 33.2% of the patients (n=272). The most common abnormality was Michels type III (10.1%), followed by type V (7.3%), type II (4.7%) and others. Type X was not observed in our series. We have noted additional, previously unclassified variations in 12 cases (1.5%). Preoperative knowledge of variant anatomy may assist in the selection of treatment options and surgical planning, which in turn facilitates surgical dissection and helps avoiding iatrogenic injury. MDCT angiography allows detailed visualization of the vascular anatomy.
Journal of Clinical and Experimental Investigations, 2015
Idiopathic granulomatous mastitis (IGM) is a rare benign chronic inflammatory disease. Etiology i... more Idiopathic granulomatous mastitis (IGM) is a rare benign chronic inflammatory disease. Etiology is unknown, but an autoimmune mechanism is suspected. Erythema nodosum is rare extramammillary manifestation of IGM, and few cases have been reported in the literature. In this study, we presented 28-year-old female patient with IGM associated with erythema nodosum. IGM can be caused by autoimmune mechanism and treated with steroid or surgical treatment.
Diagnostic and interventional radiology (Ankara, Turkey), Jan 21, 2015
The aim of this study was to determine the incidence of invasive breast carcinoma in patients wit... more The aim of this study was to determine the incidence of invasive breast carcinoma in patients with preoperative diagnosis of ductal carcinoma in situ (DCIS) by stereotactic vacuum-assisted biopsy (SVAB) performed for microcalcification-only lesions, and to identify the predictive factors of invasion. From 2000 to 2010, the records of 353 DCIS patients presenting with microcalcification-only lesions who underwent SVAB were retrospectively reviewed. The mammographic size of microcalcification cluster, presence of microinvasion within the cores, the total number of calcium specks, and the number of calcium specks within the retrieved core biopsy specimen were recorded. Patients were grouped as those with or without invasion in the final pathologic report, and variables were compared between the two groups. The median age was 58 years (range, 34-88 years). At histopathologic examination of the surgical specimen, 63 of 353 patients (17.8%) were found to have an invasive component, althou...
Balkan Medical Journal, 2015
Background: Diffusion-weighted magnetic resonance imaging (DWI) is a widely-accepted diagnostic m... more Background: Diffusion-weighted magnetic resonance imaging (DWI) is a widely-accepted diagnostic modality whose efficacy has been investigated by numerous past studies in the differentiation of malignant lesions from benign entities. Aims: The aim of this study was to evaluate the efficiency of diffusion-weighted magnetic resonance imaging in the characterization of renal lesions. Study Design: Diagnostic accuracy study. Methods: A total of 137 patients with renal lesions were included in this study. The median apparent diffusion coefficient (ADC) values as well as the b 800 and b 1600 signal intensities of normal kidneys, solid components of mixed renal masses, and total cystic lesions were evaluated. Results: There were significant differences between the ADC values of lesions and normal renal parenchyma, and between the ADC values of benign and malignant renal lesions on DWIs at b values of 800 and 1600 s/mm² (p<0.001 and p<0.001, respectively). There were significant differences between the ADC values of Bosniak Category 1 and 2 cysts and the ADC values of Bosniak Category 1 and 3 cysts on DWIs at b values of 800 s/mm² (p<0.001) and 1600 s/mm 2 (p<0.001). A cutoff value of 1.902 x 10-3 mm²/s for the ADC with a b value of 800 s/mm² provided 88% sensitivity and 96% specificity for differentiation between benign and malignant renal lesions. A cutoff value of 1.623 x 10-3 mm²/s for the ADC with a b value of 1600 s/mm² provided 79% sensitivity and 96% specificity (p<0.001) for the differentiation between benign and malignant renal lesions. Conclusion: Accurate assessment of renal masses is important for determining the necessity for surgical intervention. DWI provides additional value by differentiating benign from malignant renal tumors and can be added to routine kidney MRI protocols.
Dicle Medical Journal / Dicle Tip Dergisi, 2015
İdiopatik granulomatöz mastit, nadir görülen, benign, kronik inflamatuar bir hastalık olup meme k... more İdiopatik granulomatöz mastit, nadir görülen, benign, kronik inflamatuar bir hastalık olup meme kanserini taklit eder. Bu çalışmada idiopatik mastitli 49 hastanın tedavisini ve kliniğini sunmayı amaçladık. Yöntemler: Hastane otomasyon sisteminde 2007-2012 yılları arasında histolojik olarak granulomatöz tanısı konulmuş hastalar incelendi. Hastalara ait klinik bulgular, demografik veriler ve tedavi yöntemleri kaydedildi. Bulgular: Ortalama yaş 37.71±7.1 idi. Tedavi gruplar arasında etiyolojik ve demografik açıdan istatistiksel fark yoktu. Nüks oranları grup 1, grup 2 ve grup 3'te sırasıyla %8,3, %14,8 %20 olup, gruplar arasında istatistiksel anlamlı farklılık yoktu. Sonuç: Steroid ve cerrahi tedavinin idiopatik granulomatöz mastitli hastalarda uygulanabileceğini, steroid tedavisinin ilk basamak tedavi olması gerektiği kanaatindeyiz. Bununla birlikte tedavi algoritması belirlenebilmesi için prospektif, randomize klinik çalışmalara ihtiyaç vardır.
European review for medical and pharmacological sciences, 2011
To evaluate the multi detector computed tomographic (CT) depiction of middle lobe vein variation ... more To evaluate the multi detector computed tomographic (CT) depiction of middle lobe vein variation of the right pulmonary vein and create a diagram for cardiologist and cardiovascular surgeons. According to hospital records, between January 2009 and April 2010, 314 consecutive patients underwent pulmonary CT angiography (CTPA) and coronary CT angiography. The CT films from these patients were retrospectively analyzed. Under normal conditions, the middle pulmonary vein (MPV) drains into the left atrium either by the "direct" or "indirect" route. Direct (37 patients, 11.8%) drainage means that the MPV does not drain into the upper or lower pulmonary veins but instead drains directly into the right pulmonary vein system. In contrast, indirect (276 patients, 87.9%) drainage occurs when the MPV drains into the upper or lower pulmonary veins. In this study, 12 different variations in drainage patterns were found. Increasing the number of patients may have led to the iden...
Radiology and Oncology, 2013
Background. Fascioliasis is a disease caused by the trematode Fasciola hepatica. Cholangitis is a... more Background. Fascioliasis is a disease caused by the trematode Fasciola hepatica. Cholangitis is a common clinical manifestation. Although fascioliasis may show various radiological and clinical features, cases without biliary dilatation are rare. Case report. We present unique ultrasound (US) and magnetic resonance cholangiopancreatography (MRCP) findings of a biliary fascioliasis case which doesn’t have biliary obstruction or cholestasis. Radiologically, curvilinear parasites compatible with juvenile and mature Fasciola hepatica within the gallbladder and common bile duct were found. The parasites appear as bright echogenic structures with no acoustic shadow on US and hypo-intense curvilinear lesions on T2 weighted MRCP images. Conclusions. Imaging studies may significantly contribute to the diagnosis of patients with subtle clinical and laboratory findings, particularly in endemic regions.
Journal of Clinical and Experimental Investigations, 2011
Postmenapozal dönemde akut üriner retansiyona neden olan adenomyomatoz polip (AP) olgusu sunulmuş... more Postmenapozal dönemde akut üriner retansiyona neden olan adenomyomatoz polip (AP) olgusu sunulmuştur. 65 yaşında G8P8 bayan hasta kliniğimize vaginal kanama şikayeti ile başvurdu ve vajende kitle varlığı saptandı. Peroperatif hazırlık için hospitalize edilen hastanın idrar yapamama şikayeti olduğu öğrenildi. Serum üre ve kreatinin değerlerinin yüksek olduğu saptandı [66 mg/dL (normal aralık= 10-45) ve 2,49 mg/dL (normal aralık = 0. 6-1. 3) sırasıyla]. Acil abdominopelvik tomografide vajinal kitle ve distandü mesane izlendi. Kitle vajinal yoldan çıkartıldı ve abdominal histerektomi uygulandı. Patolojik incelemede malign olmayan ve yoğun nekroz alanları içeren AP olduğu saptandı. Kadın genital sistem patolojilerinin bazıları uriner retansiyona neden olabilirler. Tedavi seçimi hastanın fertilite beklentisine bağlıdır.
Journal of Clinical and Analytical Medicine, 2015
Nörofibromatosis tip 1 (NF-1), benin tümörleri içeren yaygın herediter bir hastalıkdır. Omuriliği... more Nörofibromatosis tip 1 (NF-1), benin tümörleri içeren yaygın herediter bir hastalıkdır. Omuriliğin primitive nöroektodermal tümörü (PNET) oldukça nadirdir. Biz burada NF-1'li bir kadın hastada paravertebral alandaki spinal epidural PNET'in US, BT ve MRG bulgularını sunuyoruz. 37 yaşındaki NF-1'li kadın hastanın bel ağrısı ve sağ alt ekstremitede ilerleyici güçsüzlüğü mevcuttu. US'da batında heterojen iyi sınırlı kitle lezyon izlendi. BT ve MRG'de L5-S1 düzeyinde sağ nöral foramenden kaynaklanan heterojen kontrastlanan kitle lezyon mevcuttu. Lezyon komşuluğunda posterolateral karın duvarında mezenter ve barsak anslarının bulunduğu büyük bir fıtık kesesi vardı. Tanı hastaya transabdominal tru-cut biyopsi yapılarak konuldu. Nadir olmasına rağmen, spinal epidural lezyonlarda PNET ihtimali akılda tutulması gerekmektedir.
Türk Üroloji Dergisi/Turkish Journal of Urology, 2011
Objective: We investigated the effectiveness of ureteroscopy (URS) performed with the smallest ca... more Objective: We investigated the effectiveness of ureteroscopy (URS) performed with the smallest caliber (4.5 F) semirigid ureteroscope in children younger than 3 years. Materials and methods: URS was performed with a 4.5 F semirigid ureteroscope (Mini-URS). The operative outcomes of 16 children [7 females, 9 males; mean age 30.5 months (range 10-36 months)] who underwent URS in our clinics were evaluated retrospectively. Results: The mean stone diameter was 5.1 mm (range 3-15 mm). A Holmium: YAG laser lithotripter was used. Double J stents were inserted in 3 patients, while ureteral catheterization was performed in 6. In 7 patients, we were unable to insert a double J stent. At the end of the first postoperative week, 13 (84%) patients were completely stone-free. Double J stents were inserted in two patients because of poor endoscopic visualization and inadequate stone fragmentation. In these patients repeat URS was performed to retrieve residual stones during removal of the double J stents. After 1 month, 15 (93.75%) patients were stone-free. No perioperative or early postoperative complication was observed in any patient. Conclusion: URS performed with a 4.5 F semirigid ureteroscope is an ideal alternative for retrieving ureteral stones, with lower complication rates, faster ureteral engagement, and shorter operating times, even in very young patients.
Abant Medical Journal, 2013
Glutarik asidüri tip 1 nedeniyle izlenen bir olguda gelişen serabral venöz tromboz Cerabral venou... more Glutarik asidüri tip 1 nedeniyle izlenen bir olguda gelişen serabral venöz tromboz Cerabral venous trombosis during follow up of a case with glutaric aciduria type 1
The Journal of Infection in Developing Countries, 2011
While diaphragmatic hydatid disease is a rare condition, subcutaneous extension of the disease is... more While diaphragmatic hydatid disease is a rare condition, subcutaneous extension of the disease is very rare. A 33-year-old female visited our clinic due to swelling on the right upper quadrant of the abdomen. Thoraco-abdominal CT scan and MRI revealed a hydatid cyst (110 x 98 x 78 mm) located in the costal part of the hemidiaphragm extending into the preperitoneal space and protruding intercostally to a subcutaneous area. Total pericyst resection without opening the cyst, including a margin of normal diaphragm, was performed. The patient was started on albendazole for three months. Hydatid cyst in the diaphragm should be considered in patients with preoperative imaging data indicating cystic lesions adjacent to the diaphragm, especially for cystic lesions encountered in patients who live in or who have come from endemic regions.
Diagnostic and interventional radiology (Ankara, Turkey)
The purpose of this study was to identify the factors that may have an impact on upgrading atypic... more The purpose of this study was to identify the factors that may have an impact on upgrading atypical ductal hyperplasia (ADH) lesions to malignancy. Between February 1999 and December 2010, the records of 150 ADH lesions that had been biopsied were retrospectively reviewed. The biopsy types included 11-gauge stereotactic vacuum-assisted biopsy (SVAB) (n=102) and ultrasonography (US)-guided 14-gauge automated biopsy (n=48). The patients were divided into two groups: those who had cancer in the final pathology and those who did not. Variables associated with underestimation of ADH lesions were compared between the groups. The underestimation rates according to the biopsy types were 41.7% (20/48) for the US-guided 14-gauge automated biopsy and 20.6% (21/102) for the 11-gauge SVAB (P = 0.007). The rate of underestimation was significantly higher in lesions greater than 7 mm than it was in smaller lesions, with both US-guided 14-gauge automated biopsy and 11-gauge SVAB (P = 0.024 and P = ...
Electronic Journal of General Medicine, 2012
Bochdalek hernia is a congenital disease characterized by protrusion of the abdominal organs into... more Bochdalek hernia is a congenital disease characterized by protrusion of the abdominal organs into the thorax through the posterior defect in the diaphragma. The detection of incidental bochdalek hernia has increased because of the widespread use of the multidedector computed tomography. It is very rare in adult population. Intrathoracic kidney in bochdalek hernia is uncommon. In this paper, a 78 year-old man who had bochdalek hernia with a kidney in the left side of the thoracic region is presented.
Electronic Journal of General Medicine, 2013
Cecal diverticulitis is an unusual condition that presents clinically similar to appendicitis. Al... more Cecal diverticulitis is an unusual condition that presents clinically similar to appendicitis. Although it is usually asymptomatic, it may cause inflammation, bleeding, or perforation. The diagnosis is not always easy and in the majority of cases, the diagnosis is usually made at laparotomy. There have been various controversies in the literature regarding the optimal management of cecal diverticulitis. The aim of this study is a detailed description of this rare cause of acute abdomen. A 40-year-old female patient presenting with acute onset pain in the right lower abdominal quadrant, nausea and fever had mild leukocytosis. Abdominal ultrasonography and computed tomography revealed findings suggestive of plastron appendicitis. The diagnosis of cecal diverticulitis was established during the surgery. The patient underwent diverticulectomy and appendectomy operations. Cecal diverticulitis is rare clinical entity that should be considered in the differential diagnosis of emergency patients admitted with the complaint of pain in the right lower abdominal quadrant.
Journal of Breast Health, 2016
Objective: Due to a lack of sufficient data, the treatment protocols for male breast cancer are u... more Objective: Due to a lack of sufficient data, the treatment protocols for male breast cancer are usually the same as those used for female breast cancer. The aim of the current study was to present our clinical experience with male breast cancer. Materials and Methods: The records of 37 patients who were treated for male breast cancer in our hospital between 2004 and 2014 were reviewed retrospectively. The data of patients were recorded and analyzed. Results: The mean age of the patients was 63.03±12.36 years. Thirty-three patients (89.2%) had invasive ductal carcinoma, two (5.4%) had ductal carcinoma in situ, and two had invasive lobular carcinoma (5.4%). The most common molecular subtype was luminal A (17 cases, 45.9%). Twentynine patients with male breast cancer underwent mastectomy and two underwent breast conserving surgery. Axillary lymph node dissection was performed in 25 patients. The most common surgical procedure was modified radical mastectomy. Distant metastases were present in 17 (45.9%) patients. Overall, the 5-year survival was 60%. The 5-year survival was 100% for those with stage 0-I disease, 87% for stage II, and 42% for stage III. The 3-year survival was 14% for stage IV. Conclusion: Patients with male breast cancer presented at an older age, a later stage, and with earlier metastasis. Early metastasis and death increases with increasing stage. Poor prognosis correlates with late admission. Data from different centers should be compiled and reviewed in order to determine a specific treatment protocol for male breast cancer; each paper published reveals new data.
Archives of Medical Science, 2017
Introduction: In this study, we aimed to evaluate the effects of the development of aspiration pn... more Introduction: In this study, we aimed to evaluate the effects of the development of aspiration pneumonia (AP) on the intensive care unit (ICU) requirements and in-hospital mortality of patients hospitalised in the neurology ward due to an acute cerebrovascular accident (CVA). Material and methods: Five hundred and three patients hospitalised in the neurology ward following an acute CVA were retrospectively analysed. The patients were divided into two groups: those with AP (group 1) and those without AP (group 2). Demographic characteristics and physical and radiological findings, including the localisation, lateralisation and aetiology of the infarction, in addition to ICU requirements and mortality, were evaluated. Results: Aspiration pneumonia was detected in 80 (15.9%) patients during the in-hospital stay. Transfer to the ICU for any reason was required in 37.5% of the patients in group 1 and 4.7% of those in group 2 (p < 0.001). In-hospital mortality occurred in 7.5% and 1.4% of the patients in group 1 and group 2, respectively (p = 0.006). The incidence of AP was highest in patients with an infarction of the medial cerebral artery (MCA) (p < 0.001). The AP was associated with older age (p < 0.001), hypertension (p = 0.007), echocardiography findings (p = 0.032) and the modified Rankin Scale (mRS) score (p < 0.001). Conclusions: Our findings suggest that the requirement rate for transfer to the ICU and the mortality rate appear to be significantly higher in patients with a diagnosis of AP. Precautions should be taken, starting from the first day of hospitalisation, to decrease the incidence of AP in patients with acute CVA, focusing especially on older patients and those with a severe mRS score.
Journal of Breast Health, 2016
Objective: The most common procedure to prevent seroma formation, a common complication after bre... more Objective: The most common procedure to prevent seroma formation, a common complication after breast and axillary surgery, is to use prophylactic surgical drains. Ongoing discussions continue regarding the ideal time for removing drains after surgical procedures. In this study, we aimed to investigate factors that affect drain indwelling time (DIT). Materials and Methods: From 2014 to 2015, a total of 91 consecutive patients with breast cancer were included in the study. The demographic characteristics of the patients, treatment methods, histopathologic features of the tumor, size of removed breast tissue (BS), tumor size (TS), number of totally removed lymph nodes (TLN), and metastatic lymph nodes (MLN), whether they had neoadjuvant chemotherapy, and the DIT were retrospectively recorded from the hospital database. Results: The mean age of the patients was 48.9 years, and the mean DIT was 4.8 days. The mean size of breast removed was 17.3 cm and tumor size was 4.7 cm, and the mean number of metastatic lymph nodes was 3.3, and mean total number of lymph nodes was 14.1. Patients who had neoadjuvant chemotherahpy had longer DIT. There was a positive correlation between the BS, TS, TLN, MLN, length of hospital stay, and DIT. Linear regresion analysis revealed that the BS, TLN, and history of neoadjuvant chemotherahpy were independent risk factors for DIT. Conclusion: DIT primarily depends on BS, TLN, and history of neoadjuvant chemotherahpy. A policy for the management of removing drains to prevent seroma formation should thus be individualized.
The Turkish Journal of Gastroenterology, 2012
Pankreas kanseri yüksek mortalite ve morbiditeye sahiptir. Genellikle hayat› tehdit edici öneme s... more Pankreas kanseri yüksek mortalite ve morbiditeye sahiptir. Genellikle hayat› tehdit edici öneme sahip olan biliyer obstrüksiyona neden olmaktad›r. En önemli biliyer drenaj metodu endoskopik retrograd kolanjiyopankreatografi'dir. Endoskopik retrograd kolanjiyopankreatografi'nin baflar›l› olamad›¤› durumlarda tercih edilen yöntem perkütan biliyer drenaj'd›r. ‹nvaziv metod olan perkütan biliyer drenaj birtak›m komplikasyonlara neden olabilmektedir. Bizim literatür araflt›rmalar›m›za göre hasta iatrojenitesine ba¤l› komplikasyon rapor edilmemifltir. Bu gibi durumlarda alternatif bir çözüm indirekt biliyer drenajd›r.
Journal of Clinical and Experimental Investigations, 2015
Objective: This survey aims to elucidate patient and health system related factors leading to del... more Objective: This survey aims to elucidate patient and health system related factors leading to delayed diagnosis and treatment of breast cancer in Southeastern Anatolia. Methods: Hundred patients admitted to Department of General Surgery at Dicle University between December 2012 and July 2014, and diagnosed with breast cancer in preceding 6 months were included in the survey after their consent. The survey has 4 chapters (patient and health system related factors, demographic data, and assessment of cancer stage) and 25 questions. Results: Fifty-eight percent of patients visited a physician with a 3 months delay after realization of breast cancer symptoms. Only 8% of patients had regular checkups. Nine percent of patients were suspicious of breast cancer due to the lesion in the breast. 86% of patients did not consider it to be a serious matter. Lack of female physicians cited by 2% as the reason for avoiding doctor's visit. Seven percent cited lack of knowledge and 23% being scared. Seventy-seven percent were able to get a doctor's appointment, 82% to get mammography, 78% underwent biopsy in a week. Women between the ages of 30-50 had higher concern about cancer (p<0.05). Women who were illiterate or housewives regarded doctor's visitation as not a good experience (p<0.05). Conclusion: Patients' age and literacy, and efficiency of health system may be contributing factors on the delay of diagnosis and treatment of breast cancer. Cancer awareness should be increased and fear being diagnosed with cancer should be overcome in women between the ages of 30-50 to decrease the delay of diagnoses.
European review for medical and pharmacological sciences, 2013
The aim of the present study was to evaluate variations in celiac trunk and hepatic artery with m... more The aim of the present study was to evaluate variations in celiac trunk and hepatic artery with multi-detector computed tomography (MDCT). Totally 820 patients who underwent angiography of the abdominal aorta were evaluated. Anatomical findings were grouped according to the Michels classification. Several variations and/or anomalies were noted in 33.2% of the patients (n=272). The most common abnormality was Michels type III (10.1%), followed by type V (7.3%), type II (4.7%) and others. Type X was not observed in our series. We have noted additional, previously unclassified variations in 12 cases (1.5%). Preoperative knowledge of variant anatomy may assist in the selection of treatment options and surgical planning, which in turn facilitates surgical dissection and helps avoiding iatrogenic injury. MDCT angiography allows detailed visualization of the vascular anatomy.
Journal of Clinical and Experimental Investigations, 2015
Idiopathic granulomatous mastitis (IGM) is a rare benign chronic inflammatory disease. Etiology i... more Idiopathic granulomatous mastitis (IGM) is a rare benign chronic inflammatory disease. Etiology is unknown, but an autoimmune mechanism is suspected. Erythema nodosum is rare extramammillary manifestation of IGM, and few cases have been reported in the literature. In this study, we presented 28-year-old female patient with IGM associated with erythema nodosum. IGM can be caused by autoimmune mechanism and treated with steroid or surgical treatment.
Diagnostic and interventional radiology (Ankara, Turkey), Jan 21, 2015
The aim of this study was to determine the incidence of invasive breast carcinoma in patients wit... more The aim of this study was to determine the incidence of invasive breast carcinoma in patients with preoperative diagnosis of ductal carcinoma in situ (DCIS) by stereotactic vacuum-assisted biopsy (SVAB) performed for microcalcification-only lesions, and to identify the predictive factors of invasion. From 2000 to 2010, the records of 353 DCIS patients presenting with microcalcification-only lesions who underwent SVAB were retrospectively reviewed. The mammographic size of microcalcification cluster, presence of microinvasion within the cores, the total number of calcium specks, and the number of calcium specks within the retrieved core biopsy specimen were recorded. Patients were grouped as those with or without invasion in the final pathologic report, and variables were compared between the two groups. The median age was 58 years (range, 34-88 years). At histopathologic examination of the surgical specimen, 63 of 353 patients (17.8%) were found to have an invasive component, althou...
Balkan Medical Journal, 2015
Background: Diffusion-weighted magnetic resonance imaging (DWI) is a widely-accepted diagnostic m... more Background: Diffusion-weighted magnetic resonance imaging (DWI) is a widely-accepted diagnostic modality whose efficacy has been investigated by numerous past studies in the differentiation of malignant lesions from benign entities. Aims: The aim of this study was to evaluate the efficiency of diffusion-weighted magnetic resonance imaging in the characterization of renal lesions. Study Design: Diagnostic accuracy study. Methods: A total of 137 patients with renal lesions were included in this study. The median apparent diffusion coefficient (ADC) values as well as the b 800 and b 1600 signal intensities of normal kidneys, solid components of mixed renal masses, and total cystic lesions were evaluated. Results: There were significant differences between the ADC values of lesions and normal renal parenchyma, and between the ADC values of benign and malignant renal lesions on DWIs at b values of 800 and 1600 s/mm² (p<0.001 and p<0.001, respectively). There were significant differences between the ADC values of Bosniak Category 1 and 2 cysts and the ADC values of Bosniak Category 1 and 3 cysts on DWIs at b values of 800 s/mm² (p<0.001) and 1600 s/mm 2 (p<0.001). A cutoff value of 1.902 x 10-3 mm²/s for the ADC with a b value of 800 s/mm² provided 88% sensitivity and 96% specificity for differentiation between benign and malignant renal lesions. A cutoff value of 1.623 x 10-3 mm²/s for the ADC with a b value of 1600 s/mm² provided 79% sensitivity and 96% specificity (p<0.001) for the differentiation between benign and malignant renal lesions. Conclusion: Accurate assessment of renal masses is important for determining the necessity for surgical intervention. DWI provides additional value by differentiating benign from malignant renal tumors and can be added to routine kidney MRI protocols.
Dicle Medical Journal / Dicle Tip Dergisi, 2015
İdiopatik granulomatöz mastit, nadir görülen, benign, kronik inflamatuar bir hastalık olup meme k... more İdiopatik granulomatöz mastit, nadir görülen, benign, kronik inflamatuar bir hastalık olup meme kanserini taklit eder. Bu çalışmada idiopatik mastitli 49 hastanın tedavisini ve kliniğini sunmayı amaçladık. Yöntemler: Hastane otomasyon sisteminde 2007-2012 yılları arasında histolojik olarak granulomatöz tanısı konulmuş hastalar incelendi. Hastalara ait klinik bulgular, demografik veriler ve tedavi yöntemleri kaydedildi. Bulgular: Ortalama yaş 37.71±7.1 idi. Tedavi gruplar arasında etiyolojik ve demografik açıdan istatistiksel fark yoktu. Nüks oranları grup 1, grup 2 ve grup 3'te sırasıyla %8,3, %14,8 %20 olup, gruplar arasında istatistiksel anlamlı farklılık yoktu. Sonuç: Steroid ve cerrahi tedavinin idiopatik granulomatöz mastitli hastalarda uygulanabileceğini, steroid tedavisinin ilk basamak tedavi olması gerektiği kanaatindeyiz. Bununla birlikte tedavi algoritması belirlenebilmesi için prospektif, randomize klinik çalışmalara ihtiyaç vardır.
European review for medical and pharmacological sciences, 2011
To evaluate the multi detector computed tomographic (CT) depiction of middle lobe vein variation ... more To evaluate the multi detector computed tomographic (CT) depiction of middle lobe vein variation of the right pulmonary vein and create a diagram for cardiologist and cardiovascular surgeons. According to hospital records, between January 2009 and April 2010, 314 consecutive patients underwent pulmonary CT angiography (CTPA) and coronary CT angiography. The CT films from these patients were retrospectively analyzed. Under normal conditions, the middle pulmonary vein (MPV) drains into the left atrium either by the "direct" or "indirect" route. Direct (37 patients, 11.8%) drainage means that the MPV does not drain into the upper or lower pulmonary veins but instead drains directly into the right pulmonary vein system. In contrast, indirect (276 patients, 87.9%) drainage occurs when the MPV drains into the upper or lower pulmonary veins. In this study, 12 different variations in drainage patterns were found. Increasing the number of patients may have led to the iden...
Radiology and Oncology, 2013
Background. Fascioliasis is a disease caused by the trematode Fasciola hepatica. Cholangitis is a... more Background. Fascioliasis is a disease caused by the trematode Fasciola hepatica. Cholangitis is a common clinical manifestation. Although fascioliasis may show various radiological and clinical features, cases without biliary dilatation are rare. Case report. We present unique ultrasound (US) and magnetic resonance cholangiopancreatography (MRCP) findings of a biliary fascioliasis case which doesn’t have biliary obstruction or cholestasis. Radiologically, curvilinear parasites compatible with juvenile and mature Fasciola hepatica within the gallbladder and common bile duct were found. The parasites appear as bright echogenic structures with no acoustic shadow on US and hypo-intense curvilinear lesions on T2 weighted MRCP images. Conclusions. Imaging studies may significantly contribute to the diagnosis of patients with subtle clinical and laboratory findings, particularly in endemic regions.
Journal of Clinical and Experimental Investigations, 2011
Postmenapozal dönemde akut üriner retansiyona neden olan adenomyomatoz polip (AP) olgusu sunulmuş... more Postmenapozal dönemde akut üriner retansiyona neden olan adenomyomatoz polip (AP) olgusu sunulmuştur. 65 yaşında G8P8 bayan hasta kliniğimize vaginal kanama şikayeti ile başvurdu ve vajende kitle varlığı saptandı. Peroperatif hazırlık için hospitalize edilen hastanın idrar yapamama şikayeti olduğu öğrenildi. Serum üre ve kreatinin değerlerinin yüksek olduğu saptandı [66 mg/dL (normal aralık= 10-45) ve 2,49 mg/dL (normal aralık = 0. 6-1. 3) sırasıyla]. Acil abdominopelvik tomografide vajinal kitle ve distandü mesane izlendi. Kitle vajinal yoldan çıkartıldı ve abdominal histerektomi uygulandı. Patolojik incelemede malign olmayan ve yoğun nekroz alanları içeren AP olduğu saptandı. Kadın genital sistem patolojilerinin bazıları uriner retansiyona neden olabilirler. Tedavi seçimi hastanın fertilite beklentisine bağlıdır.
Journal of Clinical and Analytical Medicine, 2015
Nörofibromatosis tip 1 (NF-1), benin tümörleri içeren yaygın herediter bir hastalıkdır. Omuriliği... more Nörofibromatosis tip 1 (NF-1), benin tümörleri içeren yaygın herediter bir hastalıkdır. Omuriliğin primitive nöroektodermal tümörü (PNET) oldukça nadirdir. Biz burada NF-1'li bir kadın hastada paravertebral alandaki spinal epidural PNET'in US, BT ve MRG bulgularını sunuyoruz. 37 yaşındaki NF-1'li kadın hastanın bel ağrısı ve sağ alt ekstremitede ilerleyici güçsüzlüğü mevcuttu. US'da batında heterojen iyi sınırlı kitle lezyon izlendi. BT ve MRG'de L5-S1 düzeyinde sağ nöral foramenden kaynaklanan heterojen kontrastlanan kitle lezyon mevcuttu. Lezyon komşuluğunda posterolateral karın duvarında mezenter ve barsak anslarının bulunduğu büyük bir fıtık kesesi vardı. Tanı hastaya transabdominal tru-cut biyopsi yapılarak konuldu. Nadir olmasına rağmen, spinal epidural lezyonlarda PNET ihtimali akılda tutulması gerekmektedir.
Türk Üroloji Dergisi/Turkish Journal of Urology, 2011
Objective: We investigated the effectiveness of ureteroscopy (URS) performed with the smallest ca... more Objective: We investigated the effectiveness of ureteroscopy (URS) performed with the smallest caliber (4.5 F) semirigid ureteroscope in children younger than 3 years. Materials and methods: URS was performed with a 4.5 F semirigid ureteroscope (Mini-URS). The operative outcomes of 16 children [7 females, 9 males; mean age 30.5 months (range 10-36 months)] who underwent URS in our clinics were evaluated retrospectively. Results: The mean stone diameter was 5.1 mm (range 3-15 mm). A Holmium: YAG laser lithotripter was used. Double J stents were inserted in 3 patients, while ureteral catheterization was performed in 6. In 7 patients, we were unable to insert a double J stent. At the end of the first postoperative week, 13 (84%) patients were completely stone-free. Double J stents were inserted in two patients because of poor endoscopic visualization and inadequate stone fragmentation. In these patients repeat URS was performed to retrieve residual stones during removal of the double J stents. After 1 month, 15 (93.75%) patients were stone-free. No perioperative or early postoperative complication was observed in any patient. Conclusion: URS performed with a 4.5 F semirigid ureteroscope is an ideal alternative for retrieving ureteral stones, with lower complication rates, faster ureteral engagement, and shorter operating times, even in very young patients.
Abant Medical Journal, 2013
Glutarik asidüri tip 1 nedeniyle izlenen bir olguda gelişen serabral venöz tromboz Cerabral venou... more Glutarik asidüri tip 1 nedeniyle izlenen bir olguda gelişen serabral venöz tromboz Cerabral venous trombosis during follow up of a case with glutaric aciduria type 1
The Journal of Infection in Developing Countries, 2011
While diaphragmatic hydatid disease is a rare condition, subcutaneous extension of the disease is... more While diaphragmatic hydatid disease is a rare condition, subcutaneous extension of the disease is very rare. A 33-year-old female visited our clinic due to swelling on the right upper quadrant of the abdomen. Thoraco-abdominal CT scan and MRI revealed a hydatid cyst (110 x 98 x 78 mm) located in the costal part of the hemidiaphragm extending into the preperitoneal space and protruding intercostally to a subcutaneous area. Total pericyst resection without opening the cyst, including a margin of normal diaphragm, was performed. The patient was started on albendazole for three months. Hydatid cyst in the diaphragm should be considered in patients with preoperative imaging data indicating cystic lesions adjacent to the diaphragm, especially for cystic lesions encountered in patients who live in or who have come from endemic regions.
Diagnostic and interventional radiology (Ankara, Turkey)
The purpose of this study was to identify the factors that may have an impact on upgrading atypic... more The purpose of this study was to identify the factors that may have an impact on upgrading atypical ductal hyperplasia (ADH) lesions to malignancy. Between February 1999 and December 2010, the records of 150 ADH lesions that had been biopsied were retrospectively reviewed. The biopsy types included 11-gauge stereotactic vacuum-assisted biopsy (SVAB) (n=102) and ultrasonography (US)-guided 14-gauge automated biopsy (n=48). The patients were divided into two groups: those who had cancer in the final pathology and those who did not. Variables associated with underestimation of ADH lesions were compared between the groups. The underestimation rates according to the biopsy types were 41.7% (20/48) for the US-guided 14-gauge automated biopsy and 20.6% (21/102) for the 11-gauge SVAB (P = 0.007). The rate of underestimation was significantly higher in lesions greater than 7 mm than it was in smaller lesions, with both US-guided 14-gauge automated biopsy and 11-gauge SVAB (P = 0.024 and P = ...