Tıp Fakültesi
https://hdl.handle.net/20.500.12511/162
School of Medicine2024-03-28T13:10:18ZEarly atherosclerosis and conduction defect in a rare case of dunnigan type familial partial lipodystrophy
https://hdl.handle.net/20.500.12511/12402
Early atherosclerosis and conduction defect in a rare case of dunnigan type familial partial lipodystrophy
Olgun, Fatih Erkam; Güler, Ekrem; Çeleğen, Muhammed Furkan; Demirçelik, Bora; Kılıçaslan, Fethi; Boztosun, Bilal
A 45-year-old female patient was admitted to the emergency department with syncope. Her medical history revealed a diagnosis of Familial Partial Lipodystrophy 2 (FPLD2). The patient's electrocardiogram showed a complete atrioventricular (A-V) block, and she had a history of insulin-dependent diabetes mellitus and coronary artery bypass surgery. A severe stenosis was observed in the aortic right coronary artery saphenous vein graft during coronary angiography, which was successfully revascularized. Subsequently, due to persistant syncope attacks, a permanent pacemaker was implanted after an electrophysiological study. This case highlights that serious cardiac conduction defects in patients with FPLD2 may not only be related to coronary artery disease but can also present as direct conduction defects.; Senkop şikayeti ile acil servise başvuran 45 yaşında kadın hastanın öyküsünden ailesel parsiyel lipodistrofi 2 (FPLD2) tanısı aldığı öğrenildi. İnsüline bağımlı diabetes mellitus ve koroner by-pass cerrahisi öyküsü olan hastanın elektrokardiyografisinde A-V tam blok izlendi. Koroner anjiyografide aort-sağ koroner arter safen ven greftinde ciddi darlık görülmesi nedeniyle başarılı revaskülarizasyon uygulandı. Sonrasında, senkop atakları devam eden hastaya yapılan elektrofizyolojik çalışma sonucunda kalıcı kalp pili takıldı. Bu olguda, FPLD2 tanısı olan hastalarda ciddi kardiyak iletim kusurlarının sadece koroner arter hastalığı ile ilişkili olmadığını, hastalığın doğrudan iletim kusurları ile de ortaya çıkabileceğini vurgulamak istedik.
2024-01-01T00:00:00ZRisk factors for pfannenstiel incisional hernia following cesarean delivery and outcomes after laparoscopic and open surgical repair
https://hdl.handle.net/20.500.12511/12401
Risk factors for pfannenstiel incisional hernia following cesarean delivery and outcomes after laparoscopic and open surgical repair
Sakoğlu, Nevin; Fırat, Aysun
Background: To analyse risk factors for cesarean section (CS)-induced incisional hernia in reproductive-aged women. Outcomes of minimal invasive herniorrhaphy and open technique were presented. Methods: Records of patients with Pfannenstiel hernia between 2010 and 2022 were reviewed. Risk factors for incisional hernia were evaluated with surgical outcomes. Results: 76 patients were included. Mean age was 46 ± 8.1 years. Bulging (81.5%), pain or discomfort (57.8%) and distention (31.5%) were the most common symptoms. We combined ultrasonography (90.7%) with contrasted tomography (71%) or magnetic resonance imaging (30%) for surgical planning. Risk factors were found as multiple previous CSs, local wound complications such as seroma, hematoma or abscess, body mass index >25, smoking, pregnancy-induced diabetes mellitus, emergency CS, and inadequate surgical technique (each, p < 0.05). In open technique (51.3%), fascia was closed by polydioxanone suture, with onlay mesh fixation. In laparoscopic hernioplasty (48.6%), tacker was used for mesh reinforcement. There was no bowel injury. Early complications were seroma and infection (p < 0.01 and p < 0.05, respectively). Most significant late complication was recurrence (7.8%). Conclusions: Clinicians should be ready to encounter more reproductive aged women with incisional hernia, since worldwide CS rate continues to rise. Awareness of risk factors, imaging methods, surgical options and outcomes are of great importance.
2024-01-01T00:00:00ZThe effect of mulligan mobilization technique application in addition to conventional physiotherapy on pain and joint range of motion in people with neck pain
https://hdl.handle.net/20.500.12511/12396
The effect of mulligan mobilization technique application in addition to conventional physiotherapy on pain and joint range of motion in people with neck pain
Özlü, Özge; Şahin, Mustafa
Background: To evaluate the effect of the Mulligan mobilization technique on pain intensity and range of motion in individuals with neck pain. Methods: Forty individuals with mechanical neck pain were enrolled in the study. The patients were randomly divided into 2 groups and a total of 10 sessions of treatment were administered to all 2 groups for 2 weeks, 5 days a week. Mulligan mobilization technique, electrophysical agents, active range of motion, and stretching exercises were carried out in the Mulligan group. In contrast, only electrophysical agents and exercises were applied to the conventional physiotherapy group. Range of motion (ROM) of the neck, Visual Analog Scale (VAS), Neck Pain and Disability Scale (NPDS), and Short-Form 36 Health Survey (SF-36) were used for evaluation. Results: Statistical analyses were done to compare the amounts at the baseline and immediately after treatment. Statistically significant improvements were found in the post-treatment ROM, VAS, NPDS values in both groups (p < 0.05). When the differences were compared, the results of the Mulligan group were significantly better than the conventional physiotherapy group (p < 0.05). There was no significant difference between the groups in terms of SF-36 parameters (p > 0.05). Conclusions: This study showed that the Mulligan mobilization technique plus conventional physiotherapy is more effective than conventional physiotherapy in increasing joint range of motion, reducing pain, and reducing neck disability. Trial registraton: ClinicalTrials.gov (NCT05074576).
2024-01-01T00:00:00ZTreatment outcomes and prognostic factors in patients with driver mutant non-small cell lung cancer and de novo brain metastases
https://hdl.handle.net/20.500.12511/12395
Treatment outcomes and prognostic factors in patients with driver mutant non-small cell lung cancer and de novo brain metastases
Kahraman, Seda; Karakaya, Serdar; Kaplan, Muhammed Ali; Sezgin Göksu, Sema; Öztürk, Akın; Sucuoğlu İşleyen, Zehra; Hamdard, Jamshid; Yıldırım, Sedat; Şendur, Mehmet Ali Nahit
Central nervous system (CNS) metastases can be seen at a rate of 30% in advanced stages for patients with non-small cell lung cancer (NSCLC). Growing evidence indicates the predictive roles of driver gene mutations in the development of brain metastases (BM) in recent years, meaning that oncogene-driven NSCLC have a high incidence of BM at diagnosis. Today, 3rd generation targeted drugs with high intracranial efficacy, which can cross the blood–brain barrier, have made a positive contribution to survival for these patients with an increased propensity to BM. It is important to update the clinical and pathological factors reflected in the survival with real-life data. A multi-center, retrospective database of 306 patients diagnosed with driver mutant NSCLC and initially presented with BM between between November 2008 and September 2022 were analyzed. The median progression-free survival (mPFS) was 12.25 months (95% CI, 10–14.5). While 254 of the patients received tyrosine kinase inhibitor (TKI), 51 patients received chemotherapy as first line treatment. The median intracranial PFS (iPFS) was 18.5 months (95% CI, 14.8–22.2). The median overall survival (OS) was 29 months (95% CI, 25.2–33.0). It was found that having 3 or less BM and absence of extracranial metastases were significantly associated with better mOS and iPFS. The relationship between the size of BM and survival was found to be non-significant. Among patients with advanced NSCLC with de novo BM carrying a driver mutation, long-term progression-free and overall survival can be achieved with the advent of targeted agents with high CNS efficacy with more conservative and localized radiotherapy modalities.
2024-01-01T00:00:00Z