SiSli Etfal Hastanesi Tip Bulteni / The Medical Bulletin of Sisli Hospital

Journal Information
ISSN / EISSN : 13027123 / 13085123
Current Publisher: Kare Publishing (10.14744)
Former Publisher: Yerkure Tanitim ve Yayincilik Hizmetleri (10.5350)
Total articles ≅ 536
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Muhittin Çelik, Ali Bulbul, Sinan Uslu
SiSli Etfal Hastanesi Tip Bulteni / The Medical Bulletin of Sisli Hospital, Volume 54, pp 113-116; doi:10.14744/semb.2018.22605

Abstract:
Congenital syphilis is a severe disease that arises from the vertical transmission of Treponema pallidum. Clinical findings are related to the pregnancy stage, fetal gestational week, maternal treatment and fetal immunologic response. Prematurity, low birth weight, nonimmune hydrops fetalis, necrotizing enterecolitis, hepatomegaly, skin eruptions, thrombocytopenia, hemolytic anemia and fever can be detected in the symptomatic newborn. Postnatal respiratory insufficiency, hepatomegaly, anemia and thrombocytopenia were detected in a baby who was born at the 29th week of gestation, weighing 1.160 g and followed due to intestinal hyperechogenicity from the second trimester. Her and her mother’s Venereal Disease Research Laboratory titers were positive, confirming test Treponema pallidum hemagglutination was reactive. After penicillin was administered for 10 days, anemia, and thrombocytopenia were regressed. In the 15th day of life, findings of perforated necrotising enterocolitis (NEC) suddenly appeared. The operation was performed due to NEC for three times but nonresponsive laboratory and clinical findings and died in the 54th day of life. We assumed that syphilis is the cause of both bowel hyperechogenicity and necrotising enterocolitis.
Onur Akan, Canan Emir, Cihat Örken, Serap Üçler
SiSli Etfal Hastanesi Tip Bulteni / The Medical Bulletin of Sisli Hospital, Volume 54, pp 73-77; doi:10.14744/semb.2019.82598

Abstract:
To investigate the clinical, electrophysiological and epidemiological features of the patients who were diagnosed as Guillain Barre Syndrome (GBS) in our clinic. The clinical and demographical properties of 30 patients with GBS who were hospitalized in our neurology clinic between March 2013 and August 2017 were retrospectively examined in this study. Patients were divided into two groups according to the requirement of stay in the intensive care unit (ICU). Patients were between 18-71 years range with 46.9 and 19.61 mean age. Seven of 30 patients (23.3%) were female, and 23 of them (76.7%) were male. Males were more dominant in the ICU (-) group (81% and 62%). A recent infection was found in 86.7% of patients. Upper respiratory tract infection (URTI) was more common in ICU (+) group whereas lower respiratory tract infection (LRTI) and acute gastroenteritis (AGE) were more common in the ICU (-) patients (p=0.007). Lower limb weakness was more frequent in the ICU (+) group (p=0.011). ICU (+) patients were lack of diplopia and dysarthria. Ataxia and dysphagia were relatively frequent in the ICU (+) group. Electrophysiological examinations revealed demyelinating polyneuropathy (26.7%), acute axonal polyneuropathy (30.1%) and acute sensorial polyneuropathy (13.3%). Demyelinating polyneuropathy was more common in the ICU (-) group, whereas acute motor and sensorial polyneuropathy (AMSAN) was more frequent in the ICU (+) group. In this study, 26.7 % of study patients required mechanical ventilation, and mortality rate was 6.8 %. URTI in ICU (+), LRTI and AGE in ICU (-) patients might be major trigger factors of GBS. Ascending weakness, dysphagia and ataxia was more frequent in ICU (+) GBS patients. Demyelinating PNP was predominant in the ICU (-) group, whereas AMSAN was more frequent in the ICU (+) patients. Multicenter randomized studies would be more useful for highlining the epidemiology of GBS.
Uğur Temel, Aslı Gül AKGÜL, Salih Topçu
SiSli Etfal Hastanesi Tip Bulteni / The Medical Bulletin of Sisli Hospital, Volume 54, pp 103-107; doi:10.14744/semb.2018.78309

Abstract:
Elastofibroma dorsi is a benign lesion commonly presents as a palpable enlarging mass at the inferior pole of the scapula. Clinical presentation and radiological characteristics are often enough to suggest an accurate diagnosis. Increased awareness of the characteristic appearance and location of these benign lesions will increase radiologic diagnosis and decrease the need for biopsy.
Ezgi Özkur, Ece Uğurer, Ilknur Kıvanç Altunay
SiSli Etfal Hastanesi Tip Bulteni / The Medical Bulletin of Sisli Hospital, Volume 54, pp 62-66; doi:10.14744/semb.2018.48108

Abstract:
Lichen planus (LP) is a chronic inflammatory disease that affects the skin, mucous membranes, scalp and nails. It has been reported that diabetes mellitus and dyslipidemia prevalence were higher in patients with LP. However, most of these reports were retrospective, database search, which included patients who were on lipid-lowering drugs. This study aims to conduct a prospective case-control study to investigate the association between LP and dyslipidemia. Methods: This study was conducted on 49 patients with LP (mucosal or cutaneous) and 99 healthy controls. All patients were subjected to clinical and histological examination, whereas controls were subjected to clinical examination. The variables analyzed were age, sex, tobacco consumption, hypertension, lipid profiles and fasting blood glucose. Results: Serum levels of triglycerides, total cholesterol and LDL cholesterol were higher in patients with LP. However, there was no significant difference between patients with LP and controls. No significant differences between LP patients and controls were observed with the average age, sex, tobacco consumption and hypertension. Conclusion: This prospective case-control study demonstrated that dyslipidemia was more common among patients with LP. Physicians should be aware of this association and consider screening them for dyslipidemia.
Murat Ferhat Ferhatoglu, Abdulcabbar Kartal
SiSli Etfal Hastanesi Tip Bulteni / The Medical Bulletin of Sisli Hospital, Volume 54, pp 1-7; doi:10.14744/semb.2018.03779

Abstract:
Gastric outlet obstruction that arises from gallstones impacted in the distal stomach or proximal duodenum after passing through a cholecystoduodenal, cholecystogastric or rarely choledocoduodenal fistula is called as Bouveret’s syndrome and it accounts for approximately 1-3% of all the patients with gallstone ileus. Although treatment modalities, including stone removal or fragmentation with classical endoscopic devices, such as snares, and forceps or fragmentation of gallstones with new devices, such as electrohydraulic lithotripsy, laser, extracorporeal shockwave lithotripsy have been described. However, only 29% of the patients benefit from nonsurgical methods. Removal of the stone through a gastrotomy or enterotomy and performing cholecystectomy and fistula repair with a second operation is an approach recommended for older patients with comorbid diseases. In this paper, a case of Bouveret’s syndrome was presented. The authors also aimed to review the diagnosis, management and treatment of this rare disease and to update the previous reviews.
Mehmet özgür Kuzdan, Altan Alim, Reyhan Alim, Suleyman Celebi, Seyithan Özaydın, Birgül Karaaslan, Cemile Besik
SiSli Etfal Hastanesi Tip Bulteni / The Medical Bulletin of Sisli Hospital, Volume 54, pp 108-112; doi:10.14744/semb.2018.00087

Abstract:
Infantile hepatic hemangioma is the most common liver tumor in children. The most common symptoms are mass in her stomach, anemia and heart failure. According to the findings of the patient, the treatment may vary from the clinical follow-up to liver transplantation. In our study, the details of the surgical technique were presented.
Eda Çoban, Songül Senadım, Ayşe Yılmaz, Hayriye Küçükoğlu, Ayhan Köksal, Dilek Ataklı, Aysun Soysal
SiSli Etfal Hastanesi Tip Bulteni / The Medical Bulletin of Sisli Hospital, Volume 54, pp 83-87; doi:10.14744/semb.2018.20438

Abstract:
Transient Ischemic Attack (TIA) is due to a temporary lack of adequate blood and oxygen to the brain. TIAs typically last less than 24 hours. 10-15% of ischemic stroke patients have a history of TIA. 18% of them experience an ischemic stroke within 90 days, and the ABCD2 scoring system is used to estimate the risk. Our study aims to investigate the risk factors, the etiology, the lesion occurrence on MRI and the near-term risk of stroke of patients on whom TIA was diagnosed. In this study, 124 patients were included between January 2012 and January 2018. Sixty-eight of the 124 patients were male. The history of patients was questioned; systemic and neurological examinations were made. The stroke risk factors and TIA duration were noted and ABCD2 scores were calculated. All the patients’ blood samples, including glucose and lipid profile, were studied. They received CT, DWI MRI, electrocardiography, transthoracic echocardiography, ultrasound and/or MR angiography of the cervical arteries. One hundred twenty-four patients were included in this study, and 56 patients were female. The mean age was 63.04±16.77. Hypertension was the most common risk factor (50.8%). Twenty-seven patients were on antithrombotic; six patients were on anticoagulant therapy, while 91 patients were not receiving any antiaggregan therapy. ABCD2 scores were significantly higher on the antithrombotic therapy group (p=0.019). In 52 patients ABCD2 score was below 4, and in 72 patients, the score was greater than 4. In 67.7% of patients, no etiology was found. An ischemic lesion was detected in 16.9% of the patients. 58 % of the patients were discharged on anticoagulant therapy. Five patients developed ischemic stroke. The risk factors of ischemic stroke and TIAs are similar factors. The etiology of TIAs cannot be found out in most of the patients. Thus, the patients are discharged with oral anticoagulant treatment.
Şükran Öztürk, Kamuran Zeynep Sevim
SiSli Etfal Hastanesi Tip Bulteni / The Medical Bulletin of Sisli Hospital, Volume 54, pp 67-72; doi:10.14744/semb.2018.26790

Abstract:
In this study, we analyzed patients with upper extremity injuries concerning patient demographics, injury type and etiological factors, and the most common problems encountered during the first 24 hours that were noted in the retrospective analysis. In this study, a total of 82 patients who presented to the emergency plastic surgery clinic in Şişli Hamidiye Etfal Research and Training Hospital, postoperatively these patients were checked after surgery for first 24 hours concerning pain, nausea and vomiting, edema, agitation, arm immobilization arm and vascular patency. Among etiological factors, 54 patients were sharp-object trauma, 10 patients punched a hard object, 15 patients had work hazard, two patients had traffic accident, one patient from the fight. When these patients were postoperatively analyzed, in 45% patients pain, in 7% nausea and in 14 % bleeding were observed. Plaster was placed in 100% of the patients in order and their arms were elevated to reduce edema. During the first four hours, in 2% of the patients, edema was seen, 16% agitation, 8%vascular problems. When the type of injury is subcategorized to injuries of several compartments (nerve, tendon, muscle, artery, vein), the early postoperative challanges are more easily and correctly handled.
Cennet Sahin, Onur Yılmaz, Burçin Ağrıdağ Üçpınar, Ramazan Uçak, Uğur Temel, Muzaffer Basak, Aylin Hasanefendioglu Bayrak, Burcin Agridag
SiSli Etfal Hastanesi Tip Bulteni / The Medical Bulletin of Sisli Hospital, Volume 54, pp 47-51; doi:10.14744/semb.2019.46338

Abstract:
Computed tomography-guided core needle biopsy has an important role in the accurate histopathological diagnosis of lung masses. The present study aims to share our results of computed tomography-guided percutaneous core needle biopsy of lung masses. A total of 117 patients had computed tomography-guided percutaneous core needle biopsy for lung masses between January 2017-September 2019 in our institution. In this study, these patients’ post-procedural complications, diagnostic-yield-rates and radiological-histopathological correlations were evaluated retrospectively. Complications occurred in 23 (20%) patients (20 (17%) of pneumothorax; 3 (3%) of hemorrhage). Chest-tube-drainage was needed in five (4%) of all patients. No significant difference was found between complication rates and patient gender/age, tumor volume/localization or needle-path-length (p>0.05). In 77 of the 85 (91%) primary-lung-cancer-cases radiological and pathological diagnostic results were correlated. Computed tomography-guided core needle biopsy has a high diagnostic yield rate with acceptable complication rates in the diagnosis of lung masses.
Mesut Demir, Melih Akın, Meltem Kaba, Şeyma Filiz, Nihat Sever, Çetin Ali Karadağ, Ali Ihsan Dokucu
SiSli Etfal Hastanesi Tip Bulteni / The Medical Bulletin of Sisli Hospital, Volume 54, pp 94-97; doi:10.14744/semb.2018.88310

Abstract:
We retrospectively evaluated the patients with primer spontaneous pneumothorax (PSP) who were treated with thoracoscopic resection. We retrospectively collected the data of the patients with a spontaneous pneumothorax who were operated with video-assisted thoracoscopic surgery (VATS) between 2010 and 2016. During the study period, 10 patients applied to our hospital with spontaneous pneumothorax. Five children (three boys, two girls) with a mean age of 16.6 (16-17) were selected with VATS. Three of the patients had bleb, one of the patients had Congenital Cystic Adenomatoid Malformation (CCAM) type 2, and the last one had chronic emphysematous tissue on pathological analyses. Post-operative follow-up time was 2.2 (1-4) years without any complication. Spontaneous pneumothorax is a disease especially seen in puberty. The main reasons are apical segment bullae formation and blebs. VATS is especially advantageous to reach apical segments and for easy resections. Blebs, CCAM and emphysematous lung tissue may cause spontaneous pneumothorax.
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