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Publication Metadata only Ultrasound-guided thrombin injection for the treatment of iatrogenic femoral artery pseudoaneurysms(Turkiye Klinikleri Turkocagi Caddesi No. 30 Balgat 06520, 2014) Aksoy, Şevki Murat; Sarici, Inanç Şamil; Uçar, Adem; Yanar, Fatih; Agcaoglu, O.; Kurtoǧlu, Mehmet Hamdi; Aksoy, Şevki Murat, Department of General Surgery, İstanbul Tıp Fakültesi, Istanbul, Turkey; Sarici, Inanç Şamil, Department of General Surgery, İstanbul Tıp Fakültesi, Istanbul, Turkey; Uçar, Adem, Department of Radiology, Bahçeşehir Üniversitesi, Istanbul, Turkey; Yanar, Fatih, Department of General Surgery, İstanbul Tıp Fakültesi, Istanbul, Turkey; Agcaoglu, O., Department of General Surgery, İstanbul Tıp Fakültesi, Istanbul, Turkey; Kurtoǧlu, Mehmet Hamdi, Department of General Surgery, İstanbul Tıp Fakültesi, Istanbul, TurkeyObjective: The aim of this study is to review our experience with percutaneous ultrasonography (USG) guided thrombin injection to treat iatrogenic femoral artery pseudoaneurysms and to assess the safety of the procedure. Material and Methods: From January 2007 to January 2011, 41 patients with iatrogenic femoral pseudoaneurysms, were included in the study. The medical records concerned the demographics, the pseudoaneurysm size and site, thrombin dose that was injected, efficacy and safety of the procedure and postintervenional follow-up for one year. Results: There were 39 (95.1%) patients, who were eligible to be included in the study. Twenty-four (61.5%) patients were male and 15 (38.5%) patients were female. The mean age was 72±11 years (49-88). All of the pseudoaneurysms were originated from the common femoral arteries. The mean maximum transverse diameter of the pseudoaneurysms was 3.7±1.1 cm (2 - 6.5 cm). The mean neck diameter was 5±1.1 mm (3-7.5 mm). After the first thrombin injection, complete thrombosis of the pseudoaneurysm occured in 34 (87.1%) of the patients. A secondary thrombin injection was required in 5 (12.8%) patients. USG-guided thrombin injection failed in 2 (5.3%) patients. There was not any complications during the follow-up. Conclusion: USG-guided thrombin injection is an effective technique for the treatment of post-catheterisation pseudoaneurysms, which is easy to perform, safe, well tolerated and highly successful in good selected patients. Copyright © 2014 by Türkiye Klinikleri. © 2014 Elsevier B.V., All rights reserved.Publication Metadata only Incidence and severity of retinopathy of prematurity in Turkey(BMJ Publishing Group [email protected], 2015) Bas, Ahmet Yagmur; Koç, Esin Merve; Dílmen, Uǧur; Oĝuz, Şerife Suna; Ovalı, Hüsnü Fahri; Demirel, Nihal; Zenciroǧlu, Ayşeg̈ul; Tekin, Neslihan; Caner, Ibrahim; Arslanoǧlu, Sertaç; Bas, Ahmet Yagmur, Department of Neonatology, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Kecioren, Turkey; Koç, Esin Merve, Department of Neonatology, Gazi Üniversitesi, Ankara, Turkey; Dílmen, Uǧur, Department of Neonatology, Dr. Zekai Tahir Burak Women's Hospital, Ankara, Turkey; Oĝuz, Şerife Suna, Department of Neonatology, Dr. Zekai Tahir Burak Women's Hospital, Ankara, Turkey; Ovalı, Hüsnü Fahri, Zeynep Kamil Maternity and Children's Training and Research Hospital, Istanbul, Turkey; Demirel, Nihal, Department of Neonatology, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Kecioren, Turkey; Zenciroǧlu, Ayşeg̈ul, Dr. Sami Ulus Maternity and Children's Hospital, Ankara, Turkey; Tekin, Neslihan, Eskişehir Osmangazi Üniversitesi, Eskisehir, Turkey; Caner, Ibrahim, Ataturk University, Faculty of Medicine, Erzurum, Turkey; Arslanoǧlu, Sertaç, Dr. Behcet Uz Children's Hospital, Izmir, TurkeyBackground: The purpose of this study was to estimate the current incidence of retinopathy of prematurity (ROP) and the need for treatment in preterm infants in Turkey. Methods: The study included preterm infants who had been screened for ROP between 2011 and 2013 in 49 neonatal intensive care units. Infants with birth weight (BW) ≤1500 g or ≤32 weeks' gestational age and those with BW >1500 g or >32 weeks' GA with an unstable clinical course were included. The incidence of any ROP or severe ROP and treatment modalities were determined. Results: The study population included 15 745 preterm infants: 11 803 (75%) with GA ≤32 weeks, and 3942 (25%) with GA >32 weeks. Overall, 30% were found to have any stage of ROP, and 5% had severe ROP. Severe ROP was diagnosed in 8.2% of infants with BW ≤1500 g and 0.6% of infants with BW >1500 g. Of all infants diagnosed with ROP, 16.5% needed laser photocoagulation, and 20 patients born at >32 weeks' GA required this treatment modality. Vitroretinal surgery was performed in 28 infants with severe ROP: 23 with GA ≤28 weeks and 5 with GA 29-32 weeks. Conclusions: The findings of our study have the important implication that more mature babies are at risk of severe ROP requiring treatment. An effective programme for detecting and treating ROP should be established in Turkey. © 2019 Elsevier B.V., All rights reserved.Publication Metadata only A comparison of off- and on-pump beating-heart coronary artery bypass surgery on long-term cardiovascular events(Clinics Cardive Publishing (PTY)Ltd PO Box 1013, Durbanville, 7551, 2017) Gürbüz, Orçun; Kumtepe, Gencehan; Yolgösteren, Atif; Özkan, Hakan; Karal, Ilker Hasan; Ercan, Abdulkadir; Ener, Serdar; Gürbüz, Orçun, Department of Cardiovascular Surgery, Balikesir Üniversitesi, Balikesir, Turkey; Kumtepe, Gencehan, Department of Cardiovascular Surgery, Balikesir Üniversitesi, Balikesir, Turkey; Yolgösteren, Atif, Department of Cardiovascular Surgery, Bursa Uludağ Üniversitesi, Bursa, Turkey; Özkan, Hakan, Bahçeşehir Üniversitesi, Istanbul, Turkey; Karal, Ilker Hasan, Department of Cardiovascular Surgery, Samsun Education and Research Hospital, Samsun, Turkey; Ercan, Abdulkadir, Department of Cardiovascular Surgery, Balikesir Üniversitesi, Balikesir, Turkey; Ener, Serdar, Department of Cardiovascular Surgery, Doruk Hospital, Bursa, TurkeyObjective: Our aim was to compare short-term outcomes and long-term major adverse cardiovascular event (MACE)-free survival and independent predictors of long-term MACE after off-pump (OPCAB) versus on-pump beating-heart (ONBHCAB) coronary artery bypass grafting (CABG). Methods: We retrospectively reviewed data of all consecutive patients who underwent elective CABG, performed by the same surgeon, from January 2003 to October 2009. A propensity score analysis was carried out to adjust for baseline characteristics and a total of 398 patients were included: ONBHCAB (n = 181), OPCAB (n = 217). Results: OPCAB was associated with significantly shorter ventilation times (p ≤ 0.001), intensive care unit stay (p ≤ 0.001) and hospital stay (p ≤ 0.001). The total blood loss was significantly more in the ONBHCAB group (p ≤ 0.001), and accordingly, the number of transfused blood units was significantly lower in the OPCAB group (p ≤ 0.001). Incidence of peri-operative renal complications were significantly higher in the ONBHCAB group (p = 0.004). The OPCAB group showed significantly lower long-term MACE-free survival (p = 0.029). The mean number of transfused blood units was the only independent predictor of MACE (HR: 1.218, 95% CI: 1.0891.361, p = 0.001). Conclusion: OPCAB provided better long-term MACE-free survival compared with ONBHCAB. Fewer units of blood transfused following OPCAB surgery may have been the main reason for this result. © 2017 Elsevier B.V., All rights reserved.Publication Metadata only Surgery for Benign Gynecological Disorders Improve Endometrium Receptivity: A Systematic Review of the Literature(SAGE Publications Inc. [email protected], 2017) Çelik, Önder; Acet, Mustafa; Küçük, Tansu; Haberal, Esra Tuştaş; Acet, Tuba; Bozkurt, Murat; Şahin, Levent; Verit, Fatma Ferda; Çalişkan, Eray; Çelik, Önder, Department of Obstetrics and Gynecology, Private Clinic, Usak, Turkey; Acet, Mustafa, Department of Obstetrics and Gynecology, İstanbul Medipol Üniversitesi, Istanbul, Turkey; Küçük, Tansu, Department of Obstetrics and Gynecology, Acıbadem Mehmet Ali Aydınlar Üniversitesi, Istanbul, Turkey; Haberal, Esra Tuştaş, Department of Obstetrics and Gynecology, Umraniye Education and Research Hospital, Istanbul, Turkey; Acet, Tuba, Department of Obstetrics and Gynecology, Medicine Hospital, Istanbul, Turkey; Bozkurt, Murat, Department of Obstetrics and Gynecology, Sakarya Üniversitesi, Serdivan, Turkey; Şahin, Levent, Department of Obstetrics and Gynecology, Kafkas Üniversitesi, Kars, Turkey; Verit, Fatma Ferda, Department of Obstetrics and Gynecology, Suleymaniye Maternity Education and Research Hospital, Istanbul, Turkey; Çalişkan, Eray, Department of Obstetrics and Gynecology, Bahçeşehir Üniversitesi, Istanbul, TurkeyRegardless of the anatomical locations, some benign gynecological disorders (BGDs) such as peritoneal endometriosis, ovarian endometrioma, adenomyosis, uterine leiomyomas, endometrial polyps, uterine septum, and hydrosalpinges may lead to implantation failure. Despite progress in medical therapies, surgery remains a mainstay of BGDs treatment. Although our knowledge of endometrial receptivity after BGDs surgery is limited, it has allowed for significant improvement in the treatment of female subfertility. Many researchers studied on pregnancy outcome following BGDs surgery, but they did not investigate the possible impact of surgery on endometrial receptivity. They, therefore, concluded that pregnancy rates improved after BGDs surgery based on clinical observations. Many of these clinicians believe that surgical resection of BGDs leads to removal of local mechanical effect over the endometrium. Moreover, they accept that BGDs surgery may inhibit the detrimental signaling and secretion of some molecules from the BGDSs into the endometrium that may lead to favorable effect on the endometrium. However, so far, data from randomized controlled trials or systematic review or meta-analyses to answer the question whether surgical treatment of BGDs can improve endometrial receptivity are lacking. The purpose of this systematic review was to evaluate the results of available publications dealing with the impact of reproductive surgery for BGDs on endometrial receptivity. © 2017 Elsevier B.V., All rights reserved.Publication Metadata only Effectiveness of platinum-based treatment for triple negative metastatic breast cancer: A meta-analysis(Asian Pacific Organization for Cancer Prevention [email protected],, 2018) Kaya, Vildan; Yildirim, Mustafa; Yazici, Gözde; Gündüz, Şeyda Gulenay; Bozcuk, Hakan Şat; Paydaş, Semra; Kaya, Vildan, Department of Radiation Oncology, Medstar Antalya Hospital, Antakya, Turkey; Yildirim, Mustafa, Department of Internal Medicine, Bahçeşehir Üniversitesi, Istanbul, Turkey; Yazici, Gözde, Department of Radiation Oncology, Hacettepe Üniversitesi, Ankara, Turkey; Gündüz, Şeyda Gulenay,; Bozcuk, Hakan Şat,; Paydaş, Semra,Background: Triple-negative breast cancer (TNBC) is a sub-group of breast cancers with a particularly poor prognosis. The results of studies investigating the role of platinum-based chemotherapy (PBC) in metastatic TNBC (mTNBC) have been conflicting. In this meta-analysis, our aim was to assess the effectiveness of PBCs for mTNBCs. Methods: The PubMed, Cochrane Controlled Trials Register Databases, and EBSCOhost databases were accessed. The English language was used as the search language and only human studies were included. The Newcastle-Ottawa Quality Assessment Scale and the Jadad scoring system were used to evaluate the quality of the included randomized controlled studies. Results: Seven studies and 1,571 patients were included in this meta-analysis. The pooled hazard ratio (HR) for overall survival (OS), evaluated on the basis of six studies, showed the use of PBC regimes to be related to OS in mTNBCs (HR 0.620, 95% CI 0.513-0.749, p: < 0.001). Four studies containing HR and abstract statistics used for HR calculation were included in the meta-analysis for progression-free survival (PFS). The pooled HR again indicated a significant relation (HR, 0.628, 95% CI, 0.501-0.786, p: < 0.001). Conclusions: In this meta-analysis, we confirmed that PBC regimes provide OS and PFS advantages compared to non-PBC regimes. The use of PBC regimes could be a good choice in mTNBC patients for better quality of life and survival. © 2018 Elsevier B.V., All rights reserved.Publication Metadata only Meningiomas in pregnancy: timing of surgery and clinical outcomes as observed in 104 cases and establishment of a best management strategy(Springer-Verlag Wien [email protected], 2018) Laviv, Yosef; Bayoumi, Ahmed B.; Mahadevan, Anand; Young, Brett C.; Boone, Myles Dustin; Kasper, Ekkehard Matthias; Laviv, Yosef, Department of Surgery, Harvard Medical School, Boston, United States; Bayoumi, Ahmed B., Department of Surgery, Harvard Medical School, Boston, United States, Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey; Mahadevan, Anand, Department of Radiation Oncology, Harvard Medical School, Boston, United States; Young, Brett C., Division of Maternal Fetal Medicine/Department of Obstetrics and Gynecology, Harvard Medical School, Boston, United States; Boone, Myles Dustin, Department of Anesthesiology, Harvard Medical School, Boston, United States; Kasper, Ekkehard Matthias, Department of Surgery, Harvard Medical School, Boston, United StatesBackground: There is a strong correlation between the level of circulating female sex hormones and the parturient growth of meningiomas. As a result, rapid changes in meningioma size occur during pregnancy, putting both the mother and fetus at risk. Large, symptomatic meningiomas require surgical resection, regardless of the status of pregnancy. However, the preferred timing of such complex intervention is a matter of debate. The rarity of this clinical scenario and the absence of prospective trials make it difficult to reach evidence-based conclusions. The aim of this study was to create evidence-based management guidelines for timing of surgery for pregnancy-related intracranial meningiomas. Method: The English literature from 1990 to 2016 was systematically reviewed according to PRISMA guidelines for all surgical cases of pregnancy–related intracranial meningiomas. Cases were divided into two groups: patients who have had surgery during pregnancy and delivered thereafter (group A) and patients who delivered first (group B). Groups were compared for demographic, clinical and radiological features, as well as for neurosurgical, obstetrical and neonatological outcomes. Statistical analysis was performed to assess differences. Results: A total of 104 surgical cases were identified and reviewed, of which 86 were suitable for comparison and statistical analysis. Thirty-five patients (40%) underwent craniotomy for resection during pregnancy or at delivery (group A) and 51 patients (60%) underwent surgery after delivery (group B). Groups showed no significant differences in characteristics such as age at diagnosis, number of gestations, presenting symptoms, tumor site and tumor size. Despite a comparable distribution over the gestational trimesters, group A had significantly more patients diagnosed prior to the 27th gestational week (46 vs 17.5%, p = 0.0075). Group A was also associated with a significantly higher rate of both emergent craniotomies (40 vs 19.6%, p = 0.0048) and emergent Caesarian deliveries (47 vs 17.8%, p = 0.00481). The time from diagnosis to surgery was significantly longer in group B (11 weeks vs 1 week in group A, p = 0.0013). The rate of premature delivery was high but similar in both groups (∼70%). Risks of maternal mortality or fetal mortality were associated with group A (odds ratio = 14.7), but did not reach statistical significance. Conclusions: While surgical resection of meningioma during pregnancy may be associated with increased maternal and fetal mortalities, the overall neurosurgical, obstetrical and neonatological outcomes, as well as many clinical characteristics, are similar to patients undergoing resection postpartum. We believe that fetal survival chances have a significant impact on decision-making, as patients diagnosed at a later stage in pregnancy (≥27th week of gestation) were more likely to undergo delivery first. This complicated clinical scenario requires the close cooperation of multiple disciplines. While the mother’s health and well-being should always be paramount in guiding management, we hope that the overall good outcomes observed by this systematic review will encourage colleagues to aim for term pregnancies whenever possible in order to reduce prematurity-related problems. © 2018 Elsevier B.V., All rights reserved.Publication Metadata only An update on the currently available and future chemotherapy for treating bone metastases in breast cancer patients(Taylor and Francis Ltd [email protected], 2018) Oruc, Zeynep; Kaplan, Muhammet Ali; Arslan, Çaǧatay; Oruc, Zeynep, Department of Medical Oncology, Mersin City Hospital, Mersin, Turkey; Kaplan, Muhammet Ali, Department of Medical Oncology, Dicle University, Faculty of Medicine, Diyarbakir, Turkey; Arslan, Çaǧatay, Department of Medical Oncology, Medical Park Hospital, Bursa, Turkey, Faculty of Medicine, Bahçeşehir Üniversitesi, Istanbul, TurkeyIntroduction: Bone metastases in breast cancer patients are a common clinical problem. Many factors influence the treatment decision, including tumor characteristics, previous treatment and tumor burden in the treatment of metastatic breast cancer. Areas covered: This present review summarizes the new treatment strategies and the chemotherapeutic agents currently available in the management of metastatic breast cancer with bone metastases. Expert opinion: Patients with bone metastases more often have hormone receptor-positive tumours. Although new treatment agents for metastatic breast cancer have been investigated, endocrine therapy is still considered as the treatment of choice for patients with bone metastases although chemotherapy still has an important place. In recent years, new chemotherapeutic agents such as etirinotecan and nab-paclitaxel have been established though there are few studies that have looked at particular types of metastases. In the last decade, therapies for bone metastasis resistant to endocrine therapy have predominantly focused on radiotherapy, surgical resection, chemotherapy, bone-targeting radiopharmaceuticals and targeted therapeutics. New targeted agents include: Src inhibitors, cathepsin K inhibitors, CXCR4 inhibitors, TGF-B blockade and integrin antagonists while drug delivery systems for chemotherapy have also been developed. These new treatment options could be future treatment options for bone metastatic disease if early promising results are confirmed by clinical trials. © 2018 Elsevier B.V., All rights reserved.Publication Metadata only Lung Adenocarcinoma Metastasis Mimicking Peripheral Nerve Sheath Tumor: Case Report and Review of Literature(Elsevier Inc. [email protected], 2018) Oktay, Kadir; Güzel, Ebru; Şimşek, Serkan; Yildirim, Mustafa; Güzel, Aslan I.; Oktay, Kadir, Department of Neurosurgery, Medical Park Hospital, Bursa, Turkey; Güzel, Ebru, Department of Radiology, Medical Park Hospital, Bursa, Turkey; null, null, Department of Pathology, Patomer Pathology Laboratory, Gaziantep, Turkey; Şimşek, Serkan, Department of Neurosurgery, Lokman Hekim Hospital, Ankara, Turkey; Yildirim, Mustafa, Department of Internal Medicine, Bahçeşehir Üniversitesi, Istanbul, Turkey; Güzel, Aslan I., Department of Neurosurgery, Medical Park Hospital, Bursa, Turkey, Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, TurkeyRoot metastases of solid organ carcinomas are rare entities. Because of their rare occurrence, they can be confused with nerve sheath tumors, such as schwannomas or neurofibromas, when detected by magnetic resonance imaging. In this paper, we reported a case of a 72-year-old woman with S1 root metastasis originating from lung adenocarcinoma. In addition, we reviewed the literature and presented the diagnosis and treatment stages of this pathology. Surgical resection should be the main treatment for symptomatic metastases. Gross total resection of tumors is usually not possible with preservation of neurologic functions. Nerve root decompression, subtotal resection, and adjuvant treatments seem to represent the best treatment option for these patients. © 2018 Elsevier B.V., All rights reserved.Publication Metadata only Exploiting DNA repair defects in breast cancer: from chemotherapy to immunotherapy(Taylor and Francis Ltd, 2019) Aktaş, Burak Yasin Yasin; Güner, Gürkan; Guven, Deniz Can; Arslan, Çaǧatay; Dizdar, Ömer; Aktaş, Burak Yasin Yasin, Department of Medical Oncology, Hacettepe Üniversitesi, Ankara, Turkey; Güner, Gürkan, Department of Medical Oncology, Hacettepe Üniversitesi, Ankara, Turkey; Guven, Deniz Can, Department of Medical Oncology, Hacettepe Üniversitesi, Ankara, Turkey; Arslan, Çaǧatay, Department of Internal Medicine and Medical Oncology, Bahçeşehir Üniversitesi, Istanbul, Turkey; Dizdar, Ömer, Department of Medical Oncology, Hacettepe Üniversitesi, Ankara, TurkeyIntroduction: Impaired DNA damage response (DDR) and subsequent genomic instability are associated with the carcinogenic process itself, but it also results in sensitivity of tumor cells to certain drugs and can be exploited to treat cancer by inducing deadly mutations or mitotic catastrophe. Exploiting DDR defects in breast cancer cells has been one of the main strategies in both conventional chemotherapy, targeted therapies, or immunotherapies. Areas covered: In this review, the authors first discuss DDR mechanisms in healthy cells and DDR defects in breast cancer, then focus on current therapies and developments in the treatment of DDR-deficient breast cancer. Expert opinion: Among conventional chemotherapeutics, platinum-based regimens, in particular, seem to be effective in DDR-deficient patients. PARP inhibitors represent one of the successful models of translational research in this area and clinical data showed high efficacy and reasonable toxicity with these agents in patients with breast cancer and BRCA mutation. Recent studies have underlined that some subtypes of breast cancer are highly immunogenic. Promising activity has been shown with immunotherapeutic agents, particularly in DDR-deficient breast cancers. Chemotherapeutics, DNA-repair pathway inhibitors, and immunotherapies might result in further improved outcomes in certain subsets of patients with breast cancer and DDR. © 2019 Elsevier B.V., All rights reserved.Publication Metadata only MitraClip Implantation in Younger Patients and Pediatric Populations: 19 Year-Old Patient with Multiple Comorbidities and a Prior Mitral Valve Annuloplasty(Elsevier Inc. [email protected], 2019) Ates, Ismail; Kaya, Zeynettin; Karaaslan, Doruk Can; Mutlu, Deniz; Ci̧lingiroǧlu, Mehmet; Ates, Ismail, Bahçeşehir Üniversitesi, Istanbul, Turkey, Department of Cardiology, Medical Park Hospital, Bursa, Turkey; Kaya, Zeynettin, Department of Cardiology, Medical Park Hospital, Bursa, Turkey; Karaaslan, Doruk Can, Department of Cardiology, Koç Üniversitesi, Istanbul, Turkey; Mutlu, Deniz, Department of Cardiology, İstanbul University-Cerrahpaşa Cerrahpaşa Faculty of Medicine, Istanbul, Turkey; Ci̧lingiroǧlu, Mehmet, Bahçeşehir Üniversitesi, Istanbul, Turkey, Arkansas Heart Hospital, Little Rock, United StatesMitraClip is an effective treatment method for severe mitral regurgitation in high-risk populations in terms of reducing morbidity and frequency of hospitalizations. Efficacy and safety of MitraClip device in elderly population have been established, yet there are only 2 case reports of MitraClip implantation in the younger patients, who generally tend to have less surgical risk (Gorenflo et al., Joffe et al., 2016). We describe a 19-year-old patient with severe mitral regurgitation with prior mitral valve annuloplasty and received MitraClip implantation due to high-surgical risk. © 2020 Elsevier B.V., All rights reserved.