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GST Primary GST Primary Best Strategies for Health Care Quality Im... Best Strategies for Health Care Quality Improvement - Diabetes Quality Improvement Strategies for Antibio... Kathryn McDonald, Stanford-UCSF Evidence-b... Systematic review assessing the effect of ... Quality Improvement Strategies for Antibiotics Management Kathryn McDonald, Stanford-UCSF Evidence-based Practice Center, 117 Encina Commons, Stanford, CA 94305-6019, Kathy.mcdonald@stanford.edu Systematic review assessing the effect of quality improvement strategies on appropriate prescribing of antibiotics and appropriate choice of antibiotics. Adherence Adherence Assistive Devices Assistive Devices Childhood Burn Hanson MacMillan Childhood Burn Hanson MacMillan CLSA_9 CLSA_9 Cyberabuse Cyberabuse Cognitive Behavioural Therapy for Violent ... This review included randomized trials abo... Cognitive Behavioural Therapy for Violent Men who Batter Their Partners This review included randomized trials about the effects of cognitive behavioral therapy on domestic violence. The intervention included programs based on the Duluth Model. The violence had to be committed by a male toward his female partner. The violence also had to be physical. The primary outcomes were new arrests and convictions, and new reports of violence. CABG vs PCI CABG vs PCI Quality Improvement Strategies for Prevent... Quality Improvement Strategies for Preventing Nosocomial Infections (Created 17-Feb-06) Quality Improvement Strategies for Asthma ... Quality Improvement Strategies for Asthma Control Erectile Dysfunction (Created 30-Jan-06) Erectile Dysfunction (Created 30-Jan-06) Inequality - Smoking Cessation to Reduce S... This review was the first part of a projec... Inequality - Smoking Cessation to Reduce Socio-Economic Differences This review was the first part of a project about inequality. It included randomized trials about the effect of smoking cessation interventions on reducing socio-economic differences. The studies had to report data either on persons with low socio-economic groups status or, preferably, on both low and high socio-economic groups. Diet and Physical Activity to Reduce Socio... This review was the second part in a proje... Diet and Physical Activity to Reduce Socio-Economic Differences This review was the second part in a project about inequality. It included randomized trials about the effect of interventions on reducing socio-economic differences in diet and physical activity. The studies had to report data either on persons with low socio-economic groups status or, preferably, on both low and high socio-economic groups. Workfare The data in SRS are not identical to the d... Workfare The data in SRS are not identical to the data in the published report. We used SRS only for an updated search. The review included randomized trials about the effect of welfare-to-work programs. Participants were welfare recipients. There were basically two types of programs. The educational type tried to build knowledge and skills in order to help the welfare recipients acquire jobs that could support them economically. The "work first" approach was more aimed at getting the participants quickly into a job. Exercise interventions for the management ... The objective of this systematic review wa... Exercise interventions for the management of frailty The objective of this systematic review was to examine the effectiveness of current exercise interventions on the management of frailty. A comprehensive search of Medline, Embase, Psycinfo, Cinahl, Scopus, Ageline, Eric, and SportDiscus databases was conducted and produced 1808 citations. So far we have completed 2 levels of “title and abstract” screening and we ended up with 262 articles. We have just started the full text screening. Eligibility criteria included original studies whose participants were identified as frail or prefrail with specific criteria and in which structured physical activity was included as at least one component of the intervention. Create a free account, build a dictionary with saved terms to re-use later! Public Domestic Violence - Using Cognitive Behavior Therapy Smoking Cessation to Reduce Socio-Economic Differences Diet and Physical Activity to Reduce Socio-Economic Differences Workfare Exercise Interventions for the Management of Frailty Search     Simple Advanced Refine (4 coded questions)  Any of these:   Exact Phrase: All of these: None of these: Author: Periodical: Projects: No restrictions   Libraries: Public   Select SRS Projects Show Saved Terms Select Library Show articles that do not have abstracts  Humans or Animals Humans Animals Ages All Infant: birth-23 months All Child: 0-18 years All Adult: 19+ years Newborn: birth-1 month Infant: 1-23 months Preschool Child: 2-5 years Child: 6-12 years Adolescent: 13-18 years Adult: 19-44 years Middle Aged: 45-64 years Middle Aged + Aged: 45+ years Aged: 65+ years 80 and over: 80+ years Undetermined Type of Article Clinical Trial Editorial Letter Meta-Analysis Practice Guideline Randomized Controlled Trial Review Addresses Bibliography Biography Case Reports Classical Article Clinical Conference Clinical Trial, Phase I Clinical Trial, Phase II Clinical Trial, Phase III Clinical Trial, Phase IV Comment Comparative Study Consensus Development Conference Consensus Development Conference, NIH Controlled Clinical Trial Corrected and Republished Article Dictionary Directory Duplicate Publication English Abstract Evaluation Studies Festschrift Government Publications Guideline Historical Article Interview In Vitro Journal Article Lectures Legal Cases Legislation Multicenter Study News Newspaper Article Overall Patient Education Handout Periodical Index Published Erratum Retracted Publication Research Support, N.I.H., Extramural Research Support, N.I.H., Intramural Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, Non-P.H.S. 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Retraction of Publication Scientific Integrity Review Support of Research Technical Report Twin Study Validation Studies Not a Primary Study or Review Unknown Primary Study Case Series Case Control Cohort Study Observational Study Qualitative Research CBA or ITS Registry Double Blind Controlled before after study Quasi-randomized trial Simple before after study Cluster-RCT Non-Randomized Study Report Book Book chapter Dissertation Conference procedings Secondary Research Not RCT Language English French German Italian Japanese Russian Spanish Afrikaans Albanian Unknown Arabic Armenian Azerbaijani Bosnian Bulgarian Catalan Chinese Croatian Czech Danish Dutch Esperanto Estonian Finnish Georgian Greek, Modern Hebrew Hindi Hungarian Icelandic Indonesian Kinyarwanda Korean Latin Latvian Lithuanian Macedonian Malay Malayalam Maori Multiple Languages Norwegian Persian Polish Portuguese Pushto Romanian Sanskrit Scottish gaelic Serbian Slovak Slovenian Swedish Thai Turkish Ukrainian Vietnamese Not English Not French Results(1-25 of 1,506) Sort By: Publication Date Relevance Took: 0.666 seconds to search 17,750,454  Action: Copy Results to new Clipboard Build Search Link Page 1 of 61 1 2 3 4 > Last >> (1506 articles found) Panniculitis as the initial manifestation of brucellosis: a case report. Apr 2008 Esra Tanyel,Nuriye Tasdelen Fisgin,Levent Yildiz,Hakan Leblebicioglu,Levent Doganci,Necla Tulek Here, we describe a 38-year-old male with an abrupt manifestation acute panniculitis as unusual presentation of brucellosis. Brucellosis is a reemerging disease in Turkey, and the disease is primarily transmitted from farm animals to humans. Farmers and shepherds are the major risk groups for bruce... ( view more )llosis in Anatolia. Brucellosis may involve almost all systems and organs, including the skin, and may mimic a wide range of illness and syndromes. Although the cutaneous manifestation of brucellosis is not disease specific, but it occurs in about 6%-13% of patients with brucellosis. Some of these lesions including rashes, papules, ulcers, abscess, erythema nodosum, ecchymosed skin rash, purpura, and vasculitis may be seen frequently in brucellosis, but panniculitis is rarely described. The case confirmed by positive blood culture had manifest skin lesion as an initial finding represented by lobular panniculitis with vasculitis. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles [Occurrence of Nosema bombycis (Naegeli, 1857) in silkworms in Turkey] 2007 Levent Aydin,Ender Güle?en,Oya Giri?gin,Levent Kurtaraner Nosema bombycis (Naegeli, 1857) is the causative agent of the "Pebrine disease" in silkworms. N. bombycis spores were found in silkworm samples originating from the Hatay, Bursa and Bilecik provinces. Clinical signs were observed in the infected silkworm larvae. Because of the transovarial transmis... ( view more )sion risk, all the infected silkworm colonies were destroyed. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Resection of giant endobronchial hamartoma by electrocautery and cryotherapy via flexible bronchoscopy. 2007 Sedat Altin,Levent Dalar,Levent Karasulu,Erdo?an Cetinkaya,Sinem Timur,Nur Solmazer Endobronchial hamartoma is a rare tumor which is 3-10% of all hamartomas. We presented a case of endobronchial hamartoma that was resected and ablated with electrocautery and cryotherapy by fiberoptic bronchoscopy. A 71-year-old male, presented with progressive dyspnea on exertion, chest pain and h... ( view more )emoptysis. Chest computed tomography (CT) scan of the patient revealed a mass lesion mostly obliterating tracheal lumen and left main bronchus. An initial bronchoscopy showed a large polypoid lesion within the left mainstem bronchus. Polypoid lesion protrudes to the right with respiration. Interventional bronchoscopy with snare probe of the electrocautery resected the polyp in 4 pieces followed by cryotherapy of the base. Pathology of the resected lesion diagnosed as bronchial hamartoma with fibrovascular component. Control bronchoscopy applied 10 days later revealed patency of all airways. The majority of hamartomas is parenchymal and is often located in the periphery of the lung, unlike our patient who had a more central lesion. Where a firm diagnosis is made preoperatively, surgical removal may not be necessary unless symptoms are present, or tumor expansion is noted. Our case demonstrates resection of an endobronchial hamartoma by snare probe of the electrocautery and with cryotherapy. Electrocautery and cryotherapy may present an alternative therapy for resection of selected benign endobronchial benign tumors. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Ureteroscopic treatment of multiple distal-ureteral stones. Dec 2006 Zafer Gökhan Gürbüz,Saban Mimaroglu,Levent Gürkan,Mehmet Oder,Levent Verim BACKGROUND AND PURPOSE: Ureteroscopic intracorporeal lithotripsy for solitary distal-ureteral stones may be considered a first-line therapy. However, few reports that mention ureteroscopic procedures for multiple ureteral stones were found in the literature. Retrospectively, we reviewed our patient... ( view more )s who were treated by ureteroscopy for multiple distal-ureteral stones. PATIENTS AND METHODS: Fifteen patients underwent ureteroscopic pneumatic lithotripsy for unilateral multiple distal-ureteral stones. Ten patients had two stones, four patients had three stones, and another patient had five stones. The average stone number per ureteral unit was 2.44, and the average stone size was 9.7 mm (range 3-23 mm). RESULTS: Eighty percent of the patients (12/15) who had unilateral stones were stone free after the first session of ureteroscopic pneumatic lithotripsy. Two patients underwent a second ureteroscopy procedure for the remaining stone or failure of ureteral access. Overall, 93.3% of the patients (14/15) were stone free. Ureteral perforation as a major complication occurred in one patient (6.6%), who was treated by open surgery. We did not routinely use Double-J ureteral stents after ureteroscopy. Only one patient required stenting because of failure of ureteral access. Steinstrasse was observed in three patients, but it resolved spontaneously in the early postoperative period. CONCLUSION: Ureteroscopic pneumatic lithotripsy has a high success rate with few complications for the treatment of unilateral multiple distal-ureteral stones. Ureteroscopic pneumatic lithotripsy seems very effective for such stones. ( view less ) View Full Abstract View Article Details   Related Articles Cardiac surgery during pregnancy. Sep 2006 Zafer H Iscan,Levent Mavioglu,Kerem M Vural,Seref Kucuker,Levent Birincioglu BACKGROUND AND AIM OF THE STUDY: Cardiac surgery during pregnancy represents a major challenge as it comprises a single operation for two survivors. METHODS: Between 1988 and 2005, 16 pregnant women underwent cardiac surgery at the authors' institution. Among 14 patients with rheumatic mitral steno... ( view more )sis operated on due to clinical deterioration, closed mitral valvulotomy was performed in 12 cases (three urgently in the third trimester, nine at term concomitantly with cesarean delivery). Two patients underwent mitral valve replacement, again, concomitantly with cesarean delivery at term, while two others underwent emergency reoperation for mechanical valve thrombosis during the second trimester, using a strategy of high-flow, high-pressure perfusion with mild hypothermia. RESULTS: A total of 12 closed mitral valvulotomies and four mitral valve replacements was performed. There was no maternal mortality, and only one stillborn occurred in the urgent closed valvulotomy group. The remaining 15 babies were born healthy. CONCLUSION: In addition to protective perinatal procedures, instances occur during pregnancy when urgent or emergency surgery becomes unavoidable due to life-threatening cardiac decompensation. In patients with mitral stenosis, which is the case in most scenarios, closed mitral valvulotomy is life-saving and offers low fetomaternal risk, as a viable, efficient and practical alternative to percutaneous mitral balloon commissurotomy. When cardiopulmonary bypass (CPB) becomes mandatory, the shortest possible periods of mildly hypothermic or normothermic CPB with a strategy of high flow-high pressure perfusion should be followed. ( view less ) View Full Abstract View Article Details   Related Articles Local anesthesia for middle ear surgery. Aug 2005 Gül Caner,Levent Olgun,Gürol Gültekin,Levent Aydar The adequacy of anesthesia and comfort during surgery was assessed for 100 consecutive patients undergoing middle ear surgery using local anesthesia, both by the patients themselves and by the surgeon. The possibility of inducing an iatrogenic facial weakness was also evaluated. Both the surgeon an... ( view more )d the majority of patients were pleased with the quality of anesthesia and little adverse effects occurred as a consequence of local anesthesia itself. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles The effect of activated protein C on experimental acute necrotizing pancreatitis. Jun 2005 Levent Yamanel,Levent Yamenel,Mehmet Refik Mas,Bilgin Comert,Ahmet Turan Isik,Sezai Aydin,Nuket Mas,Salih Deveci,Mustafa Ozyurt,Ilker Tasci,Tahir Unal INTRODUCTION: Acute pancreatitis is a local inflammatory process that leads to a systemic inflammatory response in the majority of cases. Bacterial contamination has been estimated to occur in 30-40% of patients with necrotizing pancreatitis. Development of pancreatic necrosis depends mainly on the... ( view more ) degree of inflammation and on the microvascular circulation of the pancreatic tissue. Activated protein C (APC) is known to inhibit coagulation and inflammation, and to promote fibrinolysis in patients with severe sepsis. We investigated the effects of APC on histopathology, bacterial translocation, and systemic inflammation in experimental acute necrotizing pancreatitis. MATERIALS AND METHOD: Forty-five male Sprague-Dawley rats were studied. Rats were randomly allocated to three groups. Acute pancreatitis was induced in group II (positive control; n = 15) and group III (treatment; n = 15) rats by retrograde injection of taurocholate into the common biliopancreatic duct. Group I rats (sham; n = 15) received an injection of normal saline into the common biliopancreatic duct to mimic a pressure effect. Group III rats were treated with intravenous APC 6 hours after induction of pancreatitis. Pancreatic tissue and blood samples were obtained from all animals for histopathological examination and assessment of amylase, tumor necrosis factor-alpha, and IL-6 levels in serum. Bacterial translocation to pancreas and mesenteric lymph nodes was measured. RESULTS: Acute pancreatitis developed in all groups apart from group I (sham), as indicated by microscopic parenchymal necrosis, fat necrosis and abundant turbid peritoneal fluid. Histopathological pancreatitis scores in the APC-treated group were lower than in positive controls (10.31 +/- 0.47 versus 14.00 +/- 0.52; P < 0.001). Bacterial translocation to mesenteric lymph nodes and to pancreas in the APC-treated group was significantly decreased compared with controls (P < 0.02 and P < 0.007, respectively). Serum amylase, tumor necrosis factor-alpha, and IL-6 levels were also significantly decreased in comparison with positive controls (P < 0.001, P < 0.04 and P < 0.001, respectively). CONCLUSION: APC improved the severity of pancreatic tissue histology, superinfection rates and serum markers of inflammation during the course of acute necrotizing pancreatitis. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles The effect of the doxycycline-rifampicin and levamisole combination on lymphocyte subgroups and functions of phagocytic cells in patients with chronic brucellosis. Mar 2005 Ufuk Dizer,Levent Hayat,Can Murat Beker,Levent Görenek,Volkan Ozgüven,Alaaddin Pahsa BACKGROUND: Brucellosis is one of the important health problems for both humans and animals in Turkey since agriculture and stock raising appears to be the most important means of subsistence. Investigations on the pathogenesis of brucellosis reveal that the etiologic agent can survive in phagocyti... ( view more )c cells, and cell-mediated immunity plays an important role in immunity against bacteria. METHODS: In this study, we investigated whether supplementation of levamisole, a well-known antihelminthic agent with immune-stimulating activity to conventional antibiotic therapy, would improve the anergy against Brucella. RESULTS: The results of our study reveal that a 6-week course of levamisole as a supplement to conventional antibiotic therapy in chronic brucellosis is not superior to conventional antibiotic treatment alone with respect to lymphocyte subgroup ratios and phagocytic function. CONCLUSION: In chronic brucellosis, levamisole administered as a supplement concomitantly with conventional antibiotic therapy has no immunostimulating effect on the basis of the lymphocyte subgroups ratios measured and the ability of phagocytosis in the present study. Further large clinical and laboratory trials are necessary to investigate the immunological and physiological effects of levamisole on T(H1) subtypes and cytokine secretion. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles [Long-term results of functional surgery for attic cholesteatoma] 2005 Gürol Gültekin,Levent Olgun,Tolga Kando?an,Sezaver Alper,Zafer Eryilmaz,U?ur Cerçi,Levent Aydar OBJECTIVES: We evaluated the long-term results of functional surgery for attic cholesteatoma. PATIENTS AND METHODS: In this study, we presented the results of 81 patients (42 males 39 females; mean age 34 years; range 8 to 59 years) who underwent functional surgical techniques for attic cholesteato... ( view more )mas between January 1992 and January 1998. All the patients were followed-up for at least five years. RESULTS: For eradication of attic cholesteatoma, canal wall-down technique tympanoplasty was required in the majority of the patients. After surgery there was a statistically significant hearing improvement in all but four cases. In the postoperative period, residual cholesteatoma and graft perforation were found in five and six patients, respectively. Two patients required revision meatoplasty for problems related with cavity clearance. CONCLUSION: Apart from satisfactory hearing improvement with functional surgery, a successful self-clearance was obtained in mastoid cavities with saucerization and meatoplasty. Canal wall-down tympanoplasty is associated with very low incidences of residual or recurrent cholesteatoma in the majority of patients. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles The prevalence of sleep related disorders in Sivas, Turkey. 2005 Levent Ozdemir,Ibrahim Akkurt,Haldun Sümer,Selma Cetinkaya,U?ur Gönlügür,Sefa Levent Oz?ahin,Naim Nur,Omer Do?an The prevalence of sleep-related disorders (SRD) in adults in Turkey is unknown. The main objective of our study was to assess the prevalence of SRD in Sivas, Turkey. Adults living in Sivas, a city of Turkey from the central region of Anatolia at 20-107 years of age, in both genders, of the 5339 per... ( view more )sons, who attended the survey 2638 (49.4%) were male and 2701 (50.6%) were female. The prevalence of insomnia, habitual snoring, obstructive sleep apnea (OSA) and day time hyper somnolence was 40.3%, 37.0%, 6.4%, 24.0% respectively. The prevalence rates of narcolepsy and nocturnal myoclonus was 30.6%, 40.1% respectively. There was a statistical significance between the persons of above 60 years old and another age groups (p< 0.05). But we did not find any significant difference between smokers and non-smokers, also between males and females about SRD prevalence (p> 0.05). However, sleep apnea prevalence was about 9 times higher in the persons suffering from hypertension than without hypertension. Also sleep apnea prevalence was 12 times higher in the persons suffering from overweight. This study has shown that sleep-disordered breathing (SDB) prevalence in Turkey is as high as in other countries and may be more common. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles The role of reactive oxygen species and apoptosis in the pathogenesis of varicocele in a rat model and efficiency of vitamin E treatment. Aug 2004 Kamil Cam,Ferruh Simsek,Meral Yuksel,Levent Turkeri,Levent Turker,Goncagul Haklar,Suha Yalcin,Atif Akdas We investigated role of reactive oxygen species (ROS) and apoptosis in the pathogenesis of infertility in experimental model of varicocele. The protective effect of vitamin E was also examined. Three groups of rats were constructed as the first group had sham operation, experimental varicoceles wer... ( view more )e established by partial ligation of the left renal vein in later two groups. Third group had received vitamin E. Production of ROS was determined by chemiluminescence assay (CL). The in situ end labelling technique was utilized to investigate apoptosis. Tissue vitamin E levels were measured by high performance liquid chromatography. The differences between luminol enhanced CL levels of groups were not statistically significant. However, the difference between CL levels of lucigenin probe in left testicles of sham and varicocele groups were statistically significant ( p = 0.0007). Similarly, the results of the third group receiving vitamin E significantly differed from the varicocele group ( p = 0.0025). The difference of apoptotic index was also statistically significant between sham and varicocele groups ( p = 0.0038). Although the values of apoptotic index detected in the vitamin E group were lower compared with the varicocele group, the difference was not significant. This study proposes that ROS production and apoptosis in the testicles were induced with experimental varicocele. Vitamin E had a protective role. An increased rate of apoptosis with experimental varicocele suggests a molecular alteration, which may involve ROS overproduction as the triggering mechanism. Consequently, this study indicates an association between varicocele and infertility at molecular level through stimulation of ROS and apoptosis. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Non-Hodgkin's lymphoma of the nose and paranasal sinuses: a case report. 2004 Tolga Kando?an,Levent Olgun,Levent Aydar,Sezgin Ozlem Primary non-Hodgkin lymphoma (NHL) of the nasal cavity is a rare neoplasm. They account for about 0.17-2% of all cases of NHL and 5.8% of all malignant neoplasms of the sinonasal region in adults. A 37-year-old male patient presented with left-sided nasal obstruction and headache which appeared a c... ( view more )ouple of weeks before the admission. Nasal examination revealed a massive polyposis. After medical therapy with corticosteroids, neither the polyposis nor his complaints showed regression; thus, he underwent a nasal polypectomy operation. Biopsy results indicated an inflammatory nasal polyp. Two weeks later, a rapidly progressive facial swelling, especially in the left periorbital area and blurred vision occurred. Second biopsy, which was also taken from the left nasal cavity suggested again an inflammatory nasal polyp. To rule out any possible malignancy, a third biopsy was conducted in the left maxillary sinus which indicated T/NK cell lymphoma of the sinonasal tract. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles External laryngeal trauma. Jun 28, 2003 Tolga Kandogan,Levent Olgun,Gurol Gültekin,Levent Aydar,Bahattin Mercan,Ziya Mehmet Ozuer Compared to internal laryngeal trauma caused by endolaryngeal procedures, trauma to the larynx caused by external forces is relatively rare. It has been incidence of 1 in every 22,900 emergency room visits. Rapid evaluation and protection of the airway are critical. A history of a cervical trauma w... ( view more )ith signs of hoarseness, difficulty breathing and pain should always alert the emergency physician to the possibility of laryngeal injury. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Prognostic factors in prosthetic replacement for acute proximal humerus fractures. Mar 2003 Mehmet Demirhan,Onder Kilicoglu,Levent Altinel,Levent Eralp,Yilmaz Akalin OBJECTIVES: To investigate the effect of some epidemiological and radiologic factors on the outcome of prosthetic replacement in acute proximal humerus fractures. DESIGN: Retrospective clinical study. PATIENTS: Thirty-two patients [mean age 58 (range 37-83 years)] with a mean follow-up period of 35... ( view more ) months (range 8-80 months). Fifteen cases had Neer type IV, 2 had type III, and 15 patients had fracture-dislocations. MAIN OUTCOME MEASUREMENTS: Neer's criteria, Constant score, and elevation degree were used. Radiological parameters were union and position of the tuberosities, bone stock, and position of the prosthesis. RESULTS: Excellent or good results according to Neer's criteria were obtained in 24 of the 32 cases (75%), and unsatisfactory results in 8 cases (25%). Mean Constant score was 68 (range 19-98) and mean elevation degree 113 (range 30-180). Thirty-one cases (97%) had no or mild pain. Cases operated within 14 days following injury had a better general outcome (p = 0.005). The humeral offset was directly correlated to the elevation degree (p = 0.011) and Constant score (p = 0.002), whereas the head height was inversely correlated to the same parameters (p = 0.001 for both). The cutoff point for the humeral offset-general outcome correlation was calculated as 23 mm using ROC curve analysis. The most common complications were problems concerning the tuberosities (50%), and they adversely affected the clinical outcome (p = 0.002). CONCLUSIONS: Preoperative delay, problems of tuberosity fixation, and position of the tuberosities were parameters influencing the clinical outcome. Lateralization of the tuberosities results in better scores, whereas their distal transfer can be related to a poorer outcome. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Giant condyloma acuminatum. Mar 2003 Selma Sönmez Ergün,Yasemin Balsever Kural,Nesimi Büyükbabani,Levent Verim,Habib Akbulut,Levent Gürkan BACKGROUND: Giant condyloma acuminatum is a warty lesion that is characterized by its large size and propensity to infiltrate into deeper tissues contrasting with its microscopically benign pattern. It is proposed that giant condyloma represents an intermediate lesion between condyloma acuminatum a... ( view more )nd verrucous carcinoma. OBJECTIVE: A primary therapeutic option of giant condyloma is radical surgery with or without adjunctive chemotherapy. Because of the tumor's large extent in this case, curative therapy would have been achieved by wide surgical excision. METHOD: We present a morphologically and histologically classic example of giant condyloma with respect to origin from common genital warts. The reason for extensive exophytic growth was due to delay in therapy because of the patient's self neglect but not due to immune deficiency. The patient was treated with wide surgical excision. RESULTS: The postoperative period was uneventful, allowing satisfactory functional and cosmetic results. CONCLUSION: This case is an interesting case because of its exceptionally huge size without any deep tissue involvement and tissue atypia. This suggests that giant condyloma is an intermediate condition that exhibits a continuous tendency for growth. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Prevalence of asthma and related symptoms in Sivas, Central Anatolia. 2003 Ibrahim Akkurt,Haldun Sümer,Sefa Levent Oz?ahin,U?ur Gönlügür,Levent Ozdemir,Omer Do?an,Dilek Arzu Demir,Zehra Seyfikli BACKGROUND: In our clinical experience, asthma is an important health problem in our region, but we did not know its prevalence. OBJECTIVE: The main objective of our study was to assess the prevalence of asthma in Sivas, a city in Central Anatolia. METHODS: A cross-sectional study was performed usi... ( view more )ng a screening questionnaire adopted from European Community Respiratory Health Survey (ECRHS). A total of 5448 adults of both genders between 20 and 107 yr of age living in Sivas, a city in the central region of Anatolia in Turkey, participated in the survey. Of the cohort, 2691 were men (49.4%) and 2757 (50.6%) were women. RESULTS: The mean age was 38.2 yr (SD = 12.7 yr), almost half of the study population was at or younger than 40 yr of age. The prevalence of wheezing in the last 12 months, diagnosis of asthma, asthma attack in the last 12 months, and use of asthma medicine were 20.9%, 4.5%, 4.9%, and 3.4%, respectively. Awakening with chest tightness, with shortness of breath, or with cough were reported as 14.2%, 14.8%, and 22.7%, respectively. The prevalence of respiratory symptoms related to asthma was statistically higher in women than that of men (p = 0.000, OR 1.346, 95% CI: 1.228-1.475). Those who had asthma/allergic symptoms in their family members were significantly younger than others (p: 0.001). CONCLUSIONS: The results of this study demonstrate that symptoms suggestive of asthma are quite common and constitute a major health problem in Sivas, Turkey. This study also showed that, despite a high rate of reported symptoms exists, the rate of diagnosis and treatment of asthma is low among the adult population in Sivas. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles A hydatid cyst of the interventricular septum diagnosed incidentally by multislice computed tomography. Aug 2008 M Timur Selcuk,Hatice Selcuk,Omac Tufekcioglu,Kazim Baser,Nilgun Isiksalan Ozbulbul,Levent Birincioglu,Sule Korkmaz Cardiac involvement of the hydatid disease is uncommon. In this report a case of 54-year-old patient with a hydatid cyst in the interventricular septum was presented. The cyst was detected incidentally by cardiac multislice computed tomography and transthoracic echocardiographic appearances of the ... ( view more )cyst raised the suspicion of cardiac echinococcosis. The patient was referred to surgery immediately for the removal of the cyst in order to prevent the potentially life threatening complications. The postoperative period was uneventful and she was discharged on albendazole therapy. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles The impact of stigma on somatic treatment and care for people with comorbid mental and somatic disorders. Jul 2008 Levent Küey PURPOSE OF REVIEW: The problems associated with high rates of medical comorbidities among people with mental disorders have multidimensional consequences, including the challenge of their management. The stigma on the treatment of these complex situations is the focus of this review. The time span ... ( view more )and context of the review are set to cover the period from 2006 to the present; the review includes related themes of stigma. RECENT FINDINGS: The stigma attached to the management of somatic illnesses of patients with mental disorders is considered as a more recent issue of concern. Few relevant studies could be found. Medical comorbidities among people with mental disorders along with the treatment gap constitute a public-health problem. SUMMARY: The stigma attached to mental disorders in general forms the basis of the stigma towards the physical health problems of these patient groups. The impact of stigma on somatic treatment and care for people with comorbid mental and somatic disorders is discussed in its context as a public-health problem. Integrative services, and optimism and hope in health professionals are essential factors in reducing such stigma, and hence in enhancing better healthcare. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Consistent chromosome abnormalities identify novel polymicrogyria loci in 1p36.3, 2p16.1-p23.1, 4q21.21-q22.1, 6q26-q27, and 21q2. Jul 1, 2008 William B Dobyns,Ghayda Mirzaa,Susan L Christian,Kristin Petras,Jessica Roseberry,Gary D Clark,Cynthia J R Curry,Donna McDonald-McGinn,Livija Medne,Elaine Zackai,Julie Parsons,Dina J Zand,Fuki M Hisama,Christopher A Walsh,Richard J Leventer,Christa L Martin,Marzena Gajecka,Lisa G Shaffer Polymicrogyria is a malformation of cortical development characterized by loss of the normal gyral pattern, which is replaced by many small and infolded gyri separated by shallow, partly fused sulci, and loss of middle cortical layers. The pathogenesis is unknown, yet emerging data supports the exi... ( view more )stence of several loci in the human genome. We report on the clinical and brain imaging features, and results of cytogenetic and molecular genetic studies in 29 patients with polymicrogyria associated with structural chromosome rearrangements. Our data map new polymicrogyria loci in chromosomes 1p36.3, 2p16.1-p23, 4q21.21-q22.1, 6q26-q27, and 21q21.3-q22.1, and possible loci in 1q44 and 18p as well. Most and possibly all of these loci demonstrate incomplete penetrance and variable expressivity. We anticipate that these data will serve as the basis for ongoing efforts to identify the causal genes located in these regions. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Gingival crevicular fluid PGE2, IL-1beta, t-PA, PAI-2 levels in type 2 diabetes and relationship with periodontal disease. Jul 2008 Levent Karde?ler,Nurcan Buduneli,Ba?ak Biyiko?lu,Sevki Cetinkalp,Necil Kütükçüler OBJECTIVES: To evaluate if type 2 diabetes mellitus increase gingival crevicular fluid (GCF) levels of prostaglandin E(2) (PGE(2)), interleukin-1beta (IL-1beta), tissue-type plasminogen activator (t-PA), and plasminogen activator inhibitor-2 (PAI-2). DESIGN AND METHODS: Seventeen type 2 diabetic pa... ( view more )tients with periodontal disease (DM), 17 otherwise healthy periodontally diseased patients (PD) and 17 systemically and periodontally healthy control subjects (H) were enrolled. Clinical periodontal measurements were recorded at six sites/tooth. GCF samples were analyzed by ELISA. Data were tested by statistical tests. RESULTS: DM group revealed lower IL-1beta levels than PD group (p<0.01). PGE(2), t-PA and PAI-2 levels were similar in DM and PD groups (p>0.05). PGE(2), t-PA levels were higher in DM and PD groups than H group (p<0.05). PAI-2 level was higher in DM group than H group (p<0.05). GCF total amount of PGE(2) in DM group exhibited significant correlations with all clinical periodontal measurements (p<0.05). CONCLUSION: Type 2 diabetes in this study seems not to increase GCF levels of the evaluated inflammatory mediators. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Negative phase advance in polarization independent, multi-layer negative-index metamaterials. Jun 9, 2008 Koray Aydin,Zhaofeng Li,Levent Sahin,Ekmel Ozbay We demonstrate a polarization independent negative-index metamaterial (NIM) at microwave frequencies. Transmission measurements and simulations predict a left-handed transmission band with negative permittivity and negative permeability. A negative-index is verified by using the retrieval procedure... ( view more ). Effective parameters of single-layer and two-layer NIMs are shown to be different. Negative phase advance is verified within the negative-index regime by measuring the phase shift between different sized negative-index metamaterials. Backward wave propagation is observed in the numerical simulations at frequencies where the phase advance is negative. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Off-pump coronary artery bypass surgery in patients with chronic renal failure. Jun 2008 Omer Tetik,Bilgin Emrecan,Berkan Ozpak,Levent Yilik,Mert Kestelli,Nagihan Karahan,Cengiz Ozbek,Ali Gürbüz OBJECTIVE: Patients with dialysis-dependent renal disease frequently present with coronary artery disease. These patients are considered to be at high risk for coronary artery bypass grafting. Therefore, off-pump coronary artery surgery may become a good option for these patients. Off-pump coronary... ( view more ) artery bypass surgery in patients with dialysis-dependent renal failure was retrospectively reviewed in this study. METHODS: From March 2001 through May 2005, we performed off-pump coronary bypass grafting in 10 patients with dialysis-dependent renal failure. Coronary artery bypass grafting was performed on beating heart in all of the patients. The patients were evaluated for perioperative variables and postoperative outcomes. RESULTS: Mean age was 58.7+/-8.9 years with a range between 45 to 76 years. Eight of the patients were male and two were female. No perioperative and postoperative deaths or ischemic cardiac events were observed. Anginal symptoms of the patients were relieved during the postoperative period. Functional status of the patients was improved postoperatively. None of the patients needed revision due to hemorrhage. Mean distal anastomosis number was 1.8+/-0.6. Mean intensive care unit stay was 1.8+/-0.8 days and hospital stay was 5.3+/-0.9 days. CONCLUSION: Off-pump coronary artery bypass grafting can be performed with good clinical results. We believe that off-pump coronary revascularization is a good option in patients with dialysis-dependent renal failure. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles MRI and DSA findings in popliteal artery entrapment syndrome. Jun 2008 U?ur Ozkan,Levent O?uzkurt,Fahri Tercan,Aysin Pourbagher PURPOSE: To evaluate magnetic resonance imaging (MRI) and digital subtraction angiography (DSA) findings in popliteal artery entrapment syndrome. MATERIALS AND METHODS: Seven limbs of 6 patients (5 men and 1 woman; mean age, 36 +/- 12 years) with popliteal artery entrapment syndrome were evaluated ... ( view more )retrospectively. Both MRI and DSA were performed on each affected limb. RESULTS: MRI findings established the diagnosis of type-3 popliteal artery entrapment syndrome in 4 limbs, and type-2 in 3 limbs. Abnormal MRI findings included popliteal artery thrombosis with aneurysm in 2 limbs (29%), popliteal artery thrombosis without aneurysm in 1 limb (14%), aberrant fibrous band in 3 limbs (43%), aberrant thick muscle bundle in 1 limb (14%), insertion anomaly of medial head of the gastrocnemius muscle (MHG) in 3 limbs (43%), lateral deviation of the MHG in 4 limbs (57%), hypertrophy of the MHG in 1 limb (14%), and atrophy of the MHG in 2 limbs (29%). Deviation of the popliteal artery in 4 limbs (57%) and distal crural embolic occlusions in 2 limbs (29%) were detected with both angiography and MRI imaging. DSA was diagnostic in 2 limbs of 1 patient, and MRI was diagnostic in all limbs examined. CONCLUSION: Popliteal artery entrapment syndrome should be considered in patients younger than 50 years of age with isolated popliteal artery stenosis or occlusion. MRI is the preferred imaging modality for diagnosis of entrapment syndrome, and may obviate the use of DSA. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Talonavicular joint approach to the talar body: a cadaver study. Jun 2008 Kamil Cagri Kose,Oguz Cebesoy,Volkan Ergan,Gokhan Maralcan,Levent Altinel,Ahmet Songur,Ilhami Kuru BACKGROUND: Lesions of the talar dome or tumors within the talar body may require an open approach with medial or lateral malleolar osteotomies. The aim of this study was to evaluate the possibility and feasibility of a new minimally invasive approach without osteotomy, using the talonavicular join... ( view more )t (TJ) as the entry portal for lesions of the talar body. MATERIALS AND METHODS: Nine cadaveric feet were used for this study. Using the TJ and a 5-mm skin incision we aimed to reach the superolateral, superomedial, inferolateral and inferomedial corners of the talar body under fluoroscopy. A 2-mm Kirshner wire and a 4-mm cannulated drill bit were used to reach the desired target area and an angled curette was used for curettage after reaching the target. The proximity of vascular structures to the entry portal was noted. The talar and navicular joint surfaces were checked for any damage. The articular areas of the talar heads and the defect areas were measured. RESULTS: All 4 targets and even the posterior talus could be reached by this approach. The nearest neurovascular structures were the saphenous vein and the saphenous nerve. The navicular cartilage was not damaged in any specimen. The talar defect area corresponded to only 3.3% of the talar head cartilaginous area. CONCLUSION: The TJ approach can be used to reach lesions in all regions of the talar body without the need for an osteotomy. A mini-incision may be used to retract the saphenous nerve and vein. Damage to the talar head cartilage is minimal with this approach which requires no special equipments. CLINICAL RELEVANCE: This study shows that talar dome lesions can be reached with a minimally invasive method. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Endolymphatic sac papillary tumor: a case report and review. Jun 2008 Ismail Yilmaz,Filiz Bolat,Beyhan Demirhan,Volkan Aydin,Levent N Ozluoglu Endolymphatic sac papillary tumor (endolymphatic sac adenoma, temporal-mastoid bone adenoma or adenocarcinoma, low-grade adenocarcinoma of potential endolymphatic sac origin, aggressive papillary tumor of the temporal bone, Heffner's tumor) is a rare lesion that involves the temporal bone. This tum... ( view more )or usually appears alone, but in 11-30% of afflicted individuals, it is accompanied by von Hippel-Lindau disease. Endolymphatic sac papillary tumors are destructive tumors that exhibit locally aggressive behavior. They slowly grow into the posteromedial section of petrous temporal bone. The main symptoms produced by these lesions include hearing loss and cranial nerve deficits. Endolymphatic sac papillary tumors develop in two principal patterns that histopathologically form follicular and papillary or solid structures. Those two patterns are usually manifested in the same tumor. Immunochemical analysis of these tumors usually reveals cytokeratin, vimentin, epithelial membrane antigen, and (less frequently) S-100 protein and neuron-specific enolase. Local excision is curative for endolymphatic sac papillary tumors. The currently favored method of treatment consists of excision and long-term follow-up. The role of adjuvant radiotherapy as treatment is controversial. This case report describes an endolymphatic sac tumor in a 22-year-old woman without von Hippel-Lindau disease who had a number of complaints, including deafness in her left ear, complete left-sided facial paralysis, and hoarseness of approximately 8 years' duration. 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