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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 4,175) Sort By: Publication Date Relevance Took: 0.501 seconds to search 17,750,454  Action: Copy Results to new Clipboard Build Search Link Page 1 of 167 1 2 3 4 > Last >> (4175 articles found) Living donor liver transplantation for hepatitis B cirrhosis. Dec 2007 Zeki Karasu,Murat Akyildiz,Murat Kilic,Murat Zeytunlu,Unal Aydin,Fatih Tekin,Funda Yilmaz,Tijen Ozacar,Ulus Akarca,Galip Ersoz,Fulya Gunsar,Tankut Ilter,Michael R Lucey BACKGROUND AND AIM: Living donor liver transplantation (LDLT) has particular advantages for Turkey where hepatitis B virus (HBV) infection is the most common cause of cirrhosis, both because LDLT circumvents the difficulties encountered in the emerging world in providing deceased donor organs, and ... ( view more )because it allows preemptive antiviral therapy. The aim of this study was to review one institution's experience with LDLT in patients with chronic HBV infection. METHODS: A total of 109 patients with chronic HBV infection underwent LDLT between September 1999 and June 2005, of whom 40 were coinfected with hepatitis D virus and 23 had hepatocellular carcinoma. Antiviral prophylaxis was attempted in all, beginning prior to transplantation with lamivudine or adefovir, and continuing after transplantation with low dose intramuscular hyperimmune B immunoglobulin (HBIg) plus lamivudine or adefovir. RESULTS: In a median follow up of 20 months (range 1-66 months), there was no donor mortality. One-year recipient survival was 90%, and in total 16 recipients died. None of the deaths was related to HBV. Recurrence of HBV infection was detected by reappearance of serum hepatitis B surface antigen in six patients (5.5%) at 5, 8, 12, 17, 34 and 46 months after transplantation, respectively. There was no influence of donor hepatitis B core antibody status on the likelihood of recurrence of HBV in the allograft. CONCLUSION: The results indicate that LDLT with antiviral treatment and low dose HBIg provides excellent results for donors and recipients. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Adefovir dipivoxil therapy in liver transplant recipients for recurrence of hepatitis B virus infection despite lamivudine plus hepatitis B immunoglobulin prophylaxis. Dec 2007 Murat Akyildiz,Zeki Karasu,Murat Zeytunlu,Unal Aydin,Tijen Ozacar,Murat Kilic BACKGROUND: Treatment of post-transplantation recurrence of hepatitis B virus (HBV) infection despite prophylaxis with hepatitis B immunoglobulin (HBIG) and lamivudine combination therapy is not easy. Because HBV reinfection has a severe course and could result in graft failure in liver transplant ... ( view more )recipients, prompt medication is essential. Herein is reported the authors' experience with adefovir dipivoxil (AD) therapy in 11 liver transplant recipients who had HBV reinfection despite the administration of lamivudine and HBIG. METHOD: Two-hundred and nine patients underwent liver transplantation (100 deceased donor liver transplantations [DDLT], 109 living donor liver transplantation [LDLT]) due to chronic hepatitis B infection between April 1997 and May 2005 in Ege University Medical School, Liver Transplantation Unit. Patients had prophylaxis with lamivudine and low-dose HBIG combination after liver transplantation. Treatment of recurrence consisted of AD 10 mg once a day and lamivudine 300 mg/daily and HBIG was discontinued in those patients. RESULTS: In total there were 11 HBV recurrences: five occurred in DDLT recipients and six in LDLT recipients, at a median follow up of 18 months (range, 6-48 months). In one of 11 patients, pretransplant HBV-DNA and HBeAg were positive. Three patients had a severe course and one patient had fibrosing cholestatic hepatitis. After AD treatment, HBV-DNA level decreased in all patients and became negative in seven patients. Two patients died due to hepatocellular carcinoma recurrence after 12 and 14 months of follow up. Serum creatinine level increased mildly in one patient and no other side-effect was observed, and all patients continued therapy. CONCLUSION: Adefovir dipivoxil is a safe, effective treatment option for post-transplant HBV recurrence even among patients with fibrosing cholestatic hepatitis caused by lamivudine-resistant HBV. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Thorax deformity, joint hypermobility, and anxiety disorders. Dec 2007 Murat Gulsun,Mehmet B Yilmaz,Murat Pinar,Murat Tonbul,Cemil Celik,Barbaros Ozdemir,Kemal Dumlu,Mevlut Erbas OBJECTIVE: To evaluate the association between thorax deformities, panic disorder, and joint hypermobility METHODS: The study includes 52 males diagnosed with thorax deformity, and 40 healthy male controls without thorax deformity, in Tatvan Bitlis and Isparta, Turkey. The study was carried out fro... ( view more )m 2004 to 2006. The teleradiographic and thoracic lateral images of the subjects were evaluated to obtain the Beighton scores; subjects' psychiatric conditions were evaluated using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-1), and the Hamilton Anxiety Scale (HAM-A) was applied in order to determine the anxiety levels. Both the subjects and controls were compared in sociodemographic, anxiety levels, and joint mobility levels. In addition, males with joint hypermobility and thorax deformity were compared to the group with thorax deformity without joint hypermobility. RESULTS: A significant difference in HAM-A scores was found between the groups with thorax deformity and without. In addition, 21 subjects with thorax deformity met the joint hypermobility criteria in the group with thorax deformity, and 7 subjects without thorax deformity met the joint hypermobility criteria in the group without thorax deformity, according to Beighton scoring. The Beighton scores of the subjects with thorax deformity were significantly different from those of the group without deformity. Additionally, anxiety scores of the males with thorax deformity and joint hypermobility were found higher than males with thorax deformity without joint hypermobility. CONCLUSION: Anxiety disorders, particularly panic disorder, have a significantly higher distribution in male subjects with thorax deformity compared to the healthy control group. In addition, the anxiety level of males with thorax deformity and joint hypermobility is higher than males with thorax deformity without joint hypermobility. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Live donor liver transplantation for acute liver failure. Aug 27, 2007 Murat Kilic,Unal Aydin,Aysin Noyan,Cigdem Arikan,Sema Aydogdu,Murat Akyildiz,Zeki Karasu,Murat Zeytunlu,Mehmet Alper,Yucel Batur BACKGROUND: Acute liver failure (ALF) carries a high mortality unless urgent orthotopic liver transplantation (OLT) is performed on time. Live donors are utilized to treat this irreversible condition first in pediatric cases and then in adults. Herein, we aimed to report our experience with live do... ( view more )nors for ALF in a country of a deceased donor organ donation rate is only 1.5 per million people. METHODS: Among the 245 live donor liver transplantations (LDLT) performed from June 1999 to December 2005, 14 of them (6%) were performed for ALF in 8 pediatric and 6 adult cases. Right lobes were harvested for the adult cases whereas left lateral segments were harvested for pediatric cases, except one child transplanted with a right lobe graft. The etiology of the disease was; acute hepatitis B in four cases, hepatitis A in three cases, Wilson disease two cases, autoimmune hepatitis in two cases, and was unknown in three cases. RESULTS: Three-year graft and patient survival is 79% for these series. Five of the six adult patients and six of the eight pediatric cases survived after transplantation. There was not any donor mortality or major morbidity. CONCLUSIONS: LDLT offers a safe and effective modality of treatment for ALF for both pediatric and adult patients to overcome the problem of organ shortage especially in countries where the chance of receiving an organ from a deceased donor is low. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Comparison between allogenic and autologous vascular conduits in the drainage of anterior sector in right living donor liver transplantation. Aug 2007 Murat Kilic,Unal Aydin,Murat Sozbilen,Ilter Ozer,Sadik Tamsel,Gulgun Demirpolat,Yuksel Atay,Mehmet Alper,Murat Zeytunlu Congestion of the anterior sector may lead to graft failure in right lobe grafts. Selective drainage of the prominent segment 5 and/or 8 veins is proposed to overcome this problem. Different vascular conduits may be used during drainage of the anterior sector. In this study, we evaluated the effici... ( view more )ency of the vascular conduits. Between June 1999 and December 2005, 190 patients underwent living donor right lobe liver transplantation and reconstruction of segment 5 and/or 8 veins was performed in 48 patients (25.2%). Two groups were formed according to the types of vascular conduits. Cryopreserved cadaveric iliac artery (n = 28) and cryopreserved cadaveric iliac vein (n = 8) were used in group A. In group B, recipient saphenous vein (n = 6), recipient umbilical vein (n = 5) and recipient collateral omental vein (n = 1) were used for reconstruction. The graft-recipient weight ratio, mean duration of anhepatic phase and MELD scores between two groups were not significantly different. All of the conduits were found to be patent just after reperfusion and in the early postoperative period by Doppler ultrasonography. In follow-up period of 1 year, four (11%) patients died in group A, two patients (16%) in group B. One of these patients died because of sepsis started from the saphenous vein incision site. None of the patients dying in the two groups were lost due to venous outflow problems. This study proves the efficacy of drainage of segment 5 and/or 8 veins using cryopreserved cadaveric vascular conduits. Every effort should be employed to store cadaveric iliac vessels, otherwise, whole other additive surgical intervention to ensure vascular conduit may lead uninvited serious complication. ( view less ) View Full Abstract View Article Details   Related Articles The comparative effects of calcium channel blockers in an experimental colitis model in rats. Dec 2004 Murat Zeytunlu,Mustafa Korkut,Erhan Akgün,Ozgür Firat,Murat Aynaci,Gökhan Içöz,Murat Kiliç,Sinan Ersin,Omer Ozütemiz BACKGROUND/AIMS: In this study two calcium channel blockers (CCB), diltiazem and verapamil, which demonstrate their effects on two different receptor blockage mechanisms, were assessed comparatively in an experimental colitis model regarding the local and systemic effect spectrum. METHODS: Eighty m... ( view more )ale Swiss albino rats were divided into eight groups (n:10 each): Group I) colitis was induced with 1 ml 4% acetic acid without any medication. Group II) Sham group. Group III) Intra-muscular (IM) diltiazem was administered daily for five days before inducing colitis. Group IV) IM verapamil was administered daily for five days before inducing colitis. Group V) Transrectal (TR) diltiazem was administered with enema daily for two days before inducing colitis. Group VI) TR saline was administered four hours before inducing colitis. Group VII) TR diltiazem was administered with enema four hours before inducing colitis. Group VIII) TR verapamil was administered with enema four hours before inducing colitis. All subjects were sacrificed 48 hours after the colitis induction. The distal colon segment was assessed macroscopically and microscopically for the grade of damage, and myeloperoxidase (MPO) activity was measured. RESULTS: All the data of the control colitis group (group I), including the microscopic, macroscopic and MPO activity measurements, were significantly higher than in the groups in which verapamil and diltiazem were administered over seven days (3.100+/-0.7379 to 1.300+/-0.9487 and 1.600+/-0.9661) (p<0.05). The data of the Sham group, group II, were less than the other groups in which colitis was induced (p<0.05). For the local effect spectrum, after the assessment of groups V-VIII, the control colitis group (group I) and group VI had significantly higher values than the others (3.300+/-0.4830 to 1.800+/-0.6325 and 1.700+/-0.8233 (p<0.05). CONCLUSIONS: Calcium channel blockage has systemic and local effects on the colitis model. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Ascending aortic dissection without intimal tear: a case report. 2002 Mehmet Kaplan,Fikri Yapici,Murat Erkan,Murat Sargin,Mahmut Murat Demirtas Aortic dissection may occur without the presence of intimal tear, and it may occur with medial dissection and intramural hematoma. We report a case in which mediastinal enlargement was found in the chest x-ray of a 79-year-old patient with chest and back pain that had started suddenly 1 week before... ( view more ). The patient had a decrease in hematocrit, and transthoracic echocardiography revealed around the heart pericardial fluid 5 cm thick. The ascending aorta could not be evaluated because of the presence of this fluid. The preoperative diagnosis, based on the computerized tomography findings (dissection of ascending aorta and pericardial fluid), was ruptured dissection of the ascending aorta. The patient underwent an emergency operation. Two liters of hemorrhagic fluid was aspirated from the pericardium during the operation. The ascending aorta was opened, but there was no intimal tear. Medial dissection and intramural hemorrhage were seen. The ascending aorta was replaced with a tube graft. Cases such as this, of medial dissection and intramural hematoma in which intimal integrity is preserved, should be approached in the same manner as classical dissections with intimal tear. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Urgent adult-to-adult right lobe living donor liver transplantation for acute liver failure; a single center experience from Turkey. 2007 Apr-May Zeki Karasu,Murat Akyildiz,Murat Zeytunlu,Aysin Noyan,Yildiray Yuzer,Yaman Tokat,Murat Kilic BACKGROUND/AIMS: Acute liver failure is a fatal condition unless an urgent liver transplantation is performed. In countries like Turkey, because of limited availability of cadaveric allografts, living donors could be used as an organ source for acute liver failure. We report our single center exper... ( view more )ience. METHODOLOGY: Six adult-to-adult right lobe living donor liver transplantations have been performed for those patients admitted with fulminant liver failure between September 2000 and April 2004. RESULTS: The age of the patients ranged between 19 and 54 years. Etiology was fulminant hepatitis B in 4 patients, Wilson's disease in 1 patient, and unknown in 1 patient. Five of 6 patients survived and are currently alive and well with a mean 30 (2-46) months follow-up. None of the survivors had neurological sequela. One patient died because of sepsis 2 months after transplantation. There was no donor mortality. CONCLUSIONS: Adult-to-adult right lobe living donor liver transplantation seems to be an effective and safe option for patients with fulminant liver failure, especially in countries with a limited number of available cadaveric donors. ( view less ) View Full Abstract View Article Details   Related Articles Late onset rheumatoid arthritis: clinical and laboratory comparisons with younger onset patients. 2006 Mar-Apr Nuran Turkcapar,Ozgur Demir,Teslime Atli,Murat Kopuk,Murat Turgay,Gulay Kinikli,Murat Duman We aimed to compare the clinical and laboratory profiles of the patients presenting late onset rheumatoid arthritis (LORA) with younger onset rheumatoid arthritis (YORA) patients. During the period between January 1995 and December 2004, 124 patients with LORA were identified from a retrospective c... ( view more )hart review of inpatients and outpatients. They were compared with 150 YORA patients examined during the same period including their clinical and laboratory findings. The mean ages of the patients with LORA and YORA were 71.7+/-5.9 years, and 52.1+/-11.5 years, respectively. The gender ratio (female/male) was 1.48 in LORA and 2.85 in YORA (p = 0.012). The average ages of the disease onset were 42.2+/-10.4 years in YORA and 68.4+/-4.6 years in LORA. The duration of the diagnosis was longer in LORA than in YORA (20.7+/-14.3 months versus 10.3+/-6.2 months, p < 0.001). Rheumatoid arthritis (RA) duration was shorter in LORA than in YORA (43.5+/-64.4 months versus 126.3+/-101.0 months, p < 0.001). Although LORA patients had more significant frequent shoulder joint involvements (p < 0.001), proximal interphalangeal (PIP), metacarpophalangeal (MCP), elbow, metatarsophalangeal (MTP) and ankle involvements were common in YORA. Wrist, knee and hip involvements were not different in the groups. Classical rheumatoid hand deformities, interstitial lung disease and Sjögren's syndrome (SS) were significantly lower in LORA than in YORA. LORA patients had more common weight loss, myalgia, lymphadenopathy, polymyalgia rheumatica (PMR)-like syndrome and neuropathy. The frequencies of RF, ANA, anti-SSA/Ro and anti-SSB/La positivities were lower in LORA than in YORA, whereas elevated erythrocyte sedimentation rates (ESR), C-reactive protein (CRP) and anemia associated with chronic disease were higher in LORA. Patients with LORA, according to the accepted international criteria, present with different clinical and laboratory profiles when compared with younger patients. These results suggest that age may influence the presentation of RA at onset. ( view less ) View Full Abstract View Article Details   Related Articles Assessment of the autonomic nervous system is an appropriate biological marker for the well-being in erectile dysfunction. Jul 2008 Tolga Dogru,Orhan Murat Kocak,Nurper Erberk-Ozen,Murat Basar AIM: To investigate whether the autonomic nervous system (ANS) components are suitable biological markers for representing well-being in patients with erectile dysfunction (ED). METHODS: The present study included 74 male patients who had applied for check-ups in the cardiology outpatient clinic at... ( view more ) Kirikkale University (Kirikkale, Turkey) and who had been diagnosed as having hyperlipidemia. Of these patients, 26 had an additional diagnosis of ED and made up the patient group. The remaining 48 patients formed the control group. Well-being was assessed with short-form 36 (SF-36). The International Index of Erectile Function (IIEF) was used as a measure of libido and erectile function. Quantitative assessment of the ANS was made based on the analysis of heart rate variability by means of 24-h holter monitorization. RESULTS: Comparisons between the ED and control groups showed significant differences only in energy scale of SF-36. The ED group also had significantly higher values of sympathetic activity. Except for the general health score of SF-36, which was found to be correlated with parasympathetic activity only in ED group, there were similar correlation patterns within the groups. Although well-being and sympathetic activity were correlated negatively, parasympathetic activity and well-being were correlated positively. CONCLUSION: Quantitative assessment of the ANS by heart rate variability analysis might be a suitable marker for well-being of patients with ED. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Timing of Roux-en-Y limb reconstruction for pediatric live donor liver transplantation. May 27, 2008 Unal Aydin,Pinar Yazici,Hasan Yuksekkaya,Cigdem Arikan,Sema Aydogdu,Murat Zeytunlu,Murat Kilic BACKGROUND: Roux-en-Y (R-Y) hepaticojejunostomy is usually accepted as the standard method of choice for biliary reconstruction in pediatric cases though the potential risks for gastrointestinal complications are higher. In this study, we examined gastrointestinal complications in pediatric patient... ( view more )s by comparing two different strategies of R-Y reconstruction with respect to the portal clampage time. METHODS: Forty-three pediatric recipients who underwent Live Donor Liver Transplantation with R-Y for biliary reconstruction between March 2001 and December 2006 in our transplantation center were divided into two groups regarding the time of dissection and creation of the roux limb. R-Y limb reconstruction was performed before clampage of the portal vein in group A-preclampage group. In group B, because of prolonged catheterization period, R-Y limb was reconstructed after implantation of the graft (Group B- postclampage group). RESULTS: Overall, seven patients (16%) had gastrointestinal bleeding in the postoperative period, all in group B (0/20 vs. 7/23, P<0.01). One of those three cases who were diagnosed after endoscopy and one another were performed surgical treatment. Although remaining three cases had multiple bleeding episodes but no diagnostic findings by endoscopic/colonoscopic interventions, conservative treatment was successful and therefore, plausible R-Y limb bleeding was considered for these cases. The timing of removal of nasogastric tube and postoperative oral intake were also significantly earlier (P<0.01) in Group A than in Group B. CONCLUSION: In Live Donor Liver Transplantation, if recipient team may have enough time until the donor team got ready for the recovery of the graft, dissection and preparation of the R-Y limb should be performed. This approach can be helpful to avoid gastrointestinal complications due to the reconstruction of the R-Y limb. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Childhood cirrhosis, hepatopulmonary syndrome and liver transplantation. May 2008 Gokhan Tumgor,Cigdem Arikan,Hasan Ali Yuksekkaya,Murat Cakir,Erturk Levent,Rasit Vural Yagci,Murat Kilic,Sema Aydogdu OBJECTIVES: The hepatopulmonary syndrome (HPS) is characterized as a triad: liver disease, intrapulmonary vascular dilatation, and arterial hypoxemia. The aim of this study is to analyze outcome of children with HPS in liver transplant era. METHODS: Between September 1996 and November 2006, 172 cir... ( view more )rhotic patients (median age 5 years; range 0.2-22 years, M/F; 97/75) were followed at Ege University Pediatric Gastroenterology, Hepatology and Nutrition Unit. All patients were evaluated by chest radiography, arterial blood gas analysis, and alveolar-arterial oxygen tension difference, contrast echocardiography (CEE) after and before the liver transplantation. RESULTS: HPS was diagnosed in 33 patients (19%) by CEE. None of them had pulmonary hypertension. HPS was not found related to etiology of the liver disease. Portal hypertension was found related to the development of HPS (75.7% in patients with HPS and 54.6% in others, p = 0.02). 17 of 33 patients with HPS underwent liver transplantation. Preoperative and postoperative period of these patients was uneventful. Patients were extubated in the operating room except for two. Median follow up of transplanted children was 1.9 year (range; 0.75-10 years). Arterial blood gas analysis and CEE positivity regressed in all of them by postoperative 6th month. CONCLUSIONS: HPS is a serious and important complication of cirrhotic children that leads to tissue hypoxia and central cyanosis. HPS seems reversible after liver transplantation in all patients. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Acute myocardial infarction, ischemic cerebrovascular disease and variceal bleeding due to portal vein thrombosis in a patient with hereditary thrombophilia. Apr 2008 Bulent Baran,Yusuf Yilmaz,Oktay Algin,Murat Keskin,Murat Kiyici,Guzin Kocamaz,Enver Dolar We report on a 43-year-old female patient with multiple thrombotic risk factors who, in a few months, developed acute myocardial infarction, an ischemic cerebrovascular event and variceal bleeding due to portal vein thrombosis. The factor V Leiden mutation was carried in heterozygous form, homocyst... ( view more )eine was elevated at 19.6 micromol/l, and methylenetetrahydrofolate reductase C677T mutation was carried in homozygous form. Moderately increased plasma homocysteine level and a reduced protein S activity were evident. Anticardiolipin IgG antibodies were mildly positive. We conclude that the presence of multiple genetic and environmental risk factors greatly amplifies the risk of clinical thrombotic events. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles A rare cause of headache: cerebral venous sinus thrombosis due to hyperthyroidism. Mar 2008 Murat Pekdemir,Serkan Yilmaz,Murat Ersel,Hasan Tahsin Sarisoy Headache represents up to 4% of all emergency department (ED) visits. Emergency physicians generally are concerned with identifying those patients whose headaches are caused by life-threatening conditions. Cerebral venous sinus thrombosis may be difficult to diagnose clinically because of its vario... ( view more )us and nonspecific manifestations. The most frequent but least specific symptom of sinus thrombosis is severe headache, which is present in more than 90% of adult patients. In the case report we present, a patient had severe headache and was diagnosed until third ED visit at different hospitals. He had one of the most unusual causes of headache, that is, cerebral venous sinus thrombosis due to hyperthyroidism. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Ischemia-reperfusion injury of rabbit ovary and protective effect of trapidil: an experimental study. Mar 2008 Salih Somuncu,Murat Cakmak,Gunnur Dikmen,Hülya Akman,Murat Kaya We aimed to detect the protective effect of trapidil in ischemia-reperfusion (IR) injury due to ovarian torsion and detorsion. Thirty-two pubertal New Zealand albino rabbits were used. Adnexal torsion was created by rotating the left adnexa including the tubal and ovarian vessels in a 360 degrees c... ( view more )lockwise direction. Adnexal detorsion was done by untwisting the adnexa. In the IR group, left oopherectomy was performed after 3 h of adnexal torsion and 3 h of adnexal detorsion. In the study group, a 3-h adnexal torsion was performed and trapidil was administered intraperitoneally as a single dose of 40 mg/kg, 1 h before detorsion. The left oopherectomy was performed after a 3-h adnexal detorsion. In the sham group, sham operation was performed followed by left oopherectomy. In the control group, normal ovarian tissue was evaluated. Catalase, superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and malondialdehyde (MDA) levels of ovarian tissue were determined for each group. The values of SOD and GSH-Px activities in the IR group were significantly decreased (P < 0.05). In addition, the MDA level was significantly higher in the IR group (P < 0.01). The trapidil-administered group showed significant increase in the levels of GSH-Px (P < 0.05), catalase (P < 0.05), SOD (P < 0.05), and decreased MDA levels (P < 0.05) compared to those in the IR group. The study has shown that trapidil treatment prevents ischemia induced oxidative damage in the ovarian tissues of rabbits. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Asymmetrical dimethylarginine level in atrial fibrillation. Feb 2008 Atiye Cengel,Asife Sahinarslan,Gursel Bibero?lu,Alev Hasano?lu,Yusuf Tavil,Murat Tulmaç,Murat Ozdemir OBJECTIVE: Atrial fibrillation (AF) is known to be related with increased risk of thromboembolic events. Asymmetrical dimethylarginine (ADMA), which is an endogenous inhibitor of nitric oxide synthase (NOS), can cause endothelial dysfunction by decreasing nitric oxide (NO) and lead to increased ris... ( view more )k of thrombosis. In the present study our aim was to compare plasma levels of ADMA in patients with acute onset (< 24 hours) and chronic AF (> 1 year) to determine the risk of thrombosis. METHOD: 17 patients with the first detected attack of AF within the first 24 hours of presentation (group 1), 25 patients who had permanent chronic AF lasting at least 1 year or more (group II) and 18 healthy persons as the control group (group III) were included in the study. For each patient the plasma ADMA, L-arginine, symmetrical dimethylarginine (SDMA) concentrations were measured by high-performance liquid chromatography in venous blood samples collected before cardioversion. We compared the plasma ADMA, L-arginine and SDMA concentrations between the groups. RESULTS: Plasma L-arginine (78.18 +/- 28.29 vs. 73.14 +/- 14.11 vs. 71.03 +/- 21.31, P = 0.549) and plasma SDMA concentrations (0.38 +/-0.18 vs. 0.42 +/- 0.21 vs. 0.32 +/- 0.24, P = 0.224) were similar in all groups. There was a significant difference between plasma ADMA concentrations (0.76 +/- 0.27 vs. 0.50 +/- 0.26 vs. 0.36 +/- 0.20, P < 0.001) among the groups. When we compared plasma ADMA levels between the subgroups, we also found a significant difference (P = 0.002 when comparing group I and group II, P < 0.001 when comparing of group I and group III, P = 0.042 when compareng of group II and group III). CONCLUSION: ADMA levels in patients with acute onset AF were significantly increased when compared with patients with chronic AF and the healthy control group indicating the presence of endothelial dysfunction and a prothrombotic state even in a very early phase of AF. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Early prediction of anastomotic leakage after colorectal surgery by measuring peritoneal cytokines: prospective study. Feb 2008 Burak U?ra?,Murat Giri?,Ye?im Erbil,Murat Gökpinar,Gamze Citlak,Halim I?sever,Alp Bozbora,Serdar Oztezcan BACKGROUND: Anastomotic leakage (AL) is a major cause of postoperative mortality and morbidity in colorectal surgery. We investigated the early prediction of peritoneal cytokine levels in developing AL after colorectal surgery. METHODS: Thirty-four patients with colorectal carcinoma, who underwent ... ( view more )elective surgery, were included prospectively. Peritoneal samples were collected on the fifth postoperative day and interleukin (IL)-6, IL-10 and tumor necrosis factor-alpha were measured. Patients were divided into two groups: those with clinical evidence of AL (group 1) and those without any evidence of AL (group 2). RESULTS: Of the 34 patients undergoing anastomoses, clinically evident AL occurred in 4 patients (11.7%). There was a positive correlation between AL and peritoneal cytokine levels and blood loss and operation time and hospital stay. Peritoneal cytokine levels were significantly higher in group 1 as compared to group 2. The significant increase in patients with AL was observed between peritoneal cytokine levels and the postoperative days. However, a significant decrease in patients without AL was observed. CONCLUSION: The peritoneal cytokine levels can be an additional diagnostic tool that can support the early prediction of AL in colorectal surgery. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Three-dimensional nasal reconstruction using a prefabricated forehead flap: case report. Jan 2008 Murat Sahin Alagöz,Tonguç I?ken,Cenk Sen,Murat Onyedi,Hakki Izmirli,Ergin Yücel Surgical treatment is extremely difficult with the combined defects of skin, cartilage, and nasal mucosa. Besides efforts geared toward ascertaining the best aesthetic outcome, an important concern is restoring normal nasal function. This can be achieved only by providing sufficiently and anatomica... ( view more )lly adapted cartilage and bone support, followed by covering the inner part using tissue closely resembling mucosa and the outer part using skin compatible with the surrounding skin. The surgical technique for three-dimensional nasal reconstruction in the first session of this study involved placing a silicon sheet between the skin and galea, which allowed two separate flaps to be obtained for the next session without vascular damage. For the epithelialization of the defect on the nasal surface, the lower surface of the galea was prefabricated with a thin skin graft obtained from the thigh. In this way, nasal mucosa cover was ensured. The expander placed under all these structures thinned them down to a thickness close to that of nasal skin and mucosa and also enabled primary closure of the donor area. Thus, the defect that emerged during the second session in cartilage framework was repaired by cartilage grafts taken from the nasal septum. The mucosal surface and skin part then could be closed with two separate flaps. The forehead flap used in this technique enabled production of an aesthetically and functionally satisfactory outcome by providing an anatomically sufficient amount of nasal skin and nasal mucosa for whole-layer wide nasal defects in only three sessions without necessitating an additional flap. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Maprotiline induced weight gain in depressive disorder: changes in circulating ghrelin and adiponectin levels and insulin sensitivity. Jan 1, 2008 Murat Pinar,Murat Gulsun,Ilker Tasci,Ahmet Erdil,Erol Bolu,Cengizhan Acikel,Ali Doruk Agents such as clozapine, olanzapine and mirtazapine frequently trigger an increase in body weight. Though the mechanisms have not been thoroughly clarified, recent studies indicate a role for ghrelin in regulation of appetite and weight gain. We investigated the relation of maprotiline induced wei... ( view more )ght gain to serum ghrelin and adiponectin levels, as well as insulin resistance in lean subjects with depressive disorder. A total of 40 male lean subjects with depressive disorder were treated with maprotiline (150 mg/day) for 30-days. Clinical data, fasting plasma glucose, lipids, insulin levels, serum ghrelin and adiponectin concentrations were determined before and after treatment. Insulin resistance was estimated using the homeostasis model assessment (HOMA) formula. After 30 days of treatment with maprotiline, mean body mass index increased significantly. Blood ghrelin and insulin levels and HOMA indexes increased, and adiponectin concentration decreased (p<0.001, for all) after the treatment period. Changes in ghrelin levels correlated neither of the parameters tested; whereas decrease in plasma adiponectin was associated with an increase in BMI (r=-0.671, p<0.001). In conclusion, the results indicate that treatment of lean patients with depressive disorder with maprotiline results in an increase in serum ghrelin and reduction in adiponectin levels. Weight gain due to maprotiline treatment may be related to its negative effects on the metabolic variables. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Evaluation of leukocyte esterase and nitrite strip tests to detect spontaneous bacterial peritonitis in cirrhotic patients. Dec 7, 2007 Serkan Torun,Enver Dolar,Yusuf Yilmaz,Murat Keskin,Murat Kiyici,Melda Sinirtas,Emre Sarandol,Selim Gurel,Selim-Giray Nak,Macit Gulten AIM: To investigate the diagnostic efficacy of leukocyte esterase and nitrite reagent strips for bedside diagnosis of spontaneous bacterial peritonitis (SBP). METHODS: A total of 63 consecutive patients with cirrhotic ascites (38 male, 25 female) tested between April 2005 and July 2006 were include... ( view more )d in the study. Bedside reagent strip testing was performed on ascitic fluid and the results compared to manual cell counting and ascitic fluid culture. SBP was defined as having a polymorphonuclear ascites count of >or= 250/mm(3). RESULTS: Fifteen samples showed SBP. The sensitivity, specificity, positive and negative predictive values of the leukocyte esterase reagent strips were; 93%, 100%, 100%, and 98%, respectively. The sensitivity, specificity, positive and negative predictive value of the nitrite reagent strips were 13%, 93%, 40%, and 77%, respectively. The combination of leukocyte esterase and nitrite reagents strips did not yield statistically significant effects on diagnostic accuracy. CONCLUSION: Leukocyte esterase reagent strips may provide a rapid, bedside diagnostic test for SBP. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Effects of intrapleural analgesia on pulmonary function and postoperative pain in patients with chronic obstructive pulmonary disease undergoing coronary artery bypass graft surgery. Dec 2007 Halide Ogus,Ozer Selimoglu,Murat Basaran,Cuneyt Ozcelebi,Murat Ugurlucan,Omer Ali Sayin,Eylul Kafali,Temucin Noyan Ogus OBJECTIVE: Pain after coronary artery bypass graft (CABG) surgery remains a significant problem and may cause serious complications because of restricted breathing and limited early mobilization. The aim of this study was to assess the effects of intrapleural analgesia on the relief of postoperativ... ( view more )e pain in patients undergoing CABG surgery. DESIGN: Postoperative pain, pulmonary function tests, and outcomes were compared with a placebo group after CABG surgery in a double-blind randomized clinical trial. Settings: Cardiovascular surgery clinic. PARTICIPANTS: One hundred twenty-five patients with decreased lung function were studied. INTERVENTIONS: Group A (62 patients) received 20 mL of 0.5% bupivacaine bilaterally in the intrapleural spaces every 6 hours for 4 days, and group B (63 placebo patients) received sterile saline solution. MEASUREMENTS AND MAIN RESULTS: Group A had a significantly shorter extubation time than the placebo group (8 +/- 1 h v 10 +/- 4 hours, p < 0.001). Blood gas analysis showed higher PaO2 and lower PaCO2 levels in group A. The patients receiving bupivicaine had significantly higher FEV1, FCV, VC, MVV, PEF, and FEF 25-75% values postoperatively when compared with the placebo group. Postoperative analgesic requirements and visual analog pain scales were significantly lower in group A. The intensive care unit stay in group A was shorter (1.2 +/- 0.7 v 1.4 +/- 0.6 days, p = 0.04); however, the hospital stay did not differ between groups. CONCLUSIONS: Improvement in lung function parameters correlating with decreased postoperative pain with intrapleural bupivacaine was observed. Intrapleural analgesia provided a good level of analgesia, improved respiratory performance, and allowed rapid mobilization, which led to a reduction of postoperative respiratory complications. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Rapid identification of disease-causing mutations using copy number analysis within linkage intervals. Dec 2007 Fatih Bayrakli,Kaya Bilguvar,Christopher E Mason,Michael L DiLuna,Yasar Bayri,Levent Gungor,Murat Terzi,Shrikant M Mane,Richard P Lifton,Matthew W State,Murat Gunel SNP and comparative genome hybridization arrays (aCGH) are powerful techniques for identifying genome rearrangements, deletions, and duplications. We hypothesized that current array-based detection of copy number variation (CNV) could complement parametric linkage analysis and allow the rapid ident... ( view more )ification of functional mutations in families with inherited disorders. Herein, we demonstrate the utility of this technique by rapidly identifying a disease causing microdeletion within the PARK2 gene in a family with autosomal recessive Parkinsonism. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Prevention of calcification with TPEN in pericardial bioprosthetic heart valve material. Dec 2007 H Ali Dönda?,Nejat Yilmaz,Ulkü Cömeleko?lu,Lülüfer Tamer,Nehir Sucu,Barlas N Aytaço?lu,Murat Ozeren,Necmi Köse,Murat Dikmengil OBJECTIVE: Calcification is a frequent cause of the clinical failure of bioprosthetic heart valves fabricated from glutaraldehyde pretreated bovine pericardium. The major object of the present study is to prevent calcification of pericardial bioprosthetic heart valve materials with TPEN. METHODS: B... ( view more )ovine pericardium was cut into 2-cm 2 pieces, rinsed in phosphate-buffered saline solution, transferred into +4 degrees C phosphate-buffered saline containing 0.625% glutaraldehyde for initial fixation for 48 h, and allocated into two groups. Control samples were treated in an identical fresh solution for five more days. Others underwent additional fixation in phosphate-buffered saline 2microM TPEN for 48 h. They were then transferred into phosphate-buffered saline + 0.625% glutaraldehyde solution at 37 degrees C (pH 7.4) for three more days. Pericardial patches were inserted into the dorsal pouches of 18 juvenile male Wistar rats as control and study groups. Rats were divided into two groups and sacrificed consecutively by the end of 9th and 12th weeks. The biomechanical properties and calcium contents of explanted tissues were tested and were also assessed histopathologically. RESULTS: The difference in the calcium contents of the control and study groups' pericardial tissues at the 9th, and 12th weeks were statistically significant (p=0.0001, p=0.0001). The comparison of calcium contents between controls of 9th and 12th weeks and study groups' of the 9th and 12th weeks pericardial tissues were also significant (p=0.0001 and p=0.0001). Histopathologic and biomechanical assessment also supported these findings. CONCLUSION: Calcific degeneration of glutaraldehyde-fixed bovine pericardium can be reduced by using TPEN without any effect on durability. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Liver transplantation for progressive familial intrahepatic cholestasis: clinical and histopathological findings, outcome and impact on growth. Sep 2007 Sema Aydogdu,Murat Cakir,C Arikan,Gokhan Tumgor,Hasan Ali Yuksekkaya,Funda Yilmaz,Murat Kilic In this study, we analyze the demographic features, clinical and histopathological findings in patients who underwent liver transplantation for progressive familial intrahepatic cholestasis. We also analyze outcome and impact of liver transplantation on growth and bone mineral content. Most of the ... ( view more )patients were presented with jaundice mainly beginning within the first six months. At the time of initial admission; eight patients had short stature (height SD score<2), and four patients had weight SD score<2. Liver transplantation were performed at the age of 43.2+/-27 months (range 9 to 96 months), 6.5+/-3.5 months later after the first admission. Infection, surgical complications and osmotic diarrhea associated with severe metabolic acidosis were noted in 41.4%, 16.6% and 33.3%, respectively. One patient developed posttransplant lymphoproliferative disorder. Overall; 1 year graft and patient survival was 69.2% and 75%, respectively. At the end of the 1st year only 2 patients had height SD score<2. Linear regression of height gain against increase in total body BMD measured at the time of transplantation and 1 year after liver transplantation gave a coefficient r=0.588 (p=0.074). No correlation was found between the height gain and age and PELD score at time of transplantation, and no difference was noted between the sexes and donor type. Liver transplantation is effective treatment modality with good outcome and little morbidity, and increases the growth acceleration in patients with PFIC associated with cirrhosis. ( view less ) View Full Abstract View Article Details   Related Articles Morphometric analysis of small-bowel mucosa in Turkish children with celiac disease and relationship with the clinical presentation and laboratory findings. Sep 2007 Cigdem Arikan,Cuneyt Zihni,Murat Cakir,Murat Alkanat,Sema Aydogdu We aimed to analyze morphometric features of the small-bowel mucosa in children with celiac disease, to assess the diagnostic limit values of morphometric findings, and to examine the association of morphometric findings with the clinical presentation and laboratory findings. The study comprised 33... ( view more ) patients with celiac disease and 35 pediatric patients undergoing endoscopy for other causes. Biopsy specimens were reanalyzed for (1) intraepithelial lymphocytes, (2) goblet cells, (3) villous height, and (4) villous/crypt ratio. The morphometric parameters of the patients were compared with controls. Then celiac patients were divided into two groups according to the presence of total villous atrophy and clinical and laboratory findings were compared. Histologic examination revealed that goblet cells, villus height, and villous/crypt ratio were significantly lower and intraepithelial lymphocytes were significantly higher in celiac patients. Cutoff values for intraepithelial lymphocytes and goblet cells in celiac patients were 31/100 and 7.8/100 epithelial cells, respectively. Moreover, for villus height and villous/crypt ratio, cutoff values were 633 microm and 0.72, respectively. Serum folic acid and vitamin B(12) levels were significantly lower in patients with total villous atrophy and were positively correlated with the severity of villous atrophy. We suggest that morphologic examination and laboratory data are important for definitive diagnosis. Villous/crypt ratio is the most sensitive and specific parameter, and intraepithelial lymphocytes may be used along with villous/crypt ratio, especially in the early phase. Folic acid and vitamin B(12) levels are good indicators of villous atrophy. 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