Amac: Ust ekstremite derin venoz trombozlari son yillarda artan invazif vaskuler girisimlere para... more Amac: Ust ekstremite derin venoz trombozlari son yillarda artan invazif vaskuler girisimlere paralel olarak daha sikca karsimiza cikmaktadir. Bu calismada risk faktorleri, bulgulari, tanisi ve tedavisi ile klinik gidisatini inceledigimiz ust ekstremite derin venoz tromboz (UEDVT) olgularimizi retrospektif olarak degerlendirmeyi amacladik. Yontem: Temmuz 1998 ile Temmuz 2002 tarihleri arasinda Doppler ultrasonografi ile tanisi dogrulanan 36 derin venoz trombozlu olgu calismamiza dahil edilmistir. Hastalarin 19'u (%52,7) erkek, 17'si (%47,3) kadin olup yas ortalamasi 54 ± 12,3 idi. Olgularin 13'unde (%36,1) santral venoz kateter mevcut olup bu risk faktoru en sik karsilasilan UEDVT nedeniydi. Bulgular: Tum hastalar etyolojik sebebe ve risk faktorlerine gore degerlendirilerek, tedavileri duzenlendi. Dusuk molekul agirlikli heparin (DMAH) ve sonrasinda ortalama 6 ay sureyle oral antikoagulan protokolu uygulandi. Tum hastalar 2 aylik peryodlarla bir yil suresince poliklinik t...
Objective: We aimed to determine the role of seasonal and meteorological variations in the incide... more Objective: We aimed to determine the role of seasonal and meteorological variations in the incidence of lower extremity deep venous thrombosis (DVT). Methods: A total of 296 patients with DVT for the first time were admitted to the Cardiovascular Surgery Clinic of the Alsancak State Hospital during the four-year period between January 1999 and December 2002. Of these cases, 151 were women (51%) and the average age was 58.8 years. We investigated the effect of each month and season on the onset of acute symptoms of DVT. Meteorological data were also compared during the onset of disease. Results: We found that DVT frequency significantly increased during the six-month period between October and March, particularly on the coldest winter days and when atmospheric pressure was low. Conclusions: Lower extremity DVT significantly correlates with meteorological variables such as cold temperatures and low atmospheric pressure. Further multicentric prospective studies are necessary to determi...
study was carried out by Gifford et al6 and found a successful vaginal delivery in 74% of patient... more study was carried out by Gifford et al6 and found a successful vaginal delivery in 74% of patients. This was comparative to our study, where the successful vaginal delivery rate was 72.3%. Our observation shows that the increase in maternal age might have adverse influence in successful vaginal breech delivery, however the association in our study failed to reach a statistical significance. Many obstetrician consider parity as an important criterion for selection of parturient to deliver vaginally, in our study, grand multipara (p>0.5) had a significant higher successful rate than nullipara group. The increase in maternal parity was a positive influence in successful vaginal delivery. This could be explained by the fact that, the history of previous successful vaginal delivery might affect the obstetrician decision regarding the choice of delivery. The pelvis of multipara has been already tested by the previous vaginal deliveries. Kayam et al7 his study did not show any increase in maternal or neonatal morbidity rate attributable to vaginal delivery. Iron et al8 found significantly lower maternal complication in planned vaginal delivery than elective CS and there was no differences in neonatal morbidity between the planned vaginal delivery and the elective CS group. Thropo-Beesteon et al,4 had a large retrospective study on 3447 singleton breech term fetus and concluded that good neonatal outcome with elective CS group than vaginal delivery. This study corresponds to our result on neonatal morbidity; it can be explained that the important issue to be consider when planning vaginal delivery includes careful selection of patient, obstetrical experience and judgment of intrapartum attendant. Although the recommendation now to do elective CS for flexed or complete breech singleton. We suggest that a trial of vaginal breech delivery is more likely to be successful if both mother and baby are of normal proportion with presentation either frank or complete and clinically adequate pelvis with no fetopelvic disproportion, the presence of an experience team of obstetrician, anesthetist and pediatrician in labor room may be more important than the planned mode of delivery. A trial of vaginal delivery in carefully selected patients with breech presentation at term might be safe procedure that was successfully completed in almost 72.3% of cases in our experience. In our retrospective study we found that, low maternal parity and increase maternal age have a negative influence on maternal progress of labor.
The creation of an arteriovenous fistula (AVF) is frequently used to achieve easier access for ha... more The creation of an arteriovenous fistula (AVF) is frequently used to achieve easier access for haemodialysis in patients with chronic renal insufficiency. The most frequent late complication of AVFs is aneurysm formation, which carries the risk of spontaneous rupture. This study reports on 18 patients with giant aneurysms that developed on antebrachial AVFs who were operated on over a period of 6 years. Colour duplex ultrasonographic examination of the upper extremity was performed in all but one patient in the preoperative period. Surgical management included resection of the aneurysm and re-establishment of arterial continuity. There were no complications such as infection, ischaemic extremity loss, neurological sequelae or mortality. Colour duplex ultrasonographic examinations after 6 months were all normal. The mean follow-up period was 29.1 months (range 7 − 50 months). There were no additional vascular complications observed during follow-up. Early surgical intervention is the...
We aimed to evaluate patients with upper extremity deep vein thrombosis (UEDVT) in terms of the r... more We aimed to evaluate patients with upper extremity deep vein thrombosis (UEDVT) in terms of the risk factors, symptoms, clinical course, diagnostic approaches and treatment outcome. Thirty-six patients with a diagnosis of UEDVT, comprising 19 males (52.7%) and 17 females (47.3%), were included in the study; the mean (± SD) age was 54 ± 12.3 years. The most common risk factor was central venous catheter use. The treatment protocol consisted of low molecular weight heparin for up to 7 days, followed by oral anticoagulants for up to 6 months. All patients were followed up for 1 year. More than 90% of the patients responded well to treatment. Nine patients (25%) died due to underlying diseases; no patients died secondary to UEDVT. None of the patients developed pulmonary embolus or recurrent deep venous thrombosis, and post-thrombotic syndrome was not observed. The mortality rate was related to the underlying diseases.
Current controlled trials in cardiovascular medicine, Jan 18, 2004
AIM: In order to avoid the complications associated with thromboembolic disease, patients with th... more AIM: In order to avoid the complications associated with thromboembolic disease, patients with this condition typically are placed on long-term anticoagulant therapy. This report compares bleeding complications in this patient population by level of achieved INR. MATERIALS AND METHODS: During the 6-year period between January 1997 and January 2003, 386 patients with venous thromboembolism of the lower extremities were admitted to the Cardiovascular Surgery Outpatient Clinic of Alsancak State Hospital. Of the 386 patients, 198 (51.2%) were women, and the average age was 52.3 years. All diagnoses of venous thromboembolism were confirmed by means of Doppler ultrasonography. Further investigation showed occult neoplasms in 22 (5.6%) of the cases. We excluded the patients with occult disease, and the remaining 364 constituted our study population. RESULTS: Oral anticoagulation was standardized at 6 months' duration in all cases. We divided the patients into two groups. Group I consis...
Amac: Ust ekstremite derin venoz trombozlari son yillarda artan invazif vaskuler girisimlere para... more Amac: Ust ekstremite derin venoz trombozlari son yillarda artan invazif vaskuler girisimlere paralel olarak daha sikca karsimiza cikmaktadir. Bu calismada risk faktorleri, bulgulari, tanisi ve tedavisi ile klinik gidisatini inceledigimiz ust ekstremite derin venoz tromboz (UEDVT) olgularimizi retrospektif olarak degerlendirmeyi amacladik. Yontem: Temmuz 1998 ile Temmuz 2002 tarihleri arasinda Doppler ultrasonografi ile tanisi dogrulanan 36 derin venoz trombozlu olgu calismamiza dahil edilmistir. Hastalarin 19'u (%52,7) erkek, 17'si (%47,3) kadin olup yas ortalamasi 54 ± 12,3 idi. Olgularin 13'unde (%36,1) santral venoz kateter mevcut olup bu risk faktoru en sik karsilasilan UEDVT nedeniydi. Bulgular: Tum hastalar etyolojik sebebe ve risk faktorlerine gore degerlendirilerek, tedavileri duzenlendi. Dusuk molekul agirlikli heparin (DMAH) ve sonrasinda ortalama 6 ay sureyle oral antikoagulan protokolu uygulandi. Tum hastalar 2 aylik peryodlarla bir yil suresince poliklinik t...
Objective: We aimed to determine the role of seasonal and meteorological variations in the incide... more Objective: We aimed to determine the role of seasonal and meteorological variations in the incidence of lower extremity deep venous thrombosis (DVT). Methods: A total of 296 patients with DVT for the first time were admitted to the Cardiovascular Surgery Clinic of the Alsancak State Hospital during the four-year period between January 1999 and December 2002. Of these cases, 151 were women (51%) and the average age was 58.8 years. We investigated the effect of each month and season on the onset of acute symptoms of DVT. Meteorological data were also compared during the onset of disease. Results: We found that DVT frequency significantly increased during the six-month period between October and March, particularly on the coldest winter days and when atmospheric pressure was low. Conclusions: Lower extremity DVT significantly correlates with meteorological variables such as cold temperatures and low atmospheric pressure. Further multicentric prospective studies are necessary to determi...
study was carried out by Gifford et al6 and found a successful vaginal delivery in 74% of patient... more study was carried out by Gifford et al6 and found a successful vaginal delivery in 74% of patients. This was comparative to our study, where the successful vaginal delivery rate was 72.3%. Our observation shows that the increase in maternal age might have adverse influence in successful vaginal breech delivery, however the association in our study failed to reach a statistical significance. Many obstetrician consider parity as an important criterion for selection of parturient to deliver vaginally, in our study, grand multipara (p>0.5) had a significant higher successful rate than nullipara group. The increase in maternal parity was a positive influence in successful vaginal delivery. This could be explained by the fact that, the history of previous successful vaginal delivery might affect the obstetrician decision regarding the choice of delivery. The pelvis of multipara has been already tested by the previous vaginal deliveries. Kayam et al7 his study did not show any increase in maternal or neonatal morbidity rate attributable to vaginal delivery. Iron et al8 found significantly lower maternal complication in planned vaginal delivery than elective CS and there was no differences in neonatal morbidity between the planned vaginal delivery and the elective CS group. Thropo-Beesteon et al,4 had a large retrospective study on 3447 singleton breech term fetus and concluded that good neonatal outcome with elective CS group than vaginal delivery. This study corresponds to our result on neonatal morbidity; it can be explained that the important issue to be consider when planning vaginal delivery includes careful selection of patient, obstetrical experience and judgment of intrapartum attendant. Although the recommendation now to do elective CS for flexed or complete breech singleton. We suggest that a trial of vaginal breech delivery is more likely to be successful if both mother and baby are of normal proportion with presentation either frank or complete and clinically adequate pelvis with no fetopelvic disproportion, the presence of an experience team of obstetrician, anesthetist and pediatrician in labor room may be more important than the planned mode of delivery. A trial of vaginal delivery in carefully selected patients with breech presentation at term might be safe procedure that was successfully completed in almost 72.3% of cases in our experience. In our retrospective study we found that, low maternal parity and increase maternal age have a negative influence on maternal progress of labor.
The creation of an arteriovenous fistula (AVF) is frequently used to achieve easier access for ha... more The creation of an arteriovenous fistula (AVF) is frequently used to achieve easier access for haemodialysis in patients with chronic renal insufficiency. The most frequent late complication of AVFs is aneurysm formation, which carries the risk of spontaneous rupture. This study reports on 18 patients with giant aneurysms that developed on antebrachial AVFs who were operated on over a period of 6 years. Colour duplex ultrasonographic examination of the upper extremity was performed in all but one patient in the preoperative period. Surgical management included resection of the aneurysm and re-establishment of arterial continuity. There were no complications such as infection, ischaemic extremity loss, neurological sequelae or mortality. Colour duplex ultrasonographic examinations after 6 months were all normal. The mean follow-up period was 29.1 months (range 7 − 50 months). There were no additional vascular complications observed during follow-up. Early surgical intervention is the...
We aimed to evaluate patients with upper extremity deep vein thrombosis (UEDVT) in terms of the r... more We aimed to evaluate patients with upper extremity deep vein thrombosis (UEDVT) in terms of the risk factors, symptoms, clinical course, diagnostic approaches and treatment outcome. Thirty-six patients with a diagnosis of UEDVT, comprising 19 males (52.7%) and 17 females (47.3%), were included in the study; the mean (± SD) age was 54 ± 12.3 years. The most common risk factor was central venous catheter use. The treatment protocol consisted of low molecular weight heparin for up to 7 days, followed by oral anticoagulants for up to 6 months. All patients were followed up for 1 year. More than 90% of the patients responded well to treatment. Nine patients (25%) died due to underlying diseases; no patients died secondary to UEDVT. None of the patients developed pulmonary embolus or recurrent deep venous thrombosis, and post-thrombotic syndrome was not observed. The mortality rate was related to the underlying diseases.
Current controlled trials in cardiovascular medicine, Jan 18, 2004
AIM: In order to avoid the complications associated with thromboembolic disease, patients with th... more AIM: In order to avoid the complications associated with thromboembolic disease, patients with this condition typically are placed on long-term anticoagulant therapy. This report compares bleeding complications in this patient population by level of achieved INR. MATERIALS AND METHODS: During the 6-year period between January 1997 and January 2003, 386 patients with venous thromboembolism of the lower extremities were admitted to the Cardiovascular Surgery Outpatient Clinic of Alsancak State Hospital. Of the 386 patients, 198 (51.2%) were women, and the average age was 52.3 years. All diagnoses of venous thromboembolism were confirmed by means of Doppler ultrasonography. Further investigation showed occult neoplasms in 22 (5.6%) of the cases. We excluded the patients with occult disease, and the remaining 364 constituted our study population. RESULTS: Oral anticoagulation was standardized at 6 months' duration in all cases. We divided the patients into two groups. Group I consis...
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