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The Evaluation of Musculoskeletal System Tumors and Tumor Like Lesions in Thrace Region
(Trakya Üniversitesi, 2018) Şenyiğit, Ece; Söyleyici, Begüm; İşkan, Nur Gülce; Çifcibaşı, Hilal Sena; Göztepe, Aslı; Çiftdemir, Mert
Aims: The aim of this study is to evaluate the data belonging to patients who were diagnosed with benign or malignant soft tissue and bone tumors and tumor-like lesions evaluated by musculoskeletal tumor study group of Trakya University Faculty of Medicine in between January 2013 and June 2017 and the relationship between the frequency of benign, malignant bone and soft tissue tumors and tumor-like lesions, with the patients’ age and gender. Methods: The data of 687 patients who were evaluated by the musculoskeletal tumor study group of Trakya University Faculty of Medicine between January 2013- June 2017 were analyzed retrospectively. All of the data was analyzed by using SPSS. Chi-square analysis was used to obtain categorical data in order to point out the distribution of age and gender of patients with musculoskeletal system tumors and tumor-like lesions. Results: The number of patients over the period from January 2013 to June 2017 was 687. The number of patients who were evaluated by biopsy and acquired histopathologic confirmation of their condition was 341. The mean of patients’ ages was 44.3±21.4 (4-92). Among 341 patients, 106 (47.1%) patients were female and 119 (52.9%) patients were male. The mean of females’ ages was 43.7±20.4 (4-92). The mean of males’ ages was 44.7±22.4 (5-90). Conclusion: Benign bone and soft tissue tumors were more common than malignant tumors. Benign bone tumors were predominantly seen in young adults. Our results was consistent with the literature however due to some patients who did not need a pathological sampling, our sample size was smaller than intended. With better archived information, more consistent results could be obtained in further studies.
Evaluation of Thoracolumbar Injuries in Trakya University School of Medicine According to Aospine Classification System
(Trakya Üniversitesi, 2020) Aksu, Gonca; Saran, Sercan; Oflaz, Mahmut Sami; Çiftdemir, Mert
Aims: This study aims to classify the thoracolumbar spinal injuries that were treated in Trakya University School of Medicineaccording to the recent Thoracolumbar AOSpine injury score and crosscheck the classified data with categorical modifiers suchas gender, trauma type and treatment type. Methods: AOSpine Classification System was used to classify thoracolumbar spinalinjuries. Classes were compared with patients’ gender, age, trauma energy and treatment type. Pearson Chi-Squared test and Shapiro-Wilk test were used for statistical analysis. Results: The total number of patients was 248. One hundred fifty-two (61.3%)were male and 96 (38.7%) were female. One hundred and three (86.6%) patients had high-energy trauma and 16 (13.4%) patientshad low-energy trauma in a total of 119 operated patients. Relationship between treatment type and AOSpine Classification System statistically significant. There was also a significant difference between trauma energy and AOSpine Classification Systemtypes. Conclusion: As a conclusion, gender and trauma energy were found to have a relationship and higher energy traumas weremost likely to cause spinal fractures. In addition, AOSpine classification system may be one of the confounding factors regardingthe choice of treatment. Keywords: Classification, spine, injury
Assessment of Inpatients in Trakya University Hospital in Terms of Informed Consent Indicated by Ministry of Health’S Patient Rights Regulations
(Trakya Üniversitesi, 2016) Keyfoğlu, Mehmet Can; Emin, Ahmet; Memiş, İdil; Demirci, Koray; Özcan, Mert
Aims: The informed consent constitutes the legal validity of any medical intervention and treatment, and it provides the patient with information about the procedure. In this study, we aimed to assess the extent informed consent is being applied in Trakya University Hospital in accordance to Ministry of Health’s regulations.Methods: A data collecting form has been prepared with respect to Ministry of Health’s relevant regulations and it was applied to 78 inpatients. The form consists of 18 two-point statements and 4 questions towards the patient’s demographic profile. As for descriptive statistics, numbers and percentages have been used for the statements, thus arithmetic mean ± standard deviation (minimum-maximum) has been used for the questions, respectively.Results: Out of all included patients, 47 (60.3 %) participants did not have any knowledge about the Informed Consent Form, 24 (30.8%) did not sign the Form, 48 (61.5%) participants did not read the Form and 49 (62.8%) did not understand the Form.Conclusion: From the results of this study, it can be inferred that the extent patients are being informed is still not on intended levels and is not satisfactory. Informed Consent is still a topic to emphasize, improve and put into practice more effectively
Facioscapulohumeral Muscular Dystrophy Without Facial Symptoms
(Trakya Üniversitesi, 2014) Ünyılmaz, Cihan; Taşdemir, Altan
Introduction: Facioscapulohumeral muscular dystrophy (FSHD) is a progressive muscular dystrophy which starts with shoulder and face muscles involvement and rarely spreads to pelvic muscles. It has autosomal dominant inheritance pattern, serum CK levels are normal or mildly high, and EMG is myopathic. Case report:We present the 43 year old male patient with pain, numbness and weakness in cervical area and both arms for 1 year. His mother has similar symptoms as well. His cervical spinal nerve EMG results were found normal. Results:EMG results were found normal. Our patient had the defect of closing eyelids or pressing them based on faced muscles involvement just like regular FSHD cases. Because of the atrophy of lower face muscles, lips seemed to be fuller. On the other hand, there was a no whistling or blowing defects related to orbicularis oris muscle and face involvement. We presented this study as this muscle disease represents itself with weakness and numbness in muscle is seen rarely in literature and our patient did not have one of its components (facial).
Periosteal Chondroma of the Femur: a Case Report
(Trakya Üniversitesi, 2018) Şenyiğit, Ece; İşkan, Nur Gülce; Çiftdemir, Mert
Aims: Periosteal chondroma is a rare and benign cartilage tumor seen mostly in long bones and in patients under30 years of age. In this case report, it is aimed to present a 16-year-old female patient with a periosteal chondroma inthe distal femur.Case Report: A 16-year-old female patient was admitted to the hospital with the history of pain in her distal partof right thigh. A superficial cortical erosion with well-defined borders without any relation to the intramedullaryarea was seen in magnetic resonance imaging. The lesion was regarded as periosteal chondroma and marginal excisionwas performed.Conclusion: This case report shows the importance of the differential diagnosis in cortical lesions. Periostealchondroma may be considered when a patient has a history of long term pain in adolescent age group
The Evaluation of Patients With Multiple Level Spinal Fractures Admitted to a Single Institution: a Retrospective Study
(Trakya Üniversitesi, 2017) İşkan, Nur Gülce; Şenyiğit, Ece; Söyleyici, Begüm; Çiftdemir, Mert
Aims: The aim of this study is to evaluate the data of the patients who are diagnosed with multiple level spinal fracturesand to find out the most common level of fractures. Furthermore, this data will be examined regarding patients’age, gender, fracture type, cause of the injury, and type of the treatment in order to get a baseline data to improvefuture outcomes.Methods: The data of 42 patients who were diagnosed with multiple spinal fractures in Trakya University Facultyof Medicine Department of Orthopedics and Traumatology in between 2012 and 2017 was analyzed retrospectively.In order to understand the incidence of multiple spinal fractures in both genders, type of the treatment and cause ofthe injury, descriptive analysis as arithmetic mean ± standard deviation, number and percentages, median (mini¬-mum-maximum) were used.Results: There were 42 patients including 32 (76.2%) men and 10 (23.8%) women with a mean age of 41 years.The most common level of injury was T12 (17.5%). The incidence of T11-L1 fractures is 62.1%. 20 (47.6%) of thefractures were caused by motor vehicle accidents. 26 patients were treated surgically and 13 patients had conservativetreatment.Conclusion: Multiple level spinal fracture is a very important clinical problem. It is seen mostly in men andmiddle-aged population. Thoracolumbar transition (T11-L2) is the most affected region due to the biomechanicsof vertebral column. The most common causes of the multiple spinal fractures are motor vehicle accidents and falls.Management of multiple level spinal fractures are based on surgical or conservative treatment modalities. Choosingthe correct treatment option for a patient with multiple level spinal fractures depends on several factors
What Is Your Diagnosis?
(Trakya Üniversitesi, 2015) Yumurtacı, Öznur; Berber, Murathan; Gökçe, Kübra; Dodurgalı, Mustafa Reha; Çiftdemir, Mert
[Abstract Not Available]
Level of Information About Radiation Among Medical Staff Working in Operating Rooms With Fluoroscopy
(Trakya Üniversitesi, 2015) Yıldız, Ege Miray; Kandemir, Yonca; Demirci, Koray; Özcan, Mert
Aims: The aim of this study is to determine the level of information regarding radiation safety and the side effects related to the use of fluoroscopy among a group of teaching assistants, research assistants, medical students, nurses, technicians and caretakers working at Trakya University Health Center for Medical Research and Practice.Methods: A descriptive, cross-sectional survey study was conducted from December 2014 to April 2015 at Trakya University Health Center for Medical Research and Practice. The questionnaire consisted of 24 questions and was applied to 53 people. Responses regarding radiation safety and the side effects of fluoroscopy were analyzed in Statistical Package for the Social Sciences (SPSS) 20.0 using descriptive statistics including frequencies and percentages.Results: 98.08% of the participants responded “yes” to the question ”Do you think fluoroscopy is hazardous to health?”. On the other hand, the results showed that only 32.69% of the participants wore lead apron and 32.77% used thyroid shields in every operation. 88.46% of the participants reported that they would like to attend a training regarding fluoroscopy and radiation safety.Conclusion: The results indicated that the operating room staff of Trakya University Health Center for Medical Research and Practice does not possess adequate knowledge regarding radiation safety
A Case Report: Radiofrequency Ablation For Osteoid Osteoma
(Trakya Üniversitesi, 2016) Yiğitbilek, Furkan; Sülün, İrem; Kısa, M. Şevval; Çiftdemir, Mert
Aims: Osteoid osteomas are benign bone-forming tumors which usually occur in long bones of young males. Its most significant finding is severe pain caused by nidus, increasing during nights. The application of radiofrequency ablation is becoming a widespread treatment method. In this case presentation, the aim is to discuss the application of radiofrequency ablation with its different aspects Case Report: Fourteen-year-old male patient had a history of left knee pain for 3 years. After his consultation at Trakya University Orthopaedics and Traumatology Outpatient Clinic, it was confirmed that the pain increases during night and it is localized in left thigh. According to these symptoms, radiological examinations performed to the patient. Taking radiology tests results into consideration, the patient was diagnosed with osteoid osteoma and treated by radiofrequency ablation. Conclusion: Osteoid osteoma is a surgical bone lesion but in late period radiofrequency ablation replaces open surgery because it has a lower risk of relapse, faster recovery, shorter hospitalization time and faster ambulation.
F-18-Fdg Pet/Ct Findings in Differentiated Papillary Carcinoma of Thyroid and Determination of Metabolic Activity
(Trakya Üniversitesi, 2017) Tezel, Mehmet Oğulcan; Mercan, Oğuz; Yumurtacı, Öznur; Kurt, Cansu; Altun, Gülay Durmuş
Aims: In well differentiated thyroid cancers, FDG PET has a relatively low sensitivity. F-18 FDG PET/CT is an imaging method which is used before the treatment and in high risk patient groups with suspected recurrent disease. In this study we aim to determine the character of metabolic activity in differentiated thyroid cancer and in case of metastasis and to evaluate the findings of F-18-FDG PET/CT images in high risk patient group of differentiated thyroid cancer. Methods: The data of 79 patients who underwent imaging for staging or restaging and followed at Trakya Univerısity Faculty of Medicine from 2010 to 2015, were included in this study. Patient reports were analyzed retrospectively. Age, gender, size of thyroid lesion, presence of lymphadenopathy, other organ metastases (lung, liver, brain, bone) were included in the study. Results: The findings of 79 patients (29 male, 50 female) with papillary differentiated thyroid cancer were included in the analyses. The mean age of participants was 51±15 years. 14 patients (18%) were evaluated as normally. Recurırent disease was detected in the thyroid gland of 10 patients (13%) (SUVmax: 6.2±5.1; 2.3-19.3). In 54 patients (68%) lymph node metastasis was detected (SUVmax; 5.8±5.1; 2.1-24.2). 12 patients had liver metastasis (SUVmax: 5.7±3.9; 2.0-11.7), 12 patients had bone metastasis (SUVmax: 6.1±2.9; 2.2-13.9), 8 patients had lung metastasis (SUVmax: 4.3±4.5; 1.0-4.9) and one patient had brain metastasis (SUVmax: 10.2). Conclusion: Papillary differentiated thyroid cancer is associated with a tumor showing low glucose affinity, but it is understood that the tumor changes its behavior and gets metabolically active in the patients within the high risk group and in those with systemic metastasis
Torticollis Secondary to a Posterior Fossa Tumor: a Case Report
(Trakya Üniversitesi, 2019) Göztepe, Aslı; Güldağ, Mahmut Alper; Akıncı, Ahmet Tolgay; Çiftdemir, Mert
Aims: Torticollis secondary to a posterior fossa tumor is a rare condition that is mostly seen in pediatric patients. In this casereport, it is aimed to present a 23-month-old male patient with a posterior fossa tumor that presents the symptoms of torticollis.Case Report: A 23-month-old male patient was admitted to the hospital with a history of a restricted range of motion in hisneck and leaning to his left side while sitting. Physical examination of the patient revealed acute onset of atlantoaxial rotatorysubluxation findings therefore, the initial diagnosis was Grisel’s Syndrome. Later, a cranial magnetic resonance imaging revealeda mass which was seen in the posterior fossa. The mass was considered as the cause of the torticollis. Conclusion: This case reportshows the importance of the differential diagnosis of torticollis. Posterior fossa tumors should not be overlooked while searchingfor the cause of torticollis. Keywords: Torticollis, posterior fossa tumors, infratentorial neoplasms
Effects of 1800 MHz electromagnetic field emitted from cellular phones on bone tissue
(2009) Atay, Tolga; Aslan, Ahmet; Hetbeli, Nurettin; Aydoğan, Nevres Hürriyet; Baydar, Metin Lütfi; Ermol, Cüneyt; Yıldız, Mustafa
Amaç: Elektromanyetik alanın (EMA) kemik hücreleri üzerine bazı biyolojik etkileri olduğu bildirilmiştir. Çalışmamızda, cep telefonlarından yayılan 1800 MHz frekansındaki EMA'nın rat kemik dokusundaki kemik mineral yoğunluğu üzerine etkilerini araştırmak amaçlanmıştır. Gereçler ve Yöntemler: Otuz erkek Wistar-albino sıçan kontrol ve EMA olmak üzere iki gruba ayrıldı. EMA grubundaki ratlar, dört hafta boyunca haftada beş gün ve günde 30 dakika 1±04 mW/cm2 gücünde 1800 MHz frekansında EMA'ya maruz bırakıldı. Kontrol grubu, aynı gün ve sürede EMA uygulanmaksızın aynı çevresel şartlarda tutuldu. Çalışma sonunda tüm sıçanların kemik mineral yoğunluğu değerleri “Dual Energy X-ray Absorptiometry” cihazı ile taranarak ölçüldü. Bulgular: EMA grubunda kontrol grubuna göre lomber kemik mineral yoğunluğunda minimal artma, femur kemik mineral yoğunluğunda ise minimal azalma saptandı. Ancak, istatistiksel olarak anlamlı fark saptanmadı (p>0.05). Sonuç: Osteoporoz açısından bakıldığı zaman yüksek frekanslı EMA'nın kemik dokusu üzerinde etkisi saptanmamıştır. Cep telefonları frekanslarına maruz kalmanın etkileri arasında kanser gibi ciddi hastalıkların olması nedeniyle insan sağlığı üzerindeki etkilerini araştırmak amacıyla daha ileri çalışmalara gereksinim olduğu kanaatindeyiz.
Proksimal humerus kırıklarının eksternal fiksasyonla tedavisi
(2008) Çopuroğlu, Cem; Gürbüz, Hakan; Eşkin, Deniz
Amaç: Bu çalışmada, kapalı redüksiyon ve eksternal fiksasyon ile tedavi edilen proksimal humerus kırıklı hastaların fonksiyonel sonuçları değerlendirildi. Hastalar ve Yöntemler: Çalışmada proksimal humerus kırıklı 16 hasta (11 erkek 5 kadın; ort. yaş 50.3; dağılım 9-81) geriye dönük olarak değerlendirildi. Tüm hastalara kapalı redüksiyon sonrasında eksternal fiksatör (9 hastaya İlizarov eksternal fiksatör, 7 hastaya monolateral eksternal fiksatör) uygulandı. Kırıklar kaynadıktan sonra eksternal fiksatörler çıkarıldı ve hastaların fonksiyonel sonuçları Constant skoru ile değerlendirildi. Ortalama takip süresi 37 ay (dağılım 4-69 ay) idi. Bulgular: Ortalama kaynama süresi 14 hafta (dağılım 8-22 hafta) idi. Bir hastada kaynama sağlanamadı. Bir hastada humerus başı avasküler nekrozu gelişti. Üç hastada görülen yüzeyel çivi dibi enfeksiyonu pansuman ve medikal tedavi ile iyileşti. Ortalama Constant skoru 81 puan bulundu. Sonuç: Deplase proksimal humerus kırıklarının tedavisinde kapalı redüksiyon ve eksternal fiksasyon uygulaması tatmin edici kırık redüksiyonu ve stabilitesi ve fonksiyonel sonuç sağlar.
Which classification system is more useful for intertrochanteric fractures? AO/ASIF or Jensen?
(2008) Memişoğlu, Serdar; Eşkin, Deniz; Yamak, Erkan; Gürbüz, Aydın; Sarıdoğan, Kenan; Dülger, Hakan
Amaç: Bu çalışmanın amacı AO/ASIF and Jensen sınıflama sistemlerinin gözlemcilerin kendi içindeki (intraobserver) ve gözlemciler arası (interobserver) uyumunu saptamak ve deneyimli ve deneyimsiz ortopedik cerrahlar tarafından uygulandığındaki uyumu kıyaslamaktı. Hastalar ve Yöntemler: Altmış intertrokanterik femur kırığına ait ön-arka ve yan radyografiler, iki gruba (G1, G2) ayrılmış 10 ortopedik cerrah tarafından üçer ay ara ile AO ve Jensen sınıflamaları kullanılarak incelendi ve sınıflandırıldı. Her grupta beş cerrah vardı. Grup 1'dekiler beş yıldan daha az, Grup 2'dekiler 10 yıldan daha fazla deneyimli idiler. İntraobserver ve interobserver varyasyonların belirlenmesinde Kappa istatistiksel analizi kullanıldı. Bulgular: Alt grupları kullanılmadan yapılan AO sınıflaması için intraobserver uyum kappa değeri 0.67 (0.47-0.90), interobserver uyum kappa değeri 0.42 (0.10-0.73) olarak bulundu. Jensen sınıflaması için intraobserver uyum kappa değeri 0.57 (0.35-0.80), interobserver uyum kappa değeri 0.30 (0.10-0.60) olarak bulundu. Altgruplar kullanılarak yapılan AO sınıflama sistemi için intraobserver uyum kappa değeri 0.49 (0.21-0.81) ve interobserver uyum kappa değeri 0.23 (0.09-0.51) olarak bulundu. Sonuç: Bu çalışmada, kullanılan sınıflama sistemlerinin dezavantajlarının olmasına karşın, intertrokanterik kırıklarda alt gruplar kullanılmadan yapılan AO sınıflamasının, Jensen ve alt gruplar kullanılarak yapılan AO sınıflamasına göre daha kullanılabilir olduğu gösterilmiştir.
Total artroplasti uygulanan dizde brusella protez enfeksiyonu: Artroskopi ve medikal tedavi ile protezi korunan bir olgu sunumu
(2008) Atay, Tolga; Baydar, Metin Lütfi; Heybeli, Nurettin; Kırdemir, Vecihi
Enfeksiyon, total diz protezi uygulamalarının önemli bir komplikasyonudur ve ciddi bir morbiditeye sahiptir. Çalışmamızda çimentolu total diz protezi uygulanmasından dört yıl sonra ortaya çıkan brusella enfeksiyonu olgusu tanımladık. Literatürde, öncesinde eksizyonel artroplasti uygulanan yada uygulanmayan durumlar için antimikrobiyal kemoterapi stratejileri belirtilmiştir. Biz ise sunulan olguda artroskopi ve debridman ile sinoviektomi sonrası eksizyonel artroplasti yapmaksızın doksisiklin ve rifampisin kombinasyonu ile tedaviye başladık. Bu tedavi planı ile hastanın yaşam kalitesini etkileyecek majör bir cerrahi uygulamadan tedavi alternatifi oluşturulabilir.
Non-operative treatment in children and adolescents with atlantoaxial rotatory subluxation
(2012) Çiftdemir, Mert; Çopuroğlu, Cem; Özcan, Mert; Ovul, Ayşe Ulusam; Yalnız, Erol
Amaç: Atlantoaksiyel rotator subluksasyon (AARS) çocuk ve adolesanlarda baş-boyun hareketlerinde kısıtlılık ve tortikollisle kendini gösteren, genellikle tanıda güçlük yaşanan ve beraberinde potansiyel riskler barındıran bir durumdur. Bu çalışmada cerrahi dışı yöntemlerle tedavi edilen 12 AARS olgusunun retrospektif analizi sunulmaktadır. Hastalar ve yöntem: AARS nedeni ile cerrahi dışı yöntemlerle tedavi edilen, ortalama yaşı 11,5 olan 12 hasta travma ve üst solunum yolu enfeksiyonu öyküsü, ek yaralanmalar, radyolojik bulgular, semptomların süresi, mentooksipital traksiyonun miktarı ve süresi ile tedavinin klinik sonuçları açısından değerlendirildi. Bulgular: Olguların 8’inde travmatik AARS saptanırken, 4 olguda subluksasyonların ardında travmatik bir neden bulunamadı. Olguların 10’unda Fielding ve Hawkins’e göre tip I, 2’sinde ise tip II subluksasyonlar saptandı. Tüm olgular yatak başı mentooksipital traksiyonla tedavi edildi. Traksiyonda kullanılan ortalama ağırlık 1,8 kg iken, ortalama traksiyon süresi 3,75 kg olarak hesaplandı. Olgular traksiyonla elde edilen klinik düzelmenin ardından 3 hafta Philadelphia boyunlukla takip edildi. Altıncı ay kontrollerde hiçbir olguda baş-boyun hareketlerinde kısıtlılık ve ağrı saptanmadı. Sonuçlar: Atlantoaksiyel eklem, baş rotasyonunun çoğundan sorumlu olan karmaşık bir yapıdır. Çocuk ve adolesanlarda boyun ağrısı ve torticollis ayırıcı tanısında atlantoaksiyel eklem patolojileri ve AARS mutlaka düşünülmeli ve ekarte edilmelidir. Tanıda gecikme yaşanan olguların tedavisinde cerrahi dışı yöntemlerle başarı şansı düşüktür.
Can Awake Thoracoscopy Procedure be Performed with the Help of Thoracic Paravertebral Anesthesia?
(IBN SINA TRUST, 2018) Yanik, Fazli; Karamustafaoglu, Yekta Altemur; Copuruoglu, Elif; Sagiroglu, Gonul
Aim: The aim of this study was to present our experience with 11 patients who were spontaneously breathing with Awake Video Thoracoscopy (AVATS) procedure with the help of TPB because of rareness in the literature. Materials and Methods: Between December 2015 and December 2017, a total of 125 VATS cases were performed; 11 cases underwent VATS operation with the help of TPB; age, gender, operation performed, duration of operation, time of onset of mobilization-oral intake, duration of hospital stay, Visual Analogue Scale (VAS) scores were evaluated retrospectively. Results: All cases were treated with uniportal AVATS procedure with the help of TPB. The mean age was 40,3 +/- 17,4 years (range 18-64 years), nine (82%) of the pateints were male and two (18%) were female. Operation procedures included wedge resection in eight (73 %) patients (six of them for pneumothorax, two of them for diagnosis), in three (27%) patients pleural biopsy (one of them used talc pleurodesis). There were no perioperative events. The mean operation time was 27,7 +/- 6,4 minutes (range, 20-40 min) and the mean anesthesia time was 25 +/- 3,8 minutes (range 20-30 min). The mean time of mobilizitation, oral intake opening time and length of hospital stay was 1,1 +/- 0,4 hours (1-2 hours), 3,5 +/- 0,5 hours (3-4 hours), 2,6 +/- 0,5 days (2-3 days), respectively. Conclusion: Awake Video Asssited Thoracoscopic Surgery with the help of TPB has less side effects and less complication risks than other awake procedures with the help of other regional anesthesia techniques. We conclude that; although AVATS with the help of TPB has some minor complications, it has advantages such as early discharge, early mobilization and early oral intake, low pain levels in well-selected patient groups.

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