Browsing by Author "Cevik, Halime"

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Citation Count: 5
Endovascular Treatment of Critical Limb Ischemia in Buerger Disease (Thromboangiitis Obliterans) With Midterm Follow-Up: A Viable Option When Bypass Surgery Is Not Feasible
(Amer Roentgen Ray Soc, 2021) Uyanik, Sadik Ahmet; Oguslu, Umut; Aminu, Ibrahim Sani; Yilmaz, Birnur; Cevik, Halime; Atli, Eray; Gumus, Burcak
OBJECTIVE. Thromboangiitis obliterans (TAO) is an occlusive inflammatory disease affecting small- and medium-sized vessels that causes decrease in life quality and eventually limb loss. The only proven treatment method is smoking cessation, but it may be insufficient for limb salvage in patients with critical limb ischemia. In this single-center retrospective study, the feasibility and efficiency of endovascular treatment in TAO were evaluated. MATERIALS AND METHODS. After approval of the local institutional review board, 41 patients who underwent endovascular treatment of TAO between January 2014 and June 2019 were evaluated retrospectively. Technical success and procedure-related complications were recorded. Decrease in Rutherford classification score, relief of pain, and wound healing were evaluated to determine clinical success. Primary patency, limb salvage rate, and amputation-free survival were also evaluated. RESULTS. A total of 45 limbs were treated during the study period. Technical success was achieved in 82.2% of procedures. Mean follow-up was 29.8 months. Clinical improvement was achieved in 35 limbs. Three patients underwent major amputation and 12 patients underwent minor amputation. Amputation-free survival and limb salvage were both 93.3% at both 1 and 2 years. Reintervention was performed in 14 patients because of occlusion and clinical relapsing of the symptoms. CONCLUSION. Endovascular treatment of TAO is feasible, has a potential to prevent limb amputation in patients with critical limb ischemia, and has acceptable technical success and limb salvage rates. Because there is no consensus in treatment of TAO, prospective comparative studies are needed to determine the effectiveness of an endovascular approach.
Citation Count: 2
RENAL STIFFNESS ON PATIENTS WITH GESTATIONAL DIABETES
(Carbone Editore, 2017) Yilmaz, Birnur; Cevik, Halime; Bildaci, Tevfik Berk; Ozdogan, Serdinc
Introduction: Gestational diabetes is defined as glucose intolerance first recognized in pregnancy. Oral glucose tolerance testing is the cornerstone in diagnosing gestational diabetes. In this study, we aimed to find a new method of diagnosis in addition to conventional diagnosed by 75 gr oral glucose tolerance testing. Material and methods: 121 pregnant woman were included part in this study, forming two groups as gestational diabetic patients (51 patients) and control group (70 pregnant woman). Both kidneys are evaluated with B Mode Ultrasound and Colour Doppler Ultrasound mode by measuring resistive index for depiction of other renal pathologies. Stiffness of renal tissue determined by Acoustic Radiation Force Impulse (ARFI) technology utilized by two blinded radiology specialists. Results: We were not able to find any correlation between gestational diabetes mellitus and resistivity index measurements (p > 0.05). But a correlation between second hour glucose levels in oral glucose tolerance test and bilateral renal stiffness was found (p < 0,05). Conclusion: ARFI ultrasound may be a non-invasive technique in determining the course of the disease.
Citation Count: 6
Value of in vitro acoustic radiation force impulse application on uterine adenomyosis
(Springer Japan Kk, 2018) Bildaci, Tevfik Berk; Cevik, Halime; Yilmaz, Birnur; Desteli, Guldeniz Aksan
Adenomyosis is the presence of endometrial glandular and stromal tissue in the myometrium. This phenomenon can be the cause of excessive bleeding and menstrual pain in premenopausal women. Diagnosis of adenomyosis may present difficulty with conventional methods such as ultrasound and magnetic resonance imaging. Frequently, diagnosis is accomplished retrospectively based on the hysterectomy specimen. This is a prospective case control study done in vitro on 90 patients' hysterectomy specimens. Acoustic radiation force impulse (ARFI) and color elastography were used to determine the elasticity of hysterectomy specimens of patients undergoing indicated surgeries. Based on histopathological examinations, two groups were formed: a study group (n = 28-with adenomyosis) and a control group (n = 62-without adenomyosis). Elasticity measurements of tissue with adenomyosis were observed to be significantly higher than measurements of normal myometrial tissue (p < 0.01). Uterine fibroids were found to have higher values on ARFI study compared to normal myometrial tissues (p < 0.01). The findings lead to the conclusion that adenomyosis tissue is significantly softer than the normal myometrium. ARFI was found to be beneficial in differentiating myometrial tissue with adenomyosis from normal myometrial tissue. It was found to be feasible and beneficial to implement ARFI in daily gynecology practice for diagnosis of adenomyosis.