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    Being a hemodialysis patient. Is it a disruption in life?
    (2019) Akyuz Ozdemir, Aydan; Ayvazoglu Soy, Ebru Hatice; Erdal, Rengin
    Aim: The restrictions of the renal replacement therapy affect the quality of life of patients diagnosed with End Stage Renal Disease (ESRD). The struggle of surviving with the chronic illness brings the need for social support. Herein, we described the perception of the hemodialysis (HD) patients to define the social support to increase the life quality. Material and Methods: We included 378 (190 females; 188 males) patients in the study. The patients were attending HD sessions for at least six months. Social relations after ESRD diagnosis were evaluated with a questionnaire. A pilot study of the questionnaire was executed at HD centers of Başkent University. According to the results, the language of the questionnaire is simplified. Data were analyzed by SPSS software version 16. Results: The mean age was 54±16.5 years. Half them had primary school education (54%), where the majority was women. The effect of the HD treatment on the social life was statistically significant in both male and female patients. The percentage of rise in the expectation from the partner (50%) and failing at the family liabilities (45.7%), were higher in male patients. In both gender, the highest percentage was the rise in the expectation from the relatives ( females 63.7%; males 66%). The effect of the HD treatment on social and work life found to be changed according to the level of education. As the level of education increased, the percentage of loneliness and social isolation increased. Among all components of social life the need of the partner support was the highest (43.4%). Conclusion: ESRD patients have a life full of disruptions starting from the first day of diagnosis. Being dependent to a health facility and living with dietary restrictions make their life more unbearable and bring the need for support by all means
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    Can platelet Iymphocyte ratio and neutrophil to lymphocyte ratio be used as prognostic predictors for hepatocellular carcinoma?
    (2019) Ayvazoglu Soy, Ebru Hatice; Aydin, Huseyin Onur; Moray, Gokhan
    Aim: To investigate the predictive value of platelet to lymphocyte and neutrophil to lymphocyte ratios for hepatocellular carcinoma outcomes Material and Methods: 37 hepatocellular carcinoma patients were retrospectively collected. All of the hepatocellular carcinoma patients were treated with conventional methods; transarterial chemoembolization, radiofrequency ablation or both. The patient and tumor characteristics, platelet to lymphocyte ratio and neutrophil to lymphocyte ratio were recorded. The association between platelet to lymphocyte ratio and neutrophil to lymphocyte ratio and tumor free survival rates, recurence rates, need of repeated conventional therapy were analyzed. Results: The mean MELD (model for end stage liver disease) score of 37 hepatocellular carcinoma patients was 10.75±4.484 (mean age 59.59±17.23 years). High platelet to lymphocyte ratio and neutrophil to lymphocyte ratio were found to be associated with hepatocellular carcinoma recurrence (p<0.01). However platelet to lymphocyte ratio and neutrophil to lymphocyte ratio were irrevelant with tumor size and number (p>0.05). Platelet to lymphocyte ratio and neutrophil to lymphocyte ratios were significantly high in patients who had repated transarterial chemoembolisation, radiofrequency ablation or both (p<0.01). The disease free survival of these patients who need repeated procedures was 6.5 months and it was significantly lower than the other patients (p<0.05) Conclusion: Platelet to lymphocyte ratio and neutrophil to lymphocyte ratio were found to be predictive for aggressive cancer behavior, so they can be used as markers for hepatocellular carcinoma
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    Surgical and endovascular treatment for mesenteric ischemia
    (2019) Aydin, Huseyin Onur; Ayvazoglu Soy, Ebru Hatice; Avci, Tevfik; Tezcaner, Tugan; Boyvat, Fatih; Yildirim, Sedat
    Aim: Mesenteric ischemia is a rare, highly fatal, surgical emergency. In addition to open surgical (OS) intervention, endovascular treatment (ET) was also recommended for treatment in last years. Surgical resection becomes inevitable in the cases of intestinal ischemia. We aimed to assess patient-related factors and compare treatment outcomes in mesenteric ischemia treated by OS and ET. Material and Methods: Patients treated for mesenteric vascular occlusion at our hospital between 2013 and 2018 were retrospectively evaluated. Duration of symptoms, time from symptom onset to treatment, treatment used and surgery used, re-laparotomy need, duration of intensive care unit stay, duration of hospital stay, and 30-day and 1-year mortality rates were evaluated. Results: Twenty patients with mesenteric ischemia were evaluated. The OS group had a significantly higher CCI score than the ET group (p<0.05). The most common comorbidities in the OS and ET groups were coronary artery disease and hypertension, respectively. The duration of symptoms and time from symptom onset to treatment were significantly shorter in the OS group than the ET group (p<0.05). The OS group most commonly had SMA emboli while the ET group most common had chronic SMA occlusion (p<0.05). Thirty-day and 1-year mortality rates were significantly greater in the OS group than the ET group (p<0.05). Conclusion: Mesenteric ischemia is a highly morbid and fatal condition. ET significantly reduces morbidity and mortality in the face of signs of intestinal ischemia. On the other hand, OS would be inevitable for patients with signs of diffuse peritoneal irritation or those with suspected intestinal necrosis.