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Öğe Re: Comment to Peripartum hysterectomy in a teaching hospital in the eastern region of Turkey(Elsevier Ireland Ltd, 2006) Zeteroglu, Sahin; Sahin, Guler; Kamaci, Mansur[Abstract Not Available]Öğe Should we use urinary catheter routinely at cesarean delivery?(2007) Kolusari, Ali; Zetero?lu, Şahin; Şahin, H. Güler; Ramazan, Sürücü; Kamaci, MansurOBJECTIVE: The aim of the study was to compare intraoperative complications and postoperative morbidity of patients to whom urinary catheter were performed or not in cesarean deliveries. STUDY DESING: This study was designed as a prospective randomised study. Fifty patients (Group 1) who delivered with cesarean section after spontaneous mixture were compared with fifty patients (Group 2) to whom Foley urinary catheter were performed before the opertaion for intraoperative complications and postoperative morbidity. FINDINGS: There were no significant differences between the groups for age, gravity, parity, cesarean indications, factors those could increase postoperative infectious risks and operative time. No intraoperative complications were noticed in both groups. Postoperative mobilization was significantly earlier in Group 1 (6.58±1.69 hours vs 12.52±4.48 hours). The average time to first void was 5.24±3.53 hours in Group 1. In Group 2, two patients (% 4) who had glob vesicate required urinary catheter drainage (Both of them had epidural anesthesia). Urinary catheter was removed at 12.08±4.42 hours in Group 2 patients. There were no urinary tract infections in group 1, four in group 2 patients which reached statistical significance. CONCLUSION: Use of urinary catheter at cesarean delivery increases postoperative urinary tract infections. We think that use of urinary catheter at cesarean delivery is ineffective.Öğe Umbilical Artery Erythropoietin Levels in Preeclamptic Pregnancies(Galenos Yayincilik, 2006) Sahin, H. Guler; Surucu, Ramazan; Zeteroglu, Fiahin; Ustun, Y. Engin; Ustun, Yusuf; Kamaci, Mansur; Kolusari, AliObjective: The aim of this study was to determine the levels of umbilical artery erythropoietin (EPO) levels and to evaluate its relation with clinical findings. Material and Methods: In this prospective study, 26 normal (Group I), 25 mild preeclamptic (Group II) and 17 severe preeclamptic (Group III) pregnant women whose gestational ages were between 37-42 weeks were enrolled. After the delivery, blood samples were taken from the umbilical artery of double clamped umbilical cord and umbilical artery EPO levels and blood gas parameters were analyzed. Sociodemographic findings, labor properties and physical examination of neonates were recorded. The blood gas parameters, EPO levels, their relationships with clinical findings of the groups were evaluated. Statistical analyses were performed by SPSS 9.05 statistical package program. Results: There were no statistical differences between gravidity, parity and gestational ages of the groups (p> 0.05). Maternal ages were significantly higher in the second group when compared with the others (p< 0.05). Systolic and diastolic blood pressures were statistically different in the groups (p< 0.05), and the highest levels were found in the third group. Birth weights were; 3480.76 +/- 431.75, 3373.20 +/- 846.83 and 2497.05 +/- 859.83 grams in group I, group II and group III, respectively (p< 0.05). First minute Apgar scores were 8 (ranges between 7-10) in the first group, 8 (ranges between 3-9) in the second group and 6 (ranges between 3-9) in the third group (p< 0.05). Umbilical cord pH levels were 7.35 +/- 0.06, 7.25 +/- 0.11 and 7.19 +/- 0.09; base excess (BE) levels were -4,71 +/- 2,02, -6.53 +/- 3.98 and -9.29 +/- 3.82 mmol/L; EPO levels were 30.0 (9.2-122), 62.5 (11.0-549) and 167.4 (10.1-908) mU/ml, respectively, and the differences between the groups were statistically significant (p< 0.05). In the Spearman bivariate correlation analysis, there was no significant relation between maternal age and EPO levels. There was significant positive correlation between EPO levels and systolic, diastolic blood pressures, pCO2 levels, and, significant negative correlation between first, fifth minute Apgar scores, birth weight, umbilical cord blood pH and BE levels. Conclusions: After delivery umbilical artery EPO levels showed significant correlation with severity of preeclampsia and, clinical and biochemical determinants of perinatal hypoxia. Our results support that erythropoietin can be used as a biochemical determinant of chronic fetal hypoxia that is caused by preeclampsia.Öğe Uterine Artery Catheterisation and Selective Leiomyoma Embolization: Patient Acceptance and Clinical Outcome(Galenos Yayincilik, 2007) Zeteroglu, Sahin; Caliskan, Eray; Harman, Mustafa; Sengul, Muzaffer; Coskun, Ebru; Tiras, Bulent; Kamaci, MansurObjective: To evaluate the patient acceptance and clinical outcome after selective uterine leiomyoma embolization. Materials and Methods: Twenty-four women with symptomatic uterine fibroid were recruited for this study. Selective uterine leiomyoma embolization proceeded until complete vascular occlusion was achieved. The main outcome measure was the decrease in the leiomyoma volume and factors that predict it. Pearson correlation analysis and linear regression analysis were performed to identify possible correlates and predictors of decrease in leiomyoma volume. Patient satisfaction was assessed by asking the subjects to indicate their degree of satisfaction on a five-point scale. Results: The mean age of the patients was 41.5 +/- 4.9 (Range: 28-52). The mean leiomyoma volume before the procedure was 157 +/- 214 cm(3) which was calculated to be 44 +/- 66 cm3 with a 76 +/- 17% (Range: 30-99%) decrease in the mean leiomyoma volume at the end of one year. Correlation analysis revealed that only preoperative estradiol level was positively correlated with the extent of decrease in the leiomyoma volume (r=0.54, p=0.005). This was also proved in the regression analysis (beta=0.25, p=0.01). During the follow-up 17 (70.8%) patients had complete remission of the symptoms, 5 (20.8%) had partial remission and 2 (8.3%) had no clinically significant change. Twenty patients (83.3%) were completely satisfied, 2 were satisfied and 2 were dissatisfied with the leiomyoma embolization procedure. Discussion: There is a positive correlation between the preoperative estradiol level and the extent of the decrease in the leiomyoma volume after the embolization procedure. As leiomyoma is a hormone dependent tumor, the shrinkage of the leiomyoma seems also dependent on the estradiol levels before the precedure besides the incurred ischemic necrosis secondary to arterial embolization.
