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    Application of radiofrequency ablation procedure on a morbidly obese patient with a venous ulcer and large saphenous vein
    (Clinics Cardive Publ Pty Ltd, 2015) Yener, Ali Umit; Yener, Ozlem; Gedik, Hikmet Selcuk; Korkmaz, Kemal; Ozkan, Turgut; Lafci, Ayse; Cagli, Kerim
    Venous ulcers that occur due to chronic venous insufficiency are seen on the upper medial malleol of the ankle. Treatment of venous ulcers is protracted and generally the success rate is low. Co-morbid factors play an important role in the success of treatment of venous ulcers. In this case report, we demonstrate successful venous ulcer treatment in a morbidly obese patient with co-morbid conditions.
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    DOES A BASIC BLOOD TEST TELL THE LOCATION OF PERIPHERAL ARTERIAL LESIONS?
    (Carbone Editore, 2015) Yener, Ali Umit; Cicek, Omer Faruk; Cicek, Mustafa Cuneyt; Ozkan, Turgut; Korkmaz, Kemal; Yener, Ozlem; Genc, Bahadir
    Aim: In this retrospective study, We investigated if neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) can suggest at hospital admission the location of lesion according to TASC 2 classification, in patients with peripheral arterial disease(PAD). Methods: In patients who underwent peripheral angiography, the routine blood tests performed before the procedure were collected. 241 patients between January 2010 and March 2013 were included in the study. The relationship between blood parameters and the location of peripheral arterial lesions was investigated. The patients were divided into 4 groups according to their TASC 2 (Trans-Atlantic Inter-Society Consensus Document on Management of Peripheral Arterial Disease)classification; group A,B,C and D. Results: According to blood tests of patients, NLR and PLR were 3.47 +/- 2.69 and 154.1 +/- 71.2, respectively. When NLR and PLR values were evaluated separately in each group, in patients of Group D according to TASC 2. median NLR and PLR values were significantly higher compared to other groups. In high PLR group, concomitant coronary artery disease was observed in 30.9% of patients, and this difference was statistically significant compared to the low PLR group. Conclusion: Widespread of the PAD may be predicted with the help of a simple blood test at the limited conditions of outpatient clinics and time will be saved in terms of prevention of PAD.
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    Does a basic blood test tell the location of peripheral arterial lesions?
    (Acta Medica Mediterranea, 2015) Yener, Ali Umit; Cicek, Omer Faruk; Cicek, Mustafa Cuneyt; Ozkan, Turgut; Korkmaz, Kemal; Yener, Ozlem; Genc, Bahadir
    Aim: In this retrospective study, we investigated if neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) can suggest at hospital admission the location of lesion according to TASC 2 classification, in patients with peripheral arterial disease(PAD). Methods: In patients who underwent peripheral angiography, the routine blood tests performed before the procedure were collected. 241 patients between January 2010 and March 2013 were included in the study. The relationship between blood parameters and the location of peripheral arterial lesions was investigated. The patients were divided into 4 groups according to their TASC 2 (Trans-Atlantic Inter-Society Consensus Document on Management of Peripheral Arterial Disease )classification; group A,B,C and D. Results: According to blood tests of patients, NLR and PLR were 3.47 ± 2.69 and 154.1 ± 71.2 , respectively. When NLR and PLR values were evaluated separately in each group, in patients of Group D according to TASC 2 , median NLR and PLR values were significantly higher compared to other groups. In high PLR group, concomitant coronary artery disease was observed in 30.9% of patients, and this difference was statistically significant compared to the low PLR group. Conclusion: Widespread of the PAD may be predicted with the help of a simple blood test at the limited conditions of outpatient clinics and time will be saved in terms of prevention of PAD.
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    Effect of acetyl salicylic acid resistance on saphenous vein graft occlusion in patients with metabolic syndrome who had coronary bypass surgery
    (Pulsus Group Inc., 2014) Baysal, Erkan; Yener, Ali Umit; Ozkan, Turgut; Karan, Adnan; Astan, Ramazan; Keskin, Gokhan; Yener, Ozlem
    PURPOSE: The goal of this study was to investigate the effect of acetyl salicylic acid (ASA) resistance on saphenous vein graft occlusion in saphenous vein graft used patients with metabolic syndrome who had CABG. ASA resistance may be higher in patients with metabolic syndrome and saphenous vein graft occlusion and this may result in adverse coronary events. MATERIAL-METHOD: 41 patients with metabolic syndrome who had previously CABG operation for whom saphenous vein graft was used and who currently used 100-300 mg/day ASA, who had postoperative angina pectoris, whose ischemia was determined by noninvasive tests and to whom coronary angiography were performed, were included in our study. The patients were divided into two groups as patients with saphenous vein graft occlusion (n:18) and the patients without saphenous vein graft occlusion (n:23). FINDINGS: In both groups with similar demographic characteristics while ASA resistance was determined in 10 patients with saphenous vein graft occlusion, 7 patients without saphenous vein graft occlusion had ASA resistance. This statistics showed us that in the patients with metabolic syndrome and who had ASA resistance, saphenous vein graft occlusion developed more. CONCLUSION: Although it is important to check ASA resistance in patients with metabolic syndrome, to whom CABG are intended, it is not checked routinely. In patients with metabolic syndrome who have ASA resistance, if CABG is planned high dose ASA treatment can be applied in early period, additional antithrombocyte treatment may be added or arterial graft may be used.
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    Radiofrequency ablation of the great saphenous vein in an elderly patient with co-morbid disease
    (Clinics Cardive Publ Pty Ltd, 2013) Yener, Ali Umit; Yener, Ozlem; Gedik, Hikmet Selcuk; Korkmaz, Kemal; Ozkan, Turgut; Lafci, Ayse; Cagli, Kerim
    An 86-year-old male patient with hypertension, Parkinsonisrn, benign prostatic hyperplasia, cataract and chronic obstructive pulmonary disease had a history of coronary bypass surgery in two veins due to anterior myocardial infarction one year earlier. He presented with pain and feelings of paresthesia below the knee of his left leg, and had fallen twice. He had used compressions and venoprotective medication for two years and had also received physiotherapy but it had not alleviated the symptoms. He had varicose dilatations in the left leg and pigmentation and a recovered venous ulcer scar were present on the medial malleolus. The patient was classed as grade 4 according to the CEAP classification. Because there was no deficiency in the superficial femoral and popliteal Veins, the patient was taken for endovenous ablation. He had no pain or sensation of heaviness in the legs on postoperative day 10, and the first, third and sixth months of check up. Endovenous ablation is a procedure that increases the quality of life and comfort in elderly patients, with minimal pain. Radiofrequency catheter procedures have proven to be more successful in patients of all age groups than procedures such as standard surgery and foam therapy.
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    The comparison of analgesic effects of various administration methods of diclofenac sodium, transdermal, oral and intramuscular, in early postoperative period in laparoscopic cholecystectomy operations
    (Professional Medical Publications, 2014) Ural, Sedef Gulcin; Yener, Ozlem; Sahin, Hasan; Simsek, Tuncer; Aydinli, Bahar; Ozgok, Aysegul
    Objective: The aim of this study was to compare the efficacy of oral, intra muscular and transdermal diclofenac sodium for pain treatment in patients undergoing laparoscopic cholecystectomy, and their effect on postoperative opioid consumption. Methods: Following informed consent, 90 ASA I-II patients scheduled for laparoscopic cholecystectomy were randomized into three groups. Group PO got oral diclofenac sodium 1 hour before the operation, Group IM 75 mg diclofenac sodium intra muscular and Group TD diclofenac sodium patch 6 hours before the operation. Patients were not premedicated. Routine anaesthesia induction was used. After the operation in post anaesthesia care unit tramadol HCl infusion was delivered by intravenous patient controlled analgesia (iv PCA). Ramsey Sedation Score (RSS), Modified Aldrete's Score System(MASS) and Visual Analog Scale Pain Score (VAS) was used for postoperative evaluation. Postoperative opioid consumption was recorded. Results: Demographic characteristics, intraoperative and postoperative hemodynamics of the patients were similar between groups. Postoperative VAS were lower at all time points in Group IM and Group TD than in Group PO. Lowest Postoperative RSS were in Group IM and the highest were in Group PO, and the difference between groups was significant. There was no significant difference in Postoperative MASS between groups. Postoperative tramadol consumption was statistically different between groups. Tramadol consumption in Group IM and Group TD was lower than Group PO. Postoperative nausea and vomiting was not observed. Local complications related to transdermal and intra muscular applications was not reported. Conclusion: In patients undergoing ambulatory laparoscopic cholecystectomy, a noninvasive application transdermal diclofenac sodium is as effective as intramuscular diclofenac sodium and can be preferred in postoperative pain treatment.