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Cardiovascular SurgeryEnez HealthNo Comments

Carotid Artery Occlusion Can Cause Paralysis

Symptoms such as loss of sensation, loss of movement, temporary or permanent visual impairment, fainting are among the symptoms of many health problems. However, it must be noted that carotid artery occlusion can also cause these symptoms. Stating that unnoticed vascular occlusions can cause severe conditions like stroke or paralysis, Liv Hospital Vascular Surgery Specialist Prof. Dr. Erdal Aslim explained the treatment of carotid artery disease.

How does it occur?

Carotid artery disease is one of the main causes of stroke, along with heart problems and brain hemorrhages. The disease occurs as a result of narrowing or occlusion of the carotid arteries, which goes along the both sides of the neck into the skull and are responsible for blood supply of two hemispheres of the brain.

What are the causes?

  • Tobacco use
  • High level of fat and cholesterol in the blood
  • High blood pressure
  • High blood sugar due to insulin resistance or diabetes
  • Genetic factors
  • Diabetes

What are the symptoms?

Loss of strength and movement in arm and/or leg at the opposite side of the affected carotid artery, permanent or temporary vision loss on the affected side, blackout, unconsciousness, facial paralysis and speech disorders.

Can cause paralysis

When the occluded carotid arteries become unable to supply the blood necessary for the brain, it can cause complaints like forgetfulness, dizziness, short-term speech or visual impairment, blackout. Patients may faint in case of more severe occlusions. The most troublesome outcome of this disease is the stroke possibility. Reduced blood circulation may leave certain areas of the brain without blood supply. If the blood clots accumulating in the occluded carotid artery travels to the brain, they can cause sudden death or permanent major paralysis.

How it is 

Lifestyle-nutrition changes: Maintaining a healthy diet and optimal weight is helpful for maintaining the cholesterol levels within the normal range and preventing the development of high blood pressure. Such precautions can prevent the disease and/or its progression.

Medical treatment: Accompanying diseases are treated with risk management; blood thinners and vasodilators are administered.

Interventional treatment: This treatment is performed for carotid arteries that are narrowed but not totally occluded. No interventional treatment is required for occluded carotid artery.

Surgical treatment: If the occluding plaque is required to be removed by endarterectomy method under general, regional or local anesthesia, the surgical treatment includes the expansion of the narrowed carotid artery by using synthetic or autologous patches, or the direct closure if the diameter is sufficient.

Interventional radiological treatment: Stent method is being used for the occlusion of neck vessels. This method is only applicable for a select patient group or in cases where operation cannot be performed for other reasons because short-term results published for this method do not present any advantage over surgery and no long-term results have been obtained yet.

General SurgeryEnez HealthNo Comments

Menopause And Sore Breast

Menopause is a long and difficult process for women. It usually starts in mid-40s and early 50s. Menopause is the time when your menstrual cycles stop and it is diagnosed after 12 months without a menstrual period. Liv Hospital General Surgery Prof. Dr. Levhi Akin highlighted sore breast and breast cancer subjects. Prof. Dr. Levhi Akin: “Menopause does not directly increase the cancer risk. However, the risk of many cancers increases with age, including the breast cancer. A woman who goes through menopause after the age of 55 has an increased risk of ovarian, breast and uterine cancer. Recent studies showed that women who receive combined hormone therapy for menopausal symptoms are at higher risk in terms of breast cancer, heart attacks, strokes and embolism. If menstrual cycles of a woman had started before age 12, then the risks are greater”.

Sensitive period for women

Approximately 70% of women experience sore breast during their lives. This pain is described as tenderness, swelling and discomfort or feeling of weight in the breasts. Depending on hormonal changes, pain occurs during menstrual cycle, onset period of puberty and first period of pregnancy. This starts to change as menopause approaches. In menopause, a sensitive period for women, there is loss of tissue and fat in the breasts, the density of the breast tissue decreases, they may start shrinking and there may be palpable lumps. Most of these lumps are not cancerous and defined as benign changes. There are two main types of sore breast during menopause. First one is the periodic sore breast; it starts with the menstrual cycle or one week prior. Second one is the nonperiodic sore breast which is not related with the menstrual cycle and can start any time. It may occur before, during or after menopause. Drugs used for the treatment of menopausal symptoms can also cause breast pain and tenderness due to their synthetic hormone content. Some drugs such as anti-depressants, cholesterol medication used with hormones, heart-related and psychiatric drugs cause increased breast pain.

The risk with hormone use during menopause

Some of the drugs used for the treatment of menopausal symptoms can increase or decrease cancer risk. Longer the estrogen and progestron hormone therapy, greater the breast cancer risk. In addition, it has been determined that women who receive combined hormone therapy for menopausal symptoms are at higher risk

in terms of breast cancer, heart attacks, strokes and embolism. Due to these risks, such therapies are not recommended or applied at low doses for a short period of time in women with breast cancer history or high breast cancer risk.

Chest DıseasesEnez HealthNo Comments

Copd Complaints Regress With This 2-Hour Procedure

Chronic Obstructive Pulmonary Disease (COPD) is disease that obstruct airways and makes breathing difficult.
Generally, based on the extent of chronic bronchitis and emphysema, patients with COPD can have varying symptoms from coughing and phlegm to shortness of breath even after a short walk. Globally fourth, nationally third most common cause of death, COPD continues to progress and treatments are usually insufficient due to lack of timely diagnosis. The most important cause of the disease is smoking. Quitting smoking is the single and most effective precaution that decreases the risk and stops the disease progression. Regular medication and newly developed bronchoscopic methods form the other parts of the treatment process.

What causes COPD?

Over the years, the structure of the bronchi and alveoli start to deteriorate as the alveoli are filled with cigarette smoke and toxic gases. As a result, bronchitis develops due to diseased and obstructed bronchi, and emphysema occurs due to the destruction of alveoli. As a result of these blockages and deteriorations in the lungs, oxygen transfer to the blood decreases and many serious diseases arise with the lack of oxygen in the body.

How COPD is diagnosed?

COPD is diagnosed with respiratory function test performed for patients with coughing, phlegm and shortness of breath and the severity of the disease determined.

What are the stages of COPD?

COPD is evaluated in 4 stages: mild, moderate, severe and extremely severe. Cardiac insufficiency may develop in extremely severe cases and edema starts in feet. In patients with cardiac insufficiency, shortness of breath becomes so severe in the later stages of the disease that patients become unable to leave the house. Patients at this stage use oxygen device for more than half the day.

How it is treated?

An effective treatment plan consists four steps.

Evaluation and follow-up of the disease
Decreasing the risk factors
Stable COPD treatment with pharmaceutical and non-pharmaceutical approaches
The treatment of acute exacerbations characterized by short-term worsening of the COPD symptoms.

Stable COPD treatment includes bronchodilator drug use for complaints and annual flu vaccination. And non-pharmaceutical therapies involve respiratory rehabilitation, oxygen therapy and, for limited eligible cases, procedures like bronchoscopic placement and balloon dilation (a bronchoscopic mechanical treatment).

What is balloon method?

Balloon method is beneficial for COPD patients with chronic bronchitis component. Obstructed bronchi are dilated with a balloon that is rhythmically inflated by a pump. This balloon opens the bronchi and allows for the development of healthy cells by destroying the mucus or phlegm-secreting defect cells. The mucus generated by the destruction of the cells is removed during bronchoscopy. Each lung lobe and segment is individually and mechanically cleaned with the balloon, enabling a significant expansion in bronchus diameter and preventing phlegm production. Shortness of breath is also treated by opening the bronchi.

How long is the treatment period?

The procedure is performed under operating room condition within 2 hours.

What does balloon method provide for the patients?

Lung function tests of the patients improve after the procedure. Bronchus diameter is significantly increased and phlegm production is prevented. Shortness of breath is also treated as the bronchi are opened. Exercise tolerance also improves and 6-minute walking test distance increases. Symptomatic scoring of the shortness of breath decreases.

Pediatric HematologyEnez HealthNo Comments

Mediterranean Anemia (Thalassemia)

Almost every mother knows the importance of nutrition and the role of iron, folic acid, vitamin B12 and zinc in blood production. They even visit doctors for the suspicion of iron deficiency due to problems like loss of appetite and learning difficulty. However, children may appear pale despite all these. Or iron levels may not improve in spite of receiving a long-term iron replacement therapy. In such case, the problem must be further investigated. Liv Hospital Pediatric Hematology Specialist Prof. Dr. Hilmi Apak explained Mediterranean anemia and its treatment.

In our country, almost 1.5 million people are Mediterranean Anemia thalassemia carriers. Half of our genes are from our mothers, and the other half is from our fathers. Thalassemia occurs like this as well; even if we inherit a disrupted gene, the disease would not occur as long as the other parent is healthy. However, we become thalassemia carriers. Even though we are not sick, we can give that gene to our children. If our partner is healthy in terms of this gene, your child will be a carrier with a fifty percent chance. However, if our partner is also a carrier, then our child may have thalassemia. Or if our child becomes a carrier, then our grandchild can have the disease. Being a thalassemia carrier may not manifest any symptoms. However, thalassemia is a severe disease and the patients are required to receive periodic blood transfusion for their lifetime. The only alarming factor that reveals thalassemia carrier might be pale look. Thalassemia carriers continue their normal life. They can perform difficult physical professions like police, military, doctor, and have multiple children although their pregnancies may be more difficult. They have slightly reduced blood count and it may be missed if not paid enough attention. Therefore, if your levels do not respond iron therapy despite long-term careful medication, thalassemia carrier is suspected.

Does every paleness mean thalassemia?

Of course not. Your child may have a light skin. However, experienced eyes of your physician will differentiate this. Because lips and auricles are pink. Or maybe the drop or syrup you use for iron deficiency is not as effective, not absorbed, or there is an intestinal problem that hinders absorption.  The best way to understand these conditions is referring a doctor.

How do I understand if I am a thalassemia carrier?

A simple blood count can tell whether you are a thalassemia carrier or not. You can clear all your questions by consulting a hematology specialist.

If carrying thalassemia is not a disease, why is it important to know?

People who are thalassemia carriers have folic acid deficiency. Therefore, they suffer from more severe infections than their peers as blood counts will be reduced. In addition, it is also important for detecting other thalassemia carriers in the family. Although it may appear as if it has no harm against the carrier, unnecessary iron intake can be prevented. In addition, future children of thalassemia carriers are at risk. These children will grow normally as their peers with a proper follow-up. Otherwise, developmental problems may occur due to chronic anemia.

Is there a definitive treatment for carriers?

It is not a treatment-requiring condition. They carry this gene for life. No treatment is required other than vitamin supplement. Thalassemia carriers can be easily diagnosed. A hematology specialist should be consulted for the early diagnosis of any future major anemias.

Breast Diseases And SurgeryEnez HealthNo Comments

Breast Cancer Affects Younger Adults, Too

Although breast cancer is most common in women between the ages of 50-70, there is risk at any age, as with all other cancer types. Breast cancer is known as a disease seen in post-menopausal women, however, Liv Hospital Ulus Breast Cancer Surgeon Prof. Dr. Ertugrul Gazioglu stated that the age range has decreased these past two decades and that breast cancer is now seen in young women, as well. Prof. Dr. Ertugrul Gazioglu said “In recent years, the mean age of breast cancer patients is shifting towards younger population. The breast cancer incidence in young women has increased in countries like Turkey in terms of social, cultural and economical aspects”. Prof. Dr. Ertugrul Gazioglu explained breast cancer.
In Turkey, one in every twelve women suffers from breast cancer.

Breast cancer is the most common type of cancer among women worldwide and is the number one cause of cancer related deaths. In the past 50 years, the incidence of breast cancer has doubled globally. Fifty years ago, the incidence of breast cancer was one in 20 women in the socioeconomically developed Western countries, but now one in every 8 women suffers from it. This rate is increasing in our country as well. In Turkey, one in every twelve women suffers from breast cancer in their lifetime.

Mean age of breast cancer incidence is decreasing

In the United States and Europe, only 7-8% of all breast cancer cases are below 40 years of age, however, in our country, 20% of all breast cancer patients are 40 or younger in our country. And almost half of the breast cancer patients in our country are younger than 50 years of age.

Why did breast cancer become prevalent under the age of 50?

  • Increased consumption of industrial and processed food
  • Use of unnecessary and uncontrolled hormone, drugs and similar products
  • Stressful work life of young women
  • Not giving birth; giving birth at a young age, no breastfeeding

Annual mammography after the age of 40

World Health Organization recommends annual mammography screening after the age of 40 for healthy women without any complaints. However, young women who have breast cancer history in their family should have breast examination once in every three years and breast ultrasonography, if needed, starting from puberty.

Factors Increasing Breast Cancer Risk

  • Being female
  • 50-70 years of age and post-menopausal period
  • Breast cancer history in the family
  • (Closer relatives and higher number of breast cancer cases leads to higher risk)
  • Previous breast cancer presence
  • Early menstruation onset, late menopause
  • Not giving birth
  • Giving first birth after the age of 30
  • Giving birth but not breastfeeding the infant
  • Long-term hormone therapy
  • Stressful environment of modern city life
  • Overweight: Gaining weight especially after menopause and excess consumption of food rich in saturated fats
  • Lack of physical activity
Infectious DiseasesEnez HealthNo Comments

Ways to Prevent Viruses Like Corona

Coronavirus that broke out in China and alarmed the whole world shows symptoms like high fever, respiratory distress, weakness, loss of appetite, body aches and pneumonitis. To protect from coronavirus that spreads through coughing, sneezing and breathing and does not have a specific vaccine or medication, general measurements should be taken. The disease continues severely in those above the age of 65 and those who have underlying diseases such as pulmonary disease, diabetes or cancer.

If someone comes to the hospital, how are they treated?

The patient is not taken outside the environment that they are in. With minimum contact, the patient and the personnel will be put on surgical masks. Both the patient and the healthcare personnel that have been in contact with the patient will come in and out of the room with surgical mask. Protective gown, hair restraint and gloves will be worn in addition to the mask and the patient will be applied contact isolation and droplet isolation. Because in the light of the information today, it is thought that the virus is spread through droplet infection (approximately 1 meter). Infection control doctor and nurse will be informed about this patient. Provincial Directorate of Health will be contacted regarding the patient. Necessary nose and throat secretion will be taken and submitted to reference center. 


How to diagnose?

If a patient with severe acute respiratory tract disease or acute respiratory tract infection (fever, coughing, requiring hospitalization) and has been in close contact with a confirmed new coronavirus case in the last 14 days or has been in China, they shall be evaluated as a case. Appropriate samples shall be taken and Provincial Directorate of Health shall be informed for definitive diagnosis and the patient shall be transferred to reference hospital. 


Is there a medication?

Research for the vaccine continues. There is no specific treatment, supportive treatments are applied.

How is the disease transmitted?

It is thought that the disease spreads through respiratory secretion. Respiratory secretion particles spread around by the diseased people during coughing, sneezing, laughing or talking contaminate mucosas of healthy people and cause them to have the disease. Close contact (closer than 1 meter) is required for the disease to be transmitted from one human to another this way. 


To protect from these kinds of viruses:

• Strengthen your immune system: Regular and healthy diet, adequate sleep, regular exercise strengthens immune system.
• Consume sufficient liquids: Upper respiratory tract mucosa like nose, nasal passage should be humid.  It is easier for the virus to pass through fragile dry mucosa.
• Especially pay attention to hand hygiene: By coughing or sneezing, saliva particles of the sick person can contaminate surfaces of chairs, tables etc. through the air. After touching a surface that has been contaminated by the virus, the person can touch their mouth, eyes or nose, thus contaminating themselves. These surfaces that have been contacted by the patient or may have been contaminated shall not be touched and if touched for any reason; hands shall be washed.
• Avoid contact with sick people.  
• Try staying away from crowded areas and sick people.
• Masks are useful in preventing you from spreading germs around.  However, it is wrong to think that just because you wear a mask that you are protected from the disease completely. As the standard unqualified masks do not have the feature to filter viruses. Other measurements shall be taken even if masks are worn.
• Avoiding high risk areas and countries at least until the epidemic is over is an important way of protection.

Pedıatric Health And DıseasesEnez HealthNo Comments

Best Pediatric Hospital of USA Boston Children’s Hospital and Liv Hospital Ulus Have Joined Their Forces For Second Opinion Services

Liv Hospital Ulus and Boston Children’s Hospital have signed a cooperation for the health and future of children. Boston Children’s Hospital, considered as the best hospital of USA in ranking of children’s hospitals, provides second opinion services for diagnosis and treatment of children with specific and difficult to diagnose diseases.

Every problem related to children is evaluated in detail

Liv Hospital Ulus is beginning a new project for children, the architects of our future, setting off from the value it puts on public health. Second opinion services are beginning from Boston Children’s Hospital, shown as the best hospital of USA in rankings of children’s hospitals for years according to the reports of U.S. News & World Report. It is planned to receive opinions from doctors of Boston Children’s Hospital, who are experts in their fields, via online consultation for the diagnosis and treatment of complex diseases that are difficult to diagnose.  


Experienced specialists, joint scientific programs

Any person that is born is very valuable for Liv Hospital Ulus. Therefore, Liv Hospital Ulus Pediatric Health and Diseases Clinic provides treatment to everyone from a newborn who has just opened their eyes, to those about to step into adolescence. In the Liv Hospital Ulus Pediatric Health and Diseases Clinic, diagnosis and treatment related to the branch can be carried out in sub-branch clinics such as Pediatric Rheumatology, Pediatric Nephrology, Pediatric Hematology, Pediatric Oncology, Pediatric Cardiology, Pediatric Endocrinology, Pediatric Gastroenterology, Pediatric Allergy and Immunology. Pediatric patients are carefully evaluated in a multi-disciplinary way by experienced lecturers and specialists within the framework of up-to-date and common scientific programs. 


Successful results with gene therapy

Also being one of the training and research hospitals of Harvard Faculty of Medicine, Boston Children’s Hospital has a history of 151 years. Describing itself as the “Hospital devoted to find answers for families”, Boston Children’s Hospital carries out researches on many diseases with Dana-Farber Cancer Institute, pediatric cancers and blood diseases being in the lead. Gene therapy program is one of the most extensive and prominent gene treatment programs of the world. Successful gene therapies are carried out in blood diseases such as sickle cell anemia, beta-thalassemia major, hemophilia A and immundeficiency diseases such as combined immune deficiency, chronic granulomatous disease.  

Rare diseases of pediatric gastroenterology

•    Neonatal hemochromatosis
•    Alfa1 antitrypsin deficiency
•    Acute intermittent porphyria
•    Congenital enteropathies
•    Some metabolic diseases involving liver
•    Diseases showing neurogastrointestinal uptake, such as mingie
•    PFIC group, i.e. progressive familial intrahepatic cholestasis 
•    Intrahepatic cholestases
•    Pseudoobstruction syndroms
•    Diseases similar to Hirschsprung 


Rare diseases of pediatric surgery and urology

•    Congenital anomalies
•    Neurogenic bladder 


Rare diseases of pediatric hematology

•    Leukemias
•    Rare anemias
​​​​​​​•    Thrombocytopenias
​​​​​​​•    Bleeding disorders
​​​​​​​•    Bone marrow deficiencies
​​​​​​​•    Childhood cancers 


​​​​​​​Rare diseases of pediatric neurology

•    Rare types of mitochondrial myopathies
•    Dystrophies other than Duchenne muscular dystrophy
•    Genetic epilepsies 
•    Spinous cerebellar atrophies (other than friedrich) 

It is possible to receive second opinion about the rare pediatric diseases mentioned below with the cooperation made by Liv Hospital Ulus and Boston Children’s Hospital for the health and future of children. 

For information and appointment: info@livhospital.com

General SurgeryEnez HealthNo Comments

Turkish Study Brings Hope for Breast Cancer Treatment

The gene study of Turkish Scientist Professor Doctor Atilla Soran and his team, who live in the USA, which is accepted as one of the most important authorities in breast cancer, can open a new horizon in the treatment of breast cancer. With this study, hope may arise to halt the spread of breast cancer.

It can open new horizons

All over the world, rates of breast cancer and breast cancer death vary according to the region and ethnicity. In the USA, more than 300 thousand patients and 40 thousand deaths are expected due to breast cancer in 2020. When diagnosed early, the 5-year survival rate in breast cancer increases to 99 percent, while this rate decreases to 20 percent in those with late spread to organs. Stating that personalized treatments are planned using the next generation sequencing methods genetically today, University of Pittsburgh University Breast Surgery Department Clinical Research Director and Liv Hospital Ulus Consultant Physician Prof. Dr. Atilla Soran points out that their latest research may open new horizons in breast cancer treatment. 


Personalized treatment with Next generation sequencing

Approximately 25 percent of patients with early stage breast cancer can have cancer re-spread after treatment. In advanced stage breast cancer that metastasizes, that is, spreading to organs, patients are treated with surgery, chemotherapy, hormonotherapy, immunotherapy and radiotherapy. Patients survive the problems caused by the side-effects of drugs or the spread of cancer. Today, personalized treatments are planned by using new generation sequencing methods. 


The prestigious medical journal in the USA published the exciting research

University of Pittsburgh Medical Center Breast Diseases Clinical Research Director Prof. Dr. Atilla Soran and Turkey held under the chairmanship of the joint studies with the prestigious US scientific high was published this week in the Journal of Clinical Breast Cancer. The collaboration followed in Turkey in 41 patient’s bone, lung, liver and by observing the cancer gene in cancer has spread to organs such as brain tumors have a distinct gene profile for patients in Turkey were investigated. In the study, the DNA sequence of tumor cells was examined with a special research technique developed at the University of Pittsburgh targeting 79 tumor genes and 1369 mutations. In Turkish patients, 59 different changes were found in 38 different tumor genes, 8 of which were found to be clinically important and could guide treatment. Unlike general studies in Turkish patients, it has been shown that some tumor genes can cause organ spread and long life can be achieved by detecting and suppressing these tumor genes. 


Treatment protocols may vary

In our country before, Prof. Dr. With the clinical research conducted under the leadership of Atilla Soran and included in the literature as a “Turkish Study”, Prof. Dr. Soran and her team showed that the chance of life was prolonged with timely surgical intervention in breast cancer patients with distant organ spread, and the 10-year life in these patients increased by 30 percent.

This newly published research supports that changes in tumor genes of Turkish patients with cancer that has spread to the distant organ may pave the way for new drugs in treatment and that survival can be achieved in much more patients in 10 years of follow-up. Prof. Dr. Atilla Soran “they found in the last 10 years in Turkey or advanced breast cancer with their work jointly with Turkey an important contribution to the world and said it changed the treatment protocols of these studies. 


Short… Short… Short…

• In the USA, over 300 thousand patients in total and over 40 thousand deaths are expected due to breast cancer in 2020.
• 3.5 million women who were diagnosed and treated for breast cancer in the USA continue their lives.
• If a woman has breast cancer in her first degree relatives like her mother, sister or daughter, her risk of getting breast cancer increases twice.
• With the decrease in the use of hormone replacement therapy without indication, the rate of breast cancer has decreased by 7 percent.
• Death from breast cancer has decreased by 2 percent compared to the previous 10 years with early diagnosis and newly developed treatments.
• When diagnosed early, the 5-year survival rate increases to 99 percent, while this rate decreases to 20 percent for those who have spread to the organs late.

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