YEDİTEPE REFERENCE A Global Reference Center in Healthcare SPRING•2017 • SPRING 2017 • VOLUME 02

BEDRETTİN DALAN EDUCATION, RESEARCH and HEALTHCARE ALL GO TOGETHER Top of the World: QUALITY MATTERS AT YEDİTEPE Don’t risk your brain! YEDİTEPE Leads the Way in Digital Marketing Sleep Apnea Why aren’t antibiotics working any more?

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02YEDITEPE UNIVERSITY HOSPITAL MAGAZINE L EADING MEDICINE A MESSAGE TO READERS FROM OUR CEO

The begining of new Welcome to Yeditepe University standard in healthcare. Healthcare Institutions, and this Yeditepe University Specialty Hospital issue of our Magazine Opening Soon

Yeditepe University Healthcare Institutions is growing and continously evolving to meet the high expectations of more and more patients from around the world.

is to provide the highest level of care support to our foreign guests. as the premier medical center for the entire region. That’s because at Yeditepe University Healthcare Institutions we take the In the past few months, we have goal of international healthcare expanded our facilities and added services seriously, and we aim to services to strengthen our role as the share Yeditepe’s exceptional human, region’s leading medical center. For research, academic and technology example: assets with every local or international • Our newly completed 212 guest. Being a University Hospital gives bed hospital offers the latest Yeditepe a real edge in monitoring- improvements in safety, comfort, and indeed contributing to- the latest and privacy, with every patient developments in medical science, and accommodated in a hi-tech private reflecting these advances in the care room. we offer to our patients. • Yeditepe’s comprehensive organ All these efforts, conducted in a transplantation Center, with its spirit of multidisciplinary teamwork At Yeditepe University Healthcare state-of-the-art technology, provides across all fields of specialization so as Institutions, we are continuing to lifesaving treatment for pediatric and to give patients a seamless medical implement a rolling program of adult patients. service, reinforce Yeditepe University investments in new technologies Healthcare Institutions’ commitment These exciting achievements build used for the diagnosis and treatment to outstanding patient service. on a foundation of excellence that of heart disease, cancer and other already featured Joint Commission We welcome you to visit Yeditepe conditions. International (JCI) certification, University Healthcare Institutions and And we are always challenging regarded as the ‘gold standard’ for see for yourself. You may write to us ourselves on ways to make the healthcare safety and quality. by e-mail, over our website, or contact healthcare experience better for our Global Services Department at any At Yeditepe, our doctors, nurses, our patients, their loved ones, our time, to see what makes Yeditepe a skilled technologists, and support physicians and staff. truly unique centre of healthcare and staff are 100% committed to medical science. Yeditepe University Healthcare exceptional patient care. And we 03 Institutions is growing and continously don’t stop there. Our Global Services evolving to meet the high expectations Department ranks among the very ALTAY BURAK DALAN, Ph.D. Yeditepe University Healthcare Institutions of more and more patients from best in Turkey for the quality and Chairman of the Board around the world. Our goal in Yeditepe dedication of its guidance and Assoc. Prof. of Biochemistry www.yeditepehospital.com www.yeditepehospital.com INDEX MEDICAL DIRECTOR

CERVICAL QUALITY HEALTH CANCER 28 OF SERVICE TOURISM 14 12 Our Values

BEDRETTIN Dear Readers, access to local expertise as well as world-renowned physicians and DALAN On behalf of our physicians, programs through our affiliation with EDUCATION, RESEARCH AND 40 leadership, and staff at Yeditepe healthcare centers abroad. University Healthcare Institutions, HEALTH CARE ALL GO TOGETHER DENTISTRY we extend a warm welcome to the With our exceptional staff, advanced second issue of our magazine. technology and range of support DON’T LET services, we provide you with I know from my personal experience excellent healthcare in a warm, CARDIOLOGY ALLERGIC that our hospital is truly unique. RHINITIS professional environment. And our Our caregivers are comprised of Global Services Department is on SPOIL YOUR people you know-they are your hand to provide 24 hour assistance LIFE friends, family and neighbors. This and support to our growing WINTER CONTENTS 20 EPIDURALS is especially important to patients number of international patents, 50 from abroad, who often require that drawn by Yeditepe University 08 34 extra attention and care to make Healthcare Institutions’ background With our up for being away from their home of many years of experience and environment. Customer satisfaction accomplishment in treating patients exceptional WHY AREN’T DON’T is a top priority for us. The entire with a wide range of conditions from ANTIBIOTICS Yeditepe healthcare team works all around the world. 44 RISK YOUR diligently to provide excellence in staff, advanced WORKING LEFT UNTREATED, service. We take great pride in not At Yeditepe University Healthcare ANY MORE? GLAUCOMA BRAIN! only meeting, but exceeding your Institutions, each of our team technology and CAN LEAD TO PERMANENT members is committed to providing LOSS OF SIGHT 16 expectations. you with the best possible range of support 54 At Yeditepe University Healthcare experience, whether you are staying Institutions we have adopted the with us as a patient from abroad, following values and believe them to utilizing our Emergency Department services, we be key to our success. or Ambulatory Services, staying as the accompanying person to a loved provide you with So you can expect that we will: A Message to Readers From Big Toes Can Be A Big Don’t let Allergic Rhinitis one, a visitor, or still just considering 3 24-27 50-51 • be professional; Our CEO Spoil Your Life us for your healthcare needs. excellent health Problem! • be respectful; Medical Director: Our Values 5 • act with integrity; I invite you to contact or visit care in a warm, Cervical Cancer 28-30 Gastroenterology • be dedicated; Yeditepe University Healthcare Contributors 6-7 Procedures: Myth and 52-53 • serve you with excellence. Institutions and encourage you to Reality professional Locations 32-33 learn more about our programs and Bedrettin Dalan: Education, Yeditepe University Healthcare services, our physicians, and our care Research and Health Care All 8-9 Institutions is widely regarded for environment. Why Aren’t Antibiotics teams. And if you are in Istanbul, I Go Together Cardiology and Sport 34-37 54-56 our excellent patient satisfaction Working Any More? urge you to call our Global Services results and exceptional care in a Department to arrange a tour of our Carrying On Making a 10-11 Sexual Dysfunction 38-39 comfortable, friendly and easily facilities. We are committed to our Difference Insurance 57 accessible location in an upscale community and offer you high quality districts in the heart of Istanbul. “A Win-Win for Patient and Dentistry: We Are a Global care and a compassionate team of Nuclear Medicine As Yeditepe University Healthcare Physician”: Yeditepe Leads 12 40-42 58-59 experts in a caring, accessible and Reference Center Institutions’ Medical Director, and the Way in Digital Marketing friendly environment. Global Services head of the urology team, I am 60-61 I offer you my most heartfelt best Quality Matters at Yeditepe 14-15 Left Untreated, Glaucoma Department’s Activities extremely proud of the service we Can Lead to Permanent 44-46 provide to our patients from all wishes for good health now and in 04 Don’t Risk Your Brain! 16-18 around the world. the future. 05 Loss of Sight Leisure & Sightseeing 62-65 Epidurals - Sorting Fact At Yeditepe University Healthcare 20-22 PROF. DR. FARUK YENCİLEK From Fiction! Sleep Apnea 48-49 Masthead 66 Institutions, we offer a warm Medical Director and nurturing environment with Head of Urology Department

REFERENCE / 02 55 www.yeditepehospital.com CONTRIBUTORS

n alphabetical order.

Bedrettin Dalan Prof. Dr. Canan Aykut Bingöl Prof. Dr. Muzaffer Değertekin Prof. Dr. Selim Pata İSTEK Foundation Founding and Honorary Rector, Yeditepe University / Neurology Head of Cardiology Department Otorhinolarygology and Head-Neck Surgery President A graduate of Marmara University Professor Pata is one of Turkey’s A graduate of Hacettepe University leading specialists in ENT diseases, Noted for the backing he gave to Medical Faculty, Prof. Dr. Canan Aykut Medical Faculty, Prof. Dr. Değertekin Head and Neck Surgery. Since educational projects during his time Bingöl enjoyed notable years of completed his specalization training graduating from Istanbul University success as the head of the Neurology Department Cerrahpaşa Medical Faculty in 1989, Professor Pata as Mayor of Istanbul Metropolitan Municipality, in cardiology in 1995. After winning the Young and Medical Director of Yeditepe University Hospital Researcher award in 2000, Prof. Dr. Değertekin has built a formidable reputation as a proponent of Bedrettin Dalan now lends his support and vision to advanced techniques in his field Professor Pata is an before her appointment as Rector of Yeditepe worked at Holland’s Erasmus University Thoraxcenter Yeditepe University and its Healthcare Institutions University and chair of board of Truebeam. active member of 11 professional associations with Cardiology department, where he applied the first numerous papers published in medical journals both in in his capacity as Honorary President of the İstek drug eluting stent in the World. Turkey and internationally. Foundation. Prof. Dr. Figen Kaptan Prof. Dr. Sibel Temür Assoc. Prof. Nalan Alan Selçuk Dean Faculty of Dentistry / Endodontics Head of Anesthesiology and Reanimation Nuclear Medicine Assoc. Prof. Ahmet Tunç Özdemir Figen Kaptan graduated from After completing her undergraduate Urology Istanbul University Faculty of Head of Yeditepe University and specialist medical training at Dentistry in 1991 and received her Hospital’s Department of Nuclear Ankara University School of Medicine, Assoc. Prof. Özdemir received his PhD in Endodontology from the same University Sibel Temür gained experience Medicine, Assoc. Prof. Nalan Alan at the cutting edge at the University of Southern medical training at the Medical Faculty in 1999. She has worked as a full-time faculty Selçuk is one of Turkey’s leading specialists in the California’s Department of Anesthesiology, following of GaziUniversity and Ankara Numune member at Yeditepe University Department of field, with a history of accomplishment that has which she returned to Turkey to continue her career Endodontics since 2000. Gained her associate Hospital where he specialized in Urology. He went on to been recognized with awards from the European in anesthesiology and reanimation, in which she has professorship in 2006 and professorship in 2014. receive further specialist training and experience at the Association of Nuclear Medicine, as well Istanbul become a leading figure, not least through her academic European Oncology Institute in Milan, Italy from 2009 She has had numerous scientific articles published and research papers that have been published or cited in Turkish and international journals. University from where Ms. Selçuk, a fluent English more than one hundred times in Turkish and international to 2010. Özdemir is a leading member of a number of speaker, graduated in 1996.Assoc. Prof. Selçuk’s medical journals. Professor Temür is also a member medical associations including the Prostate Cancer specialized fields of interest span PET Oncology, of a number of professional associations, including the European Society of Anesthesiology. Association in which he serves as General Secretary. Hasan Arslanyüreği Radionuclide Therapy, Pediatric Nephro-urology and Neurology; eight of her academic and research Director of Global Services articles have been published in international M. Tufan Sarinoğlu General Manager Assoc. Prof. Atakan Yeşil Having obtained a Masters Degree in medical journals. Medical Genetics, Hasan Arslanyüreği Since starting his career in banking Gastroenterology an Internal Medicine / and finance in Sweden, M. Tufan Bağdat Cad. Pol. Medical Director went on to play an instrumental role Sarınoğlu has served in senior in the start-up of 3 leading hospital groups “Global Prof. Raciha Beril Küçümen positions in some of Turkey’s largest Associate Professor Atakan Yeşil has Services Departments in Turkey. With a background Ophthalmology corporations. Having successfully been a member of Yeditepe University of 14 years” experience in global marketing in the launched a number of start-up projects in Turkey, he healthcare sector, he currently heads the Global is currently serving as General Manager of Yeditepe Hospital’s team since 2014 as a specialist at our Professor Küçümen received University Healthcare Institutions. Internal Diseases and Gastroenterology Clinic. A Services Department of Yeditepe University and specialized training at Hamburg number of professional associations including the Hospital. University’s Department of Ophthalmology European Association for the Study of Liver Diseases, following graduation from Istanbul University’s Prof. Dr. Uğur Şaylı Orthopaedics Surgery and Traumatology Assoc. Prof. Yeşil’s particular fields of interest Cerrahpaşa Medical Faculty, and has had numerous Prof. Dr. Meral Sönmezoğlu encompass interventional endoscopy, diseases of papers published in medical journals around the A graduate of Ankara University the liver, pancreas and anal region, inflammatory Infectus Diseases and Clinical world during her 30-year career, during which she Medical Faculty, Prof. Dr. Uğur Microbiology Şaylı completed his training at Gazi intestinal disorders, and peptic ulcer reflux conditions. has been invited to make presentations at more University before working in various The Head of Yeditepe University than 50 international congresses. pioneering centers including the world Hospital Department of Infectious famous Alfred I duPont Institute and Johns Hopkins University in the United States. Assoc. Prof. Dr. Burcu Örmeci Diseases and Clinical Microbiology, Professor Sönmezoğlu has been at the forefront of Prof. Dr. Selami Sözübir Neurology developments in the field in Turkey and abroad, Head of Pediatric Surgery Department Prof. Dr. Ümmühan Meral Aban having served at a number of pioneering institutions Obstetrics & Gynecology A graduate of Akdeniz University including the Copenhagen Bispebjerg Hospital and A graduate of Istanbul University Medical Faculty, Assoc. Prof. Dr. Burcu St. Bartholomew’s Hospital in London. No fewer than Cerrahpaşa Medical Faculty, Prof. An internationally known specialist in 93 of her studies and research papers have reached Dr. Selami Sözübir studied and gynecological diseases and childbirth, Örmeci completed her post graduate program in 1st Professor Aban has worked at some a wide audience through their publication in Turkish worked as an intern during his education at Umea 06 place in 2008. Specializing in the field of Neurology, of the world’s leading centers in the 07 and international journals. Meral Sönmezoğlu is a University, Sweden and Erlangen University in field including as a professor at Yale University, the Assoc. Prof. Örmeci takes role as an instructor at the member of a number of associations including the Germany. He specializes in the areas of pediatric Memorial Sloan-Kettering Cancer Center and the Turkish EEG-EMG Neurophysiology association. International Society for Blood Transfusion. surgery and urology. Roswell Park Cancer Institute in the United States.

REFERENCE / 02 www.yeditepehospital.com İSTEK FOUNDATION

Bedrettin Dalan Education, Research and Healthcare All Go Together

Our medical faculty has become a world leader in terms of our own in-house research and development work.

Like Japanese technology, German have become highly competitive develop as psychologically healthy in terms of fighting and eradicating Everyone wonders about your cars or Swiss clocks, the concept of internationally and now top the societies. Therefore, as a foundation hospital germs and bacteria. This overseas investments. Are we Turkish healthcare and training has rankings in terms of medicine and serving the public good, we are not hospital is almost completed. The going to be able to see Yeditepe recently made great strides. What medical education and training, with a commercial organization. We are day will come when all hospitals look abroad? a very favorable position in terms a body that works for the good of like Yeditepe University. There’s no gives us our self-confidence in this Not in the short term. There is a of both quality and price, in a highly people and society. Naturally, other other way. Because the one thing field? greater need for these services in competitive environment. If risks organizations operate as commercial that afflicts every hospital in the Turkey, but our doctors continue to Health is number one. Otherwise in international relations decrease, entities. Commerce is an important world, including the most celebrated conduct training sessions abroad all the zeros that come after “one” I believe that Turkey could earn activity in the life of society but as a ones, is hospital-formed resistance would be meaningless. So health from time to time and transfer our twice the amount from medical foundation we are working on more and the development of germs and know how. and healthcare are areas that all tourism that it does from regular important issues. On R&D, training, bacteria that cannot be medically individuals, families and states need tourism. That is how far Turkey everything. And I can tell you we are treated. For the first time in the What does “being a Yeditepe to prioritize. A society of healthy has come. Our average healthcare competing on a world scale. world, with our own technology we person” really mean to you? What We are a people is a healthy society. Looking services really are better than have created a hospital that does not sets us apart? There is a new trend for new back at the history of human many developed countries. About generate germs and bacteria. university hospitals in Turkey. You It all boils down to just one essential healthcare, we see that the Turks healthcare we are in a pretty good body that foresaw this 15 years ago. What The international team at Yeditepe point. Following the path of Atatürk were among the pioneers. From the place. traditions of ancient times in Central inspired you? was set up a year ago. They are our leader. And that just needs Our distinguishing feature is the promoting the hospital in more one thing: prioritizing science and works for Asia up until today, the Turks really The main difference between importance we attach to education than 35 countries. Yeditepe technology and genuinely competing have lead the field. Indeed, the books university hospitals and regular and training. For example, our is receiving more visibility with the world accordingly. Matching of Avicenna (Ibn-i Sina) were used hospitals is that university hospitals investments have been devoted and exposure as a healthcare and exceeding world standards. That the good of as basic texts in western universities don’t just deliver healthcare services; exclusively to education, training institution in the international was the goal Atatürk set us. up until modern times. Health and they also conduct research to and healthcare. How can we explain arena. Can we expect more healthcare fields regressed during improve health and wellbeing. Since Do you have a message for young people and this approach? surprises from you internationally? the era of the Ottomans, who fell we are a university with a medical people from Yeditepe? behind in science. People once It’s very simple, because the faculty, we established a medical What I can say is that we are Whatever you do, wherever you go, again took a serious interest in the society. foundation I established 30 years ago faculty capable of implementing becoming a “Center of Excellence” never stray from the example and field during the Republican period, was set up as the Istanbul Education and advancing both research and on a world scale. We are focused on light of Atatürk our leader. with world-beating success. For and Culture Foundation. So it was healthcare services. And our medical excellence and quality. If this quality example, organizations set up to about two subjects that are central faculty has become a world leader in is well promoted, it may be that we 08 battle tuberculosis and malaria to people and society-education terms of our own in-house research shall have more international than 09 achieved outcomes that lead the and health. In any case you have to and development work. Based on domestic patients coming to us for developing world. Hospitals that have good education and training to our own scientific and technological treatment in the future. And this is BEDRETTİN DALAN have been established by prestigious have good healthcare. Well educated developments, our new hospital is only the beginning. İSTEK Foundation Honorary President universities in Turkey in recent years societies are healthy societies and number one in the world, especially

REFERENCE / 02 www.yeditepehospital.com INNOVATION

in terms of the preferences of our revisions to your investment and international patients. We have a employment policies? Global Services Department employing YEDİTEPE: trained, multilingual professionals to We have already reached our annual guide and assist foreign patients and targets for treating 130,000 out- A HOSPITAL OF their loved ones throughout their stay patients and 6,000 surgical in-patient at Yeditepe, and monitor their recovery cases, even before the term has ended. and follow-up care in liaison with their We are going full speed ahead with our “FIRSTS” doctors in their home countries. efforts to achieve our new targets for Carrying on making a attracting international patients. There Turkey's first permanent artificial INTRAOPERATIVE MRI WILL BE is no change to our investment and heart pump operation USED FOR THE FIRST TIME AT employment policies; we are carrying YEDITEPE’S NEW ONCOLOGY on with our investments to be the Turkey’s first impella supported bypass operation difference HOSPITAL. IMRI WILL REDUCE leader, and make a difference, in the THE SCAN DURATION FROM 40 sector. Turkey’s first cochlear implant project MINUTES TO ABOUT 4 MINUTES. What about your roadmap for 2017? How do you evaluate Turkey’s Could you tell us something about Turkey’s first double balloon current position in the global your new investment areas and endoscopy In response to our questions about Yeditepe healthcare sector? What projects? What about your medium- New voice surgery techniques; University Healthcare Institutions Current and future are Turkey’s advantages and and long-term objectives? disadvantages? ground-breaking methods to objectives, General Manager M. Tufan Sarınoğlu Our new hospital still under correct voice characteristics and Although the rapid rise of the dollar construction in the Asian district of timbre, and increase the ease details the hospital’s commitment to major steps against the Turkish Lira has had a Istanbul will focus on oncology, and and comfort of use for people looking forward, and how Yeditepe is set to maintain negative impact on costs, the Turkish will be the first hospital in the world with voice disorders healthcare sector is remarkably to use intraoperative MRI equipment. First flexible urological its position in the vanguard of the sector. robust in its commitment to growth Thanks to this device, the scan duration ureteroscopy and development. We are pressing will be reduced from 40 minutes to ahead with our efforts to realize our about 4 minutes. This device is a highly The world's first ‘vascular planned projects, in spite of severe significant breakthrough, especially in bone transplantation’ using a cost increases. The healthcare emergency cases… MRI procedures will technique developed at Yeditepe What is the vision and mission and outcomes, and some have One of the factors putting us ahead of sector in Turkey is also growing now be possible during surgery. using bone from the patient’s underlying Yeditepe’s projected scored successes on an international the competition is our status as a non- rapidly on account of the vision of own body (without needing knee investments in the health sector? scale. Our Brain and Neuro Surgery profit institution employing close to the government. New healthcare In addition, this will be the world’s replacement). This technique And could you tell us a little about Department is worthy of particular 800 people, which helps achieve high investments are being carried out first “total antimicrobial hospital”. was published in international your corporate structure, and note in this respect. The department is levels of patient trust and confidence, in the private and public sectors. Thanks to a special coating developed scientific journals Yeditepe’s position in the sector? staffed by surgeons and neurologists as well as the benefits of superior I believe that Turkey’s advanced by Yeditepe University, the hospital with a background of world-class technology infrastructure for all our progress, position and status in the In the light of Yeditepe University’s will itself prevent bacteria and germs The only foundation hospital to training, knowledge and experience. patients. We are the first Foundation healthcare field will serve to attract guiding principles and values, we finding a home within its walls. The be licensed by the Ministry of Our hospital has an ongoing record University Hospital established in many more patients from abroad in aim progressively to increase the hospital will have the capacity to serve Health in Turkey as a transfusion of success in studies and research Turkey. We invest in science and the future. In addition, Turkish patients 1,000 patients at the same time. Our center number of people benefitting from in the fields of neuro-oncology, are increasingly inclined to consult a research. We encourage our doctors difference-making Brain and Neuro our accomplished healthcare teams’ cerebrovascular surgery, epilepsy doctor. These conditions will work The first heart transplant- advanced diagnostic and treatment to obtain Board Certification; Surgery Department is set for further surgery, spinal surgery, pediatric in parallel to maintain an increasing bridging artificial heart pump methods; we direct our investments academicians with Board Certification neurosurgery, stereotactic and demand for healthcare services. growth as it moves into this new implantation in Istanbul in line with this overarching objective. from Europe and the United States functional neurosurgery, peripheral facility. Among our targets for 2018 is Our goal is the fullest and quickest currently work in our Departments neurosurgery and neuro-spinal Could you tell us how you evaluate the planned opening of a new pediatric The first foundation university recovery for all our patients. Our of Urology, Orthopedics, Cardiology, 2016? To what extent did you fulfill traumatology. Our Orthopedics surgery hospital. This will be another hospital in Istanbul to perform a vision is to be an academic healthcare Brain Surgery and General Surgery. And your objectives? Department’s prosthetic surgery, hand Yeditepe “first” in Turkey. We also want heart transplant institution making a difference through we facilitate our specialists’ ability to surgery and microsurgery, as well as to open a psychiatric hospital but our the services we provide, in the light conduct research and studies into their Progress in the first quarter exceeded Turkey’s pioneer in using the state-of-the-art surgical techniques in priority of course is the new hospital on of modern science. With Yeditepe concerned fields of specialization by our expectations, so our expectations SAN-TEZ project soluble stent cases of shoulder fractures, tumors, the Asian. We shall then give priority to University Hospital and its affiliated giving them one day a week off for this for the end of the year are still high. congenital and acquired curvatures, specialized hospitals. The world’s first successful institutions’ services internationally purpose, as well as providing financial We do not anticipated any negative provide effective treatment with completion of epilepsy surgery recognized and certified by JCI, the support. In this way we aim to deliver a developments. The formation of our Could you share with us your vision high rates of success. And our using a special technique by gold standard in terms of patient safety higher level of healthcare service to our International Sales, Marketing and for 2023, the Turkish Republic’s our specialized neurology and and quality of care in the healthcare Cardiology Department continues patients. Business Development Department in centenary year? neurosurgery team sector worldwide, we are taking to apply innovative treatment 2016 is also playing a significant role in methods and techniques with their Why do patients from abroad choose enabling us to reach our targets. The Our 2023 target is to increase the confident and significant steps as we Yeditepe for treatment? The world's first total look forward. eight-bed Coronary Intensive Care rise in the number of patients coming number of Yeditepe University Unit, Cardiology Clinic, and their to Yeditepe from abroad has given us a antibacterial hospital There are a number of reasons why Hospitals and to bring the world’s Which departments at Yeditepe Catheterization, Angiography and significant boost. In the coming period foreign patients choose our hospital. most advanced treatments to Turkey. stand out in terms of innovative Electrophysiology laboratories. we aim to achieve a first in the field by We are justifiably proud and ambitious We aim to implement projects that 10 treatment systems? How are you setting up “contact offices” in about 30 11 about the healthcare services we offer will bring value added to Turkey, such making a difference in these areas? Could you tell us about your foreign countries. technology infrastructure, the number to patients from abroad. Our bone as the proton therapy project and All our departments deliver of people employed at the hospital marrow transplantation, orthopedics In terms of your year-end targets investments in specialized fields like TUFAN SARINOĞLU outstanding healthcare services and your strategies for the future? and oncology units top the rankings for 2016, are you considering any psychiatric and pediatric hospitals. General Manager

REFERENCE / 01 www.yeditepehospital.com HEALTH TOURISM L EADING MEDICINE

“A Win-Win for Patient and Physician”: Yeditepe Leads the Way in Digital WE DIDN’T IMPROVE Marketing OUR SURGICAL CARE FOR THE AWARDS We spoke to Hasan Arslanyüreği, head of Yeditepe University Healthcare Institutions’ global marketing team, about the work of his group, which includes the International Patient Services Department that interfaces with international patients and guests at Yeditepe University Hospital.

Patients are using digital means to find and engage with healthcare organizations, which is why digital marketing is so critical.

Could you tell us a little about what What principles guide these efforts, And how is the behavior of patients global marketing means to you in and what are your department’s affected by today’s digital technologies? the context of Yeditepe University objectives? According to a Think With Google study, Healthcare Institutions? The underlying objective of Yeditepe 84 percent of patients use both online Making the decision to receive medical University Healthcare Institutions is and offline sources for hospital research. treatment abroad is not an easy one. to deliver a world class healthcare Likewise, search engines drive nearly That’s why a professional digital service to our patients from all around three times as many visitors to hospital marketing and information strategy the world, it’s as simple as that. We sites compared with non-search visitors, is so important to any enterprise. never lose touch with that objective in and 44 percent of patients who research Patients and physicians need to be able everything we do. Yeditepe University hospitals on a mobile device schedule an to find you, and above all to obtain the Healthcare Institutions is known for its appointment. information they require easily and groundbreaking approach. We are an So online content is important… accurately. organization of ‘firsts’ in the medical Totally. It is impossible to build a successful And how does this impact on the field, and now we are pioneering strategy without the right online content. end result, especially for Yeditepe’s our marketing efforts to match our To succeed in today’s developing healthcare growing number of international standards of excellence as a leading industry, physicians and hospital groups patients? healthcare and research institution in need to constantly produce new content Yes, our global services effort has the region. that not only gets them found but also enables patients to access clear, accurate become a central part of Yeditepe You said that the healthcare sector is University Healthcare Institutions’ and up-to-the-minute information that behind in digital marketing. What are directly relates to their search and situation. work and our strategy for growth and you doing to address that? development. And again, patients from And what means is Yeditepe using in this To reach physicians and patients on a other countries, their own doctors, effort? global basis, we are working to change and their loved ones, need to be able From blog posts to social media updates, to access accurate information, and to the tendency of the healthcare sector being behind in digital marketing videos, e-books, webinars, and more, you appreciate the range and extent of our need to publish content that will get you WE DID IT by helping other teams working at healthcare services, at the touch of a found online by the search engines and button. Yeditepe reach and engage today’s social media channels your target audience tech-savvy patients and physicians uses to learn about healthcare services We don’t often think of the healthcare through digital marketing. Digital sector in this respect.. and products. From my perspective as marketing is no longer optional for a marketing person in the healthcare FOR YOU You’re right, the healthcare industry hospitals and practices, insurance sector, I saw a great void in the digital historically has not been keeping providers, pharmaceutical companies, marketing space for physicians, so now I am pace with these developments. The medical device manufacturers, or other actively helping our healthcare organizer widespread distribution of digital organizations in the healthcare space. community to use these tools to help technology has changed the nature of patients find and access Yeditepe University marketing. Businesses are now moving You mentioned this is about doctors, as well as patients? Healthcare Institutions by providing them away from the distribution of massive, with worthwhile content and strong shotgun-style email campaigns and Absolutely. Doctors and healthcare branding in their marketplace. It truly is a implementing targeted efforts aimed professionals are using search engines, win-win for the patient and physician. 12 at getting in touch with more focused like Google, in diagnosis, treatment, and demographics. In fact, comparative ongoing care. Also, patients are using research shows the healthcare sector these means to find and engage with is about two years behind other healthcare organizations, which is why HASAN ARSLANYÜREĞİ www.yeditepehospital.com industries. digital marketing is so critical. Director for Global Services

REFERENCE / 02 QUALITY OF SERVICE

What is Yeditepe’s latest achievement in this field? Recently, we gained third-time JCI accreditation, this time including the areas of Medical Education Academic Standards and Human Participant Research. We are now fully accredited as an Academic Top of the World: Medical Center Hospital. We hear that Turkish regulatory bodies also operate strict quality regimes. Is this the case? Quality Matters at Yeditepe In Turkey, there has been a remarkable growth and development in the healthcare sector over the past years. And yes, Professor Selami Sözübir, M.D., Professor, Quality Development the Turkish Ministry of Health is at the forefront of maintaining and Manager at Yeditepe University Healthcare Institutions, gives us regulating quality in all healthcare an in-depth perspective on Yeditepe’s approach to quality, and the institutions in Turkey. Could you be more specific? tough process of gaining domestic and international accreditation. The Ministry of Health increasingly prioritizes the work of it’s dedicated “Department of Healthcare Quality We have read in the press that Tell us about that, many of our quality. JCI audits the hospital in and Accreditation”. Healthcare Yeditepe has gained firsts in quality readers may not know about JCI. an incredibly rigorous way, using Services Quality Standards are and international accreditation. Is it’s Targeted Solutions Tools™ to JCI is the recognized leader set with the input of domestic this a focus of your work? trigger improvements in the most in international healthcare and international sources, with a critical patient safety and quality focus on “Patient and Employee Absolutely. At Yeditepe we have a accreditation, known as the global areas. Safety”, and these standards department specifically devoted ® Full Accreditation Status from Gold Seal of Approval . It audits and are continuously improved and to maintaining and developing our the Medical Programs Evaluation checks about 20,000 healthcare Is that why Yeditepe chooses to updated. The basic purpose of quality standards. I manage the and Accreditation Association institutions in more than 90 be audited and monitored by JCI? domestic healthcare quality policy “Incredible department, and with my background countries. No other accreditor has Because it’s tough? (TEPDAD) and the National Medical is to formulate a common language Accreditation Agency (UTEAK), in the real world of medicine, I as many sets of standards approved for healthcare services across the understand the crucial importance of In a way, yes. At Yeditepe, our which acts as a guiding and advances have and endorsed by the International fundamental vision is to be a country as the basis for a process of umbrella group designed to develop maintaining total quality as it impacts Society for Quality in Healthcare. continuous improvement. directly on patients and their loved leading training and research and improve standards in medical It’s a really tough audit, and it’s part faculties across the country. This been made in ones. hospital, which we believe requires How does Yeditepe perform in of an ongoing process. So we are a continuous and relentless focus terms of quality improvement shows our commitment to Medical How do you see Yeditepe University proud of Yeditepe’s “first” with JCI. on the quality and safety of the efforts conducted within Turkey? Training and Education. the medical Hospital’s overall approach to And how does accreditation healthcare services we offer to What about cutting edge maintaining quality? Yeditepe University Healthcare benefit patients? patients, as well as prioritizing Institutions scored a major success technology in the medical field? field in recent As we all know, incredible advances our training work, working with a gaining accreditation in the Quality How does Yeditepe perform in That’s a great question, because have been made in the medical professional healthcare team, and Standards in Healthcare Services genetic medicine, for example? years, with the accreditation, and the work of field in recent years, with the implementing proactive processes Assessment in 2014. Our hospitals Yeditepe is right at the forefront of Yeditepe’s Quality Development application of new technologies and for constant quality improvement underwent a rigorous audit, with advances in genetic medicine. Our application techniques. Yeditepe is committed Department, is all about patients and development in all areas. separate expert committees Genetic Diseases Diagnosis Center in the end. At Yeditepe, that’s what examining our performance and to staying right at the forefront of Is this a new process? and Tissue Typing Laboratory lies these developments. This requires matters, especially with our growing standards in different fields. These at the heart of these efforts. That of new the rigorous implementation of number of international patients No, our commitment to quality intensive efforts are ongoing, with is why we are currently undergoing world class standards, not only in who rightly expect world class development is really an integral the active support and coordination intensive work in order to achieve technologies maintaining, but actually developing quality and standards. part of Yeditepe’s DNA. We of our hospital administration. ISO 15189, the international and improving quality standards and exposed ourselves to the toughest One of Yeditepe’s strengths standard for quality and and How does the accreditation competence in medical laboratories protocols. process work? comprehensive quality audit back lies in its status as a Training in 2007, when we gained JCI Hospital and a center for medical implemented by the Turkish You talk about world class Accreditation Agency to confirm techniques.” Accreditation is essentially accreditation at the end of JCI’s first education. Have you achieved standards. So has Yeditepe gained and recognize the competence of a corporate commitment to audit. That process took 16 months, specific quality achievements in international recognition for its laboratories such as ours. developing patient healthcare which gives you some idea of how this field? standards? quality at the optimal level, rigorous JCI is. We were accredited ISO sums it all up in their words 14 That’s true, being a training and when they say “International 15 Yes. In fact, we are the first University minimizing risks to healthcare once again in 2010 and undergo education center gives Yeditepe a Standards make things work”. Hospital group in Turkey to have been workers and patients, and a process a process of continuous auditing seriousness, depth and status that granted accreditation by JCI (Joint that ensures the development and monitoring. It’s not a one-off sets us apart. In 2014, Yeditepe PROF. DR. SELAMİ SÖZÜBİR Commission International). and continuous improvement of achievement! University Medical Faculty achieved Quality Improvement Director

REFERENCE / 02 www.yeditepehospital.com NEUROLOGY

Don’t risk ABOUT PROF. DR. CANAN AYKUT BİNGÖL

your brain! A graduate of Marmara University Medical Faculty, Prof. Dr. Canan Aykut Bingöl gained prominence over many years as a neurologist and physician before It takes more than just doing puzzles to avoid getting Alzheimer’s becoming Medical Director of one day. Because research shows that just as people who are Yeditepe University Hospital in 2007, Chair of the Board overweight, have an unhealthy diet and a sedentary lifestyle expose of Trustees of Yeditepe themselves to higher risks of cardiovascular disease, bad health University in 2012, and Rector habits have a negative impact on brain health too. in March 2016.

IT IS NOW RECOGNIZED THAT Bingöl defines them as stealthy, Patients admitted to the center SHOCK TREATMENT! the main objective of our program is The remaining healthy brain tissue ALZHEIMERS IS INFLUENCED BY silent brain damage that occurs provide a detailed medical history in to explain to people the direct links is called ‘reserve capacity’. Current Professor Bingöl details the A NUMBER OF FACTORS AND throughout a person’s life as a result line with the lifestyles set out by the between things that don’t at first medical methods cannot prevent this importance and objectives of the DEVELOPS IN THE BRAIN OVER of risk factors such as high blood World Health Organization; a mass of sight appear to be connected.” 20% loss. Therefore the remaining MANY YEARS. pressure and diabetes. Another little information from smoking to exercise Brain Health Protection Program 80% reserve capacity needs to be People with a family history of known fact is that silent strokes and general habits is obtained in these words. “In this age of mass well organized. Professor Bingöl 60-90% of Alzheimer sufferers dementia, Alzheimer’s or strokes constitute one of the leading factors in this way. Then, as Professor communication everyone has explains that specialists in the field also develop cerebral blood vessel should undergo a medical check-up triggering Alzheimer’s. Explaining Bingöl describes, various body learned about health measures like have developed the concept of ‘super conditions. 50% of Alzheimer cases and tests. that patients suffering from vascular measurements are recorded. “There keeping their blood pressure down, ageing’ in which the aim is to reach are thought to be related to damage risk factors that cause silent strokes is a direct relationship between the controlling their weight, and taking centenarian longevity, which people to the capillaries, the small branching PROTECT YOUR BRAIN RESERVES often come to her complaining of risk of contracting Alzheimer’s and exercise, but it can be hard to really should prepare for by safeguarding blood vessels that represent the absentmindedness, Professor Bingöl body mass index (BMI). Therefore get people to grasp and pursue the The human brain is the last organ their existing brain capacity after smallest of the body’s blood vessels. the age of 70. This is facilitated by goes on to say “Patients who have body measurements are significant benefits even small changes can to develop. While all our organs undergone brain damage over many make. For example, if you don’t walk productive use of the brain between We found about the risk factors to for us.” have a certain capacity from birth, years as a result of tiny silent strokes the ages of 25 and 70. a healthy brain and protecting the just half an hour a day your risk the brain continues to develop and also have a higher risk of dementia. GENETIC FACTORS ARE KEY! brain’s reserve capacity from the of having a heart attack goes up! make fresh connections until the Professor Bingöl lists the Therefore we need to define people’s Everyone understands this but it’s age of 25, when it plateaus and then Rector of Yeditepe University, Prof. Professor Bingöl goes on to underline internationally recognized criteria for risk factors and measure their hard to grasp the connection when Dr. Canan Aykut Bingöl. that the APOE gene has been typed begins to go into functional and what is required to protect reserve severity to provide lifelong treatment someone says if you don’t walk half because everyone has it but certain physical reverse during ones 30’s and capacity as follows. DEMENTIA’s HIDDEN CAUSE: appropriate treatments that will sub types represent a cerebrovascular an hour a day your brain structures 40’s. Even the healthiest individuals “SILENT STROKES” protect the brain.” disease risk factor, including an will shrink and you’ll have memory will have lost 20% of their cerebral problems when you get to 75. So volume by the time they reach 70. A stroke is the medical incident that BEING OVERWEIGHT INCREASES increased risk of Alzheimer’s: “The older people fear most. It is well ALZHEIMER RISK close genetically based relationship known that strokes can be related to The ‘Brain Health Protection and link between heart and brain heart disease, high blood pressure, Program’ launched for the first time disease and Alzheimer’s disease 16 diabetes, cholesterol, smoking in Turkey by Yeditepe University opens the way to preventive action 17 and immobility. A widespread but Hospital aims to raise awareness of to protect a person’s brain.” For these much less well known condition is these issues in society and to treat reasons, evaluation of a family history known as ‘silent strokes’. So what people who suffer from conditions of dementia, Alzheimer’s or strokes is are these ‘silent strokes’? Professor that affect the health of their brain. required to determine dementia risk.

REFERENCE / 02 www.yeditepehospital.com NEUROLOGY DEPARTMENT OF RADIOLOGY & MEDICAL IMAGING

TAKE EXERCISE QUALITY SLEEP KEEP HORMONES ON CHECK You don’t need to go to the gym Brain shrinkage is significantly Menopause related increases in to achieve this. Driving less, using speeded up by lack of good sleep. thyroid hormones and reduced muscle power instead of all those Moreover, the brain produces estrogen levels increase a woman’s electric gadgets all the time, and most millions of toxic items every day. susceptibility to Alzheimer’s in later It could be the most importantly walking for at least an Sleep cleanses these and numerous life. For this reason post-menopause hour a day can be sufficient. These studies have shown that sleep hormone replacement therapy may kinds of changes help to activate reducesthe Amyloid Betaprotein in be considered, under a specialist’s important unused muscles as well as firing up the the brain responsible for Alzheimer’s. guidance and administration. brain that organizes it all. This leads Medication-induced sleep doesn’t

to the formation of new electrical count! Because this kind of sleep can connections, and increases cognitive actually obstruct the benefits the REVIEW YOUR MEDICATIONS brain should get from a natural night’s PICTURE capacity. As the most glucose consuming organ in a unit of time in sleep. Recent research has revealed that the human body, the brain benefits certain medications can play a role of your life hugely from physical exercise. in the emergence of dementia and Alzheimer’s, in particular stomach EAT A MEDITERRANEAN DIET acid reducing proton pump inhibitors What’s good for the heart is good and antihistaminic headache pills. If for the brain! A Mediterranean diet no problems or side effects develop protects vascular structures and helps in the first few months, it might be to prevent hardening of the arteries. necessary to take these medications for a prolonged period, so it is important to establish that they are not laying the ground for other conditions. Some medications can lead to Alzheimer’s and dementia by having a deactivating effect on the brain.

KEEP LEARNING A day spent monotonously using existing or stale knowledge represents a functionless day for the brain. So you need to try to learn something new every day. Clinical research shows that PROTECT YOURSELF FROM the age people suffer from dementia DEPRESSION goes up in line with increases in their intellectual level and years of A person’s susceptibility to depression education and learning. increases with age. One of the reasons for this together with a decline in the

brain’s energy can be an individual’s KEEP SOCIALLY ACTIVE personal experiences as they get older. Depression in old age needs You should join a social club or to be taken especially seriously. It is sometimes take part in activities that important not to think a person has are rich in social interaction. These just grown silent with age, but to environments harbor people’s feelings encourage older people to maintain of pleasure and joy. Emotional activity an active life. When required, anti- helps to protect the brain’s reserve depressant treatment should be capacity. considered, though not for prolonged periods. AVOID STRESS CHECK YOUR HEARING CAPACITY Stress does not always mean sadness Most people’s hearing capacity and depression. Stress can be caused declines with age. This condition is 18 by ‘racing with time’, or when a person often left untreated or ignored. It is is over-occupied with social media. easy for a person to slip into a ‘silent You should define what is causing world’ that can lay the foundations stress in your life and try to remove it for depression. Hearing check-ups are PROF. DR. CANAN AYKUT BINGÖL from your life. important for people as they get older. Rector, Yeditepe University / Neurology L EADING MEDICINE

www.yeditepehospital.com REFERENCE / 02 ANESTHESIOLOGY AND REANIMATION

EPIDURALS SORTING FACT FROM FICTION!

ABOUT We have all heard about “epidurals”, Returning to childbirth and cesarean conscious, to feel the birth of her child, but apart from an association with births, you mentioned the mother hear its first cries and share the joys of PROF. DR. We spoke to Professor Sibel Temür childbirth, we don’t really know much remaining awake and aware. Are childbirth with others. SİBEL TEMÜR about what they really are.. there any other advantages? of Yeditepe University Hospital’s A number of studies have shown that Yes, epidural anesthesia is widely talked Pain causes a stress reaction in the epidural anesthesia also serves to After completing her undergraduate and specialist Department of Anesthesiology about but its field of application is not body, with the secretion of hormones reduce the incidence of post-op bowel medical training at Ankara limited to childbirth. Basically, it is a special such as adrenalin and noradrenalin. movement reduction (paralytic ileus) University School of Medicine, and Reanimation about epidural kind of regional anesthesia in which These hormones in turn cause a and deep vein thrombosis. reaction during surgery, including Sibel Temür gained experience anesthetic is injected into the epidural And how is the epidural anesthetic anesthesiology- popularly known increased blood pressure and more at the cutting edge at the space of the spinal cord. This blocks administered? rapid heartbeat rates. During labor, University of Southern transmission of signals through nerve California’s Department of simply as “epidurals”. Here, Professor they can have a negative impact on the The patient is seated or lies on their fibers in or near the spinal cord. Regional Anesthesiology, following baby. side, with their head forward, knees Temür shares her background of anesthesia differs from general anesthesia which she returned to bent and back arched as far as possible. in that the patient remains awake and Since epidural anesthesia only numbs Turkey to continue her An antiseptic solution is wiped on knowledge and experience in the field aware of what is going around them. You the pain nerves, it achieves total pain career in anesthesiology and the patient’s lower back region and mentioned childbirth, and this is a major control. The patient may not feel any reanimation, in which she has covered in sterile surgical cloth. The to give Reference readers all you need field of application because epidural pain at all after the procedure, whereas become a leading figure, not region where the injection is to be anesthesia allows pain free surgery while in general anesthesia post-op pain least through her academic given is first numbed with a fine needle. to know about a subject of interest relief medication can cause drowsiness and research papers that the mother remains conscious; she can see A slightly thicker needle is then used and dizziness. And while they enjoy the have been published or cited and hear her baby at the moment of birth. to administer the anesthetic into not only expectant mothers, but also elimination of pain, epidural anesthesia more than one hundred times the epidural space and a thin plastic So what are the other areas of patients can move around and play an in Turkish and international catheter is fixed in place. The needle many patient awaiting surgery. application? active role in the childbirth process medical journals. Professor is removed and the catheter is fixed including the final stage of pushing the Temür is also a member of Apart from controlling pain during in place with a transdermal patch. 20 newborn into the world. a number of professional 21 childbirth and cesarean surgery, epidural This facilitates the administration of associations, including anesthesia is used in leg and foot surgery, The chief advantage of epidural anesthetic as and when required to the European Society of hip replacement surgery, hernia repair, knee anesthesia in cesarean surgery is that achieve long term pain relief during the Anesthesiology. surgery, and in the relief of post-op pain. it allow the mother, who remains procedure.

REFERENCE / 02 www.yeditepehospital.com ANESTHESIOLOGY AND REANIMATION L EADING MEDICINE You know the best shoe stores in İstanbul for your kids. How does an epidural actually reduced blood pressure, perforation work? of the spinal cord membrane, an inability to urinate, lower back pain, Every organ in the body has temporary neurologic problems, structures called pain receptors. hematoma, a fall in temperature, These pain receptors create the and technical or anatomical issues. sensation of pain by transmitting But as long as the epidural is being pain stimuli with the help of nerve handled by an experienced team fibers first to the spinal cord then in a well-equipped facility, the risk to the brain’s pain centers. Epidural factors are minimal. anesthetic reaches the pain stimuli in Are any patients not able to the spinal cord, temporarily numbing undergo epidural anesthesia? the fibers that transmit signals further up the body and eradicating Yes, some patients should not the sensation of pain. undergo the procedure, in particular those who are susceptible to Used in appropriate dosages, local excessive bleeding, have low anesthetic does not affect the nerve blood pressure or allergies to the fibers that facilitate the working of anesthetic in question, have an the muscles. This allows the patient infection in the injection region, are to maintain normal movement and suspected of having a neurologic avoids any negative impact on the condition, those with blood clotting childbirth process. disorders, using blood thinning medications, and of course those The patient may have a sensation who have not given their consent to of cold when the medication is the procedure. administered, and needs to wait And what of Yeditepe University 20-25 minutes for the medication Hospital? Why should an to take full effect. The degree of international patient choose your drowsiness depends on the type Department? and dosage of the anesthetic. To prevent post-op pain, a pump is That’s an interesting question! I placed on the tip of the catheter mentioned that the procedure-and indeed any medical procedure- and local anesthetic continues to be should only ever be considered administered for a period of 24 to when it is conducted by competent, 48 hours. trained experts in a certified Are there any risks? facility. Our doctors have an incredible range of experience not Epidural anesthesia is highly only in Turkey but in Europe, the effective in eradicating pain and has States and elsewhere, and all our a low risk of side effects. However, it departments are internationally is important that it is administered certified and monitored for quality Do you know and overseen by experienced as well as being equipped with the anesthetists specifically trained in most advanced equipment and the field. technology. the best hospital? Like any medical procedure, there PROF. DR. SİBEL TEMÜR are possible side effects including Head of Anesthesiology and Reanimation

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REFERENCE / 02 ORTHOPEDIC SURGERY & TRAUMATOLOGY

Big Toes Can Be A Big Problem! Treating Bunions and Big Toe Arthritis

Surgical procedures are complex, and require an experienced surgical team with the proper advanced equipment. Fortunately, we are fully equipped to perform these kind of surgical interventions at Yeditepe University Hospital.

Hallux Valgus (bunions) and Hallux pain or soreness, inflammation and Rigidus (stiff big toe/big toe arthritis) redness, a burning sensation, and are the most frequent problems possible numbness. ABOUT impacting on the big toe and the first Symptoms occur most often when PROF. DR. metatarsophalangeal joint of the wearing shoes that crowd the UĞUR ŞAYLI foot that links the big toe to the foot. toes, such as shoes with a tight Hallux Valgus (HV) toe box or high heels. This may explain why women are more likely A graduate of Ankara A bunion (also referred to as Hallux University Medical to have symptoms than men. In Valgus) is often described as a bump Faculty, Prof. Dr. Uğur addition, spending long periods of Figure 1: Young woman with on the side of the big toe. But a Şaylı completed his time on your feet can aggravate healthy feet bunion is more than that. The visible training at Gazi University the symptoms of bunions. bump actually reflects changes in the before working in various Pain (with or without physical activity), pioneering centers including bony framework of the front part of The visible symptom is a shoe wearing and selection difficulty, the world famous Alfred I the foot. The big toe leans toward protuberance from the side of limping and problems while walking on duPont Institute and Johns the second toe, rather than pointing the foot, often to a degree that uneven ground are common complaints. Hopkins University in the straight ahead. This throws the can cause significant health In the longer term, this condition can United States. bones out of alignment-producing and cosmetic problems for the develop to have a severe affect on the In this article, Professor Şaylı the bunion’s “bump”. sufferer, as well as being painful. other toes and even the entire foot (Fig 2). briefs us on dealing with The joint may partially or even Bunions are a progressive disorder. common issues relating to totally dislocate (Figures 1 and 2). They begin with a leaning of the big our feet, especially the area HV is one of the most common toe, gradually changing the angle of the big toe. surgically treated forefoot of the bones over the years and deformities. And the advanced slowly producing the characteristic procedures carried out at Yeditepe bump, which becomes increasingly University Hospital are a far cry prominent. Symptoms usually appear from the first surgical treatment at later stages, although some people 24 recorded in 1881! 25 never have symptoms. Non-visible symptoms, which occur Figure 2: Grandmother with severe deformity at the site of the bunion, may include

REFERENCE / 02 www.yeditepehospital.com ORTHOPEDIC SURGERY & TRAUMATOLOGY

Osteotomies combined with soft tissue procedures are the general preferred surgeries (Figs 5, 6, and 7). At Yeditepe University Hospital, we discuss the expectations of the patients thoroughly and sympathetically. With appropriate surgical techniques, satisfactory results can be expected. Figure 3: Fashionable shoes Hallux Rigidus (Stiff Big Toe/ again! 1 year after HV surgery Big Toe Arthritis) Hallux Rigidus is a disorder of the joint located at the base of the big toe. It causes pain and stiffness in the joint, and with time it gets increasingly harder to bend the toe. ‘Hallux” refers to the big toe, while “rigidus” indicates that the toe is rigid and cannot move. Hallux Rigidus Figure 9: 56 year old female with pain and loss of motion of both big toes is actually a form of degenerative arthritis. Figure 8: Outward sign of Hallux patients confuse Hallux Rigidus with a Early signs and symptoms include bunion, which affects the same joint, Figure 4: The foot structure Rigidus pain and stiffness in the big toe but they are very different conditions usually has maternal affect The best during use, aggravated by cold, Figure 5: 55 year old female requiring different treatment. damp weather; difficulty with dancer, careful surgical planning In some cases, surgery is the only way time to see Apart from limitingwalking, running, running or squatting, and swelling show incisions clearly defined to eliminate or reduce pain. There are several types of surgery for treatment and sportive activities, the condition and inflammation around the joint. before surgery a foot and of Hallux Rigidus. In selecting can make the simple business As the disorder gets more serious, additional symptoms may develop, the procedure or combination of of choosing and wearing normal procedures for your particular case, ankle surgeon footwear extremely challenging including pain, even during rest, we will take into consideration the (Fig 3). difficulty wearing shoes because extent of your deformity based on the is when you bone spurs develop, pain in the hip, x-ray findings, your age, your activity The deformity prevalence is reported knee, or lower back due to changes level, and other factors. first notice between 12 to 56 %, with a family in the way you walk, and in severe The length of the recovery period will history of 80 % , most frequently cases limping. vary, depending on the procedure or symptoms. from maternal transmission. It is also procedures performed. The sooner this condition is If you wait more frequent in women (Fig 4). If pain and stiffness continue, surgery diagnosed, the easier it is to treat. Many studies about the impact of HV may be necessary. Shaving the bone Therefore, the best time to see a foot until bone severity on general and foot-specific spur (cheilectomy) may help relieve and ankle surgeon is when you first the pain and preserve joint motion. health-related quality of life have notice symptoms. If you wait until Figure 6: X ray before surgery Sometimes it may be necessary to spurs develop, confirmed the condition’s highly bone spurs develop, your condition is cut the bone (osteotomy) is order to negative effect. And that HV surgery realign or shorten the big toe. your condition has a positive impact effect on the likely to be more difficult to manage. A procedure called interpositional health related quality of life. Because Hallux Rigidus is a is likely to be arthroplasty has been successful in There is no known prophylaxis progressive condition, the toe’s younger patients with hallux rigidus. more difficult method to prevent the deformity; motion decreases as time goes on. In In this procedure, a “spacer” of donor conservative measures may help only its earlier stage, when motion of the tissue is placed between the ends to manage. to relieve pain temporarily. On the big toe is only somewhat limited, the Figure 10: Implant arthroplasty of of the joints to relieve pain. If the condition is severe, arthroplasty or other hand, surgical procedures are condition is called “Hallux Limitus.” the first metatarsophalangeal joint But as the problem advances, the joint fusion (arthrodesis) may be the complex, and require experienced best option for long-lasting pain relief 26 surgical team with the proper toe’s range of motion gradually (Figs 9 and 10). 27 advanced equipment. Fortunately, decreases until it potentially reaches This disorder can be very troubling we are fully equipped to perform the end stage of “rigidus,” in which and even disabling, since we use the Figure 7: X ray after surgery these kind of surgical interventions the big toe becomes stiff, or what is big toe whenever we walk, stoop PROF. DR. UĞUR ŞAYLI at Yeditepe University Hospital. sometimes called a “frozen joint.” down, climb up, or even stand. Many Orthopedics Surgery and Traumatology

REFERENCE / 02 www.yeditepehospital.com CERVICAL CANCER

All you need to know about cervical cancer Women diagnosed “early” can beat it!

Continuous medical advances are giving women significant advantages in ABOUT treating and preventing the risks of cervical cancer. But it is still important PROF. DR. for women to know the A to Z of the disease. ÜMMÜHAN WHO SHOULD GET CERVICAL CANCER VACCINATION? MERAL ABAN HPV infection can be prevented with the HPV vaccine, which aims to protect An internationally known women against HPV before they are The third most frequently occurring proactive in overcoming the disease WHAT ARE THE SIGNS AND specialist in gynecological sexually exposed to it. 2 vaccines are cancer in women in the world, SYMPTOMS? through early diagnosis. In this approved by the US Federal Food and diseases and childbirth, cervical cancer is a form of cancer framework, Yeditepe University Professor Aban has worked Major risk factors in cervical Drug Administration (FDA): that can be successfully treated Hospital’s Prof. Dr. Ümmühan Meral cancer include starting sexual at some of the world’s leading thanks to advanced early diagnostic 1. A 4-valent vaccine covering four Aban, who has particular experience relations at an early age, sexual centers in the field including as and treatment methods. In particular, types of HPV (HPV types 6,11,16 and a professor at Yale University, in the prevention and surgical relations with multiple partners 18). It is used to prevent cervical cancer, laparoscopic and robotic surgical treatment of cervical cancer, gives or men with multiple partners, genital warts and anal cancer in girls the Memorial Sloan-Kettering procedures have made things much Reference readers a potentially life- sexually transmitted disease, HIV and women between the ages of 9 Cancer Center and the Roswell more comfortable for both patients saving briefing. infection, smoking, and exposure and 26. It is also approved for boys and Park Cancer Institute in the and doctors as well as easing the to synthetic estrogen in the womb. men in the same age group. Scientific United States. WHAT IS CERVICAL CANCER? recovery process and shortening the But there is no question of genetic studies have shown that it provides protection up to the age of 45. period of planned post-op preventive Cervical cancer is defined as cancers predisposition. The most common treatments. that develop in the lower section of symptoms are excessive vaginal “Robotically assisted bleeding, vaginal discomfort, foul CAN CERVICAL WOUNDS The truth is that the greatest risk the uterus (the cervix). One of the laparoscopic protective factor in cervical cancer is being a most frequently occurring forms of smelling vaginal discharge and post- BECOME CANCEROUS? coital bleeding. uterine surgical procedures woman. That is why it is critically cancer in women, cervical cancer Most cervical wounds are normal important for women to have high generally appears in young women HOW IS EARLY DIAGNOSIS are comfortable for the physiological changes occurring levels of risk awareness and to be of reproductive age. POSSIBLE? patient and restore women’s in menstruating women. They chances of having a baby.” can become precancerous cancer Although in its advanced stages lesions when exposed to the HPV cervical cancer is a life threatening NEW VACCINATION ON THE WAY! virus. Therefore these lesions, disease, it is actually a type of cancer which are identifiable by means of that is preventable and treatable if In addition to the vaccines currently gynecological examination and a PAP diagnosed early. A PAP smear test used to prevent cervical cancer smear test, must be treated. is the universally recognized and another one is imminent. Known HOW IS IT TREATED? advised method to achieve early as ‘Gardasil 9’, it provides higher protection (95%) when used in detection. HPV (Human Papilloma combination with the other two types. There are established protocols Virus) screening has recently been The new vaccine is expected to begin based on scientific data for the added to routine screening programs. being used in Turkey within the next treatment of cervical cancer. Vaccination is important as a primary IS IT CONTAGIOUS? few months.” preventive treatment against the 2. A 2-valent vaccine against HPV types The HPV virus that causes cervical disease. Secondary prevention of 16 and 18. It is approved for girls and cervical cancer is by screening for 28 cancer is sexually transmitted and women between the ages of 9 and 25 29 cervical cancer develops in the wake and apart from warts it is used for cancer precancerous lesions and early of genital HPV infection. Therefore prevention. Routine vaccination involves diagnosis followed by adequate protected sex is key in terms of a 3-shot program (both 4- and 2-valent) treatment. This involves smear tests preventing HPV transmission. administered to 11-12 year old girls. and screening for the HPV virus.

REFERENCE / 02 www.yeditepehospital.com CERVICAL CANCER L EADING MEDICINE

Congrats Mrs. Alice,

In the event that both screening treatment or unmet endogenous UTERUS-SPARING tests are carried out in combination estrogen (e.g. anovalation, polycystic PROCEDURES with negative results, there is no ovary disease, granulosa cell Uterine protective surgery involves it’s a boy! need for further screening for a tumors), or exposure to medications removal of part of the cervix, one period of three years. These days that affect the development of the third of the upper section of the more advanced liquid-based pap uterine wall. The risk of uterine vagina, and part of the connective testing may be chosen as it renders cancer is also elevated in some cases tissue around the cervix. The of familial cancer syndrome, breast clearer and more accurate results. remaining part of the uterus and colon cancer. In cases where there are early stage is reconnected to the vagina precancerous lesions graded as In modern societies uterine cancer is (anastomosis) after removing the CIN 1, active surgical treatment is more frequently related to obesity; intraabdominal lymph nodes. not required. The patient returns cervical cancer is more prevalent in These procedures are carried for further check-ups after six countries with lower socio-cultural out with meticulous expertise months. On the other hand, removal and economic levels of development. at Yeditepe University Hospital, of the affected area is the most “The 4-valent vaccine is also where we currently have a effective method of treatment in recommended for 11-12 year old particular focus on nerve-sparing CIN 2 and CIN 3 cases. Therefore the boys and previously unvaccinated surgery. These robotically-assisted appropriate early stage treatment males between the ages of 13 and laparoscopic procedures, designed is surgery, which yields highly 21. Males who have, or likely to be to spare the uterus and especially positive outcomes when the disease exposed to, HPV infection are also its nerves, offer far higher levels of is caught early. Radiotherapy and more prone to anal, intraoral and comfort and ease to both patient chemotherapy may be used in throat (oropharyngeal) and penile and surgeon. Traditional surgical inoperable cases. Early diagnosed cancers. Therefore, vaccination is methods fail to spare the nerves cervical cancer cases have a five- also advised for boys.” leading to the bladder well; this year survival rate of 70-88%; this can makes it impossible to avoid post- rise to 98-99% when the disease is “Screening is not recommended in op urological problems such as the caught at the beginning of its early women under the age of 21 or over inability to urinate comfortably stage. the age of 65 who have undergone and long-term catheter usage. previous screening with negative Nerve sparing surgery serves to WHAT’S THE DIFFERENCE results, unless there is the presence ensue the patient can return to BETWEEN CERVICAL CANCER of any high risk factor. Women normal life without any problems AND CANCER OF THE WOMB? between the ages of 21-29 should and without the need for Cancer of the womb (or uterine undergo a PAP smear test every 3 chemotherapy and radiotherapy. cancer) originates in the inner years, those between the ages of surfaces of the uterus and is 30-65 should undergo HPV and PAP medically termed ‘endometrial smear testing 5 years or just the PAP cancer’. The 6th most frequently test every 3 years.” occurring cancer in women, and IS IT POSSIBLE TO GET High success contrary to cervical cancer, it PREGNANT IN SPITE OF generally occurs in older women CERVICAL CANCER? rates in pregnancy (mostly over the age of 55). and childbirth Patients generally go the doctor It is possible for a woman with complaining of post menopausal undiagnosed cervical cancer to at Yeditepe or non menstrual bleeding; other get pregnant, as is the case for University symptoms include vaginal discharge, women undergoing cervical cancer pain during intercourse, and difficulty treatment. In early stage cervical Healthcare 30 in urination. cancer cases where the size of the tumor has not reached a certain Institutions Endometrial cancer risk factors extent, women can maintain their PROF. DR. ÜMMÜHAN MERAL ABAN include not having given birth, late chance of having a baby with uterine Obstetrics & Gynecology Specialist / menopause, hormone replacement protective surgical procedures. Gynecologic Oncology Surgery Specialist www.yeditepehospital.com

REFERENCE / 02 LEADING MEDICINE

“ WHEREVER THE ART OF MEDICINE IS LOV ED THERE IS ALSO A LOVE OF HUMANITY”

HIPPOCRATES

DENTAL YEDİTEPE SPECIALTY MEDICAL HOSPITAL UNIVERSITY HOSPITAL CENTER GENETIC TEACHING & CENTER RESEARCH EYE HOSPITAL HOSPITAL

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REFERENCE / 02 www.yeditepehospital.com CARDIOLOGY

Taking physical exercise as part of your daily routine is important in preventing coronary artery disease, but it’s just as crucial for patients who have already undergone surgery for the disease…

Patients need to abandon sedentary heart disease or coronary artery unless risk factors are eliminated. For recurrence is reduced by 27% to 31% and inactive lifestyle habits in order disease. Ischemic heart disease may this reason people who have undergone with regular physical exercise. In this article, to avoid the recurrence of disease, present with different symptoms in coronary bypass surgery need to give Can every coronary bypass patient Professor Değertekin, especially cardiovascular conditions. proportion to the degree of narrowing up the sedentary lifestyles and habits do physical activity? of the aerosclerotic vessel lumen. that constitute one of the fundamental Cardiovascular disease is a significant There are three treatment options the Head of Yeditepe With indications ranging from chest risk factors, in order to avoid seeing the health issue in Turkey as in the rest in coronary artery disease cases, pain during physical effort to heart disease recur. The way to achieve this of the world; official data show it was depending on the condition of the ABOUT University Hospital’s attacks, ischemic heart disease can is through regular sports or physical is cause of death of over 200,000 patient and the disease: Cardiology and Heart people in Turkey every year. Within also progress without showing any exercise. PROF. DR. Disease Department, that figure the leading single cause symptoms. How does physical exercise help? 1. Medical treatment of death is coronary artery disease, Who is susceptible to coronary 2. Coronary balloon and/or stenting MUZAFFER Daily physical exercise taken for the 3. Coronary bypass surgery briefs Reference defined as ischemic heart diseases, artery disease? recommended period of time and in line DEĞERTEKİN Just as treatment options vary in readers on the which take a 22% share. So what is Leaving aside familial predisposition with medical advice: ischemic heart disease? and diabetes, there are five important line with the patient’s condition and • Reduces body weight. particular importance risk factors that can be partially or the progress of the disease, physical Hardening of the arteries A graduate of Hacettepe entirely averted through changes in • Regulates blood pressure. exercise programs depend on the exact of physical exercise (atherosclerosis) has a negative University Medical Faculty, impact on human beings as it does on lifestyle: • Reduces bad cholesterol (LDL) levels. treatment method, its impact and outcome. In this context there are two Prof. Değertekin completed for cardiovascular many living creatures. Atherosclerosis 1. High blood pressure • Raises good cholesterol (HDL) levels. fundamental factors. his specialization training occurs when fat in our blood combines 2. High levels of fat in the blood patients. • Increases the body’s sensitivity to in cardiology in 1995. with calcium to form a complex that 3. Smoking Interventions and surgery to treat insulin. This helps people with diabetes After winning the Young collects on the inner surfaces of the 4. Obesity narrowing of the coronary arteries to regulate their blood sugar. Researcher award in 2000, arteries. More commonly referred 5. Sedentary lifestyles balloon, stent and coronary bypass • Has a positive impact on muscle Prof. Değertekin worked to as hardening of the arteries, the Abandoning sedentary lifestyles procedures, generally categorized function, increasing flexibility. at Holland’s Erasmus condition is most commonly observed and adopting sports and physical under the heading “revascularization” University Thoraxcenter in medium and large blood vessels. activity as part of ones daily life is as • Ensures maximum blood oxygenation. are followed by a rehabilitation and Cardiology department, 34 Hardening of the arteries can lead important to patients who have had Scientific studies have shown that recovery phase. While this phase 35 to various diseases depending on surgery for ischemic heart disease as regular physical activity reduces the risk may be prolonged after bypass where he applied the first the organs involved. If it involves the it is in preventing the disease in the of heart attacks and strokes. This applies surgery, it is generally significantly drug eluting stent in the coronary arteries feeding the heart first place… because unfortunately to patients who have undergone bypass shorter after balloon and stenting World. muscles, it is defined as ischemic hardening of the arteries will progress surgery; research shows that the risk of procedures. However revascularization

REFERENCE / 02 www.yeditepehospital.com CARDIOLOGY

is performed, the rehabilitation problems (joint and skeletal system weeks after surgery. Avoid uneven REMEMBER! WHO NEEDS AN EXERCISE phase is split between in-patient and diseases or blockages in the blood ground and walking on sand. PROGRAM? • Warm up and cool down periods out-patient periods; it is critically vessels in the legs). Hardening of • Avoid eating 1-2 hours before immediately before and after important that post- coronary heart The physical activities talked about in • Pre-exercise warm up and exercise. You may have light snacks exercise the arteries disease revascularization patients stretching are important. Take care that are gentle on your stomach to this article are specifically referenced strictly follow their doctor’s advice on not to neglect them! maintain your calorie intake. • To avoid any possible damage to to exercise programs for patients (atherosclerosis) has the exercise program to be followed your musculoskeletal system, start • Avoid caffeine and alcohol before who have undergone coronary bypass a negative impact beyond discharge from the hospital. slowly with easy exercise and Frequency exercise. Caffeine’s stimulatory surgery to do alone beyond the Your doctor will carry out a series of build up gradually on human beings effect has a negative impact on hospital setting. Even in the presence assessments before recommending an • Do your planned exercise program your exercise capacity. Alcohol can • Stop exercising immediately in of negative factors such as those as it does on many exercise program: every day. The program should start easy and gradually become be harmful as it slows down the the event you experience listed below, appropriate physical living creatures. • Your revascularization results more strenuous, in line with flow of blood in the coronary headache, arrhythmia, shortness exercises within the scope of a cardiac of breath unrelated to physical • Heart contractile strength personal factors. arteries. rehabilitation program monitored by Atherosclerosis activity, chest pain or a sensation of • Blood supply to your heart muscles • Take care to maintain sufficient a center specializing in this subject pressure occurs when fat in • Examination and tests to see Duration fluid intake - preferably can be carried out, provided a bone whether there are any • Set aside 10 minutes for warm up water - during exercise. • Give yourself a break if you have a examination is carried out. our blood combines supplementary conditions and stretching before exercising. • Very hot or cold weather can have fever In the presence of one or more of with calcium to A specific exercise program will be • The basic exercise activity should a negative impact on your • Drink enough fluids while taking the following factors, the outpatient recommended after this evaluation last 20-40 minutes. exercise program. What you exercise form a complex has been completed. It is critically wear is important. In hot weather exercise program should be halted • There should be a cool down post- • Dress and choose the time of day that collects on the important that you follow these choose the early morning or late and medical advice sought before exercise period of 5-10 minutes that according to the weather recommendations. in the day to do your exercise; in inner surfaces of requires less effort. restarting: very cold weather, the afternoons. • Never smoke What should a post-op exercise • Persistent symptoms of ischemic the arteries. More Wear a scarf over your mouth and • Taking a hot shower can disrupt program involve? Exercise tips for post-op bypass nose to protect against the (coronary) heart disease and patients your heart rhythm: it’s better to take commonly referred I would like to stress here the key negative effects of breathing a shower 15 minutes after exercise related chest pain when at significance of having a medical • Don’t consider things you do as in cold air. In extreme rest (unstable angina pectoris) to as hardening of examination and tests before you start part of your daily chores or weather, do your exercise in indoor the arteries, the any program of physical exercise, and work that do not require sustained sports areas or the corridors of WHAT EXERCISE, HOW MANY • The patient depends on a proceeding strictly in line with medical effort, or occasional walking large shopping centers - on CALORIES? pacemaker condition is most advice. We should remember that at home or in the garden, as part of condition you avoid window Exercise Intensity Energy • Chronic rhythm conditions such as commonly observed the method, frequency and type of your exercise program. shopping! consumption atrial fibrillation exercise in every patient’s program is • Never run for exercise. There are • Avoid saunas, and taking very hot or (cal/hour) in medium and large different. important physiological differences cold showers. Walking 3km/hour 175 • Cardiac valve disease, especially blood vessels. between running and walking. This • Do not play golf or tennis, or aortic stenosis Walking 5 km/hour 245 Methods could damage your bone and swim, in the first three months • Severe infection relating to the • The exercise program should involve skeletal systems. after coronary bypass surgery. Gardening Continuous 310 heart and blood vessels diagnosed movement of the major muscle • Walk on flat surfaces for the first six Playing these sports can lead to Cycling Gentle 280 groups and sustained physical weeks after coronary bypass problems with respect to the chest as “endocarditis” Cycling Average 400 activity. E.g. walking, swimming, fast surgery. You may try walking bone, which has still not completely • Heart failure walking, cycling, group aerobics. up gentle slopes after that, fused. Swimming Gentle 315 36 37 • Arm- and shoulder- focused depending on your personal • It takes 8-12 weeks for the chest Swimming Fast 490 capacity. ergonomic physical exercise bone to fully fuse; do not lift, push or Tennis Singles match 525 programs can be designed • You may experience difficulties pull anything weighing more Tennis Doubles match 420 PROF. DR. MUZAFFER DEĞERTEKİN for patients with lower extremity keeping your balance in the first 4-6 than 5 kg during this period. Head of Cardiology Department

REFERENCE / 02 www.yeditepehospital.com UROLOGY

SEXUAL DYSFUNCTION

Reference spoke to Associate mild, moderate or severe erectile What should one do if one is overcome the issue and begin a Health is defined as Professor Ahmet Tunç Özdemir dysfunction between the ages of experiencing sexual dysfunction? happier and healthier life. Research of Yeditepe University Hospital’s 40 and 70. 15% of adult men, and shows that most people seeking a state of physical, Sexual dysfunction is a matter of Department of Urology about this 30% of men over 50, encounter expert assistance from qualified concern to both men and women; mental and social important issue that continues loss of sexual desire. 30% of men centers achieve positive outcomes - it includes both physical and to blight the lives of men and suffer from premature ejaculation sexual problems are no one’s ‘destiny’! wellbeing. When any psychological dimensions. For this women throughout the world. while 10% sometimes experience Individuals and couples should not reason, evaluation by a specialist in a one of these elements Özdemir answered a wide range an inability to ejaculate or delayed hesitate to seek the support of particular field of expertise may not of questions to brief Reference ejaculation. professionals in the field. is disrupted, the be sufficient. Modern medical practice readers. And if the problem goes involves resolution with the advice others are affected And the frequency of such issues untreated? What kind of sexual problems in women? and support of a team of experts in and it becomes hard arise? fields such as urology, psychology and Sexual problems and dysfunction can The most frequently occurring gynecology. often lead to psychological trauma in ABOUT to maintain a happy Sexual problems include all kinds issues in women are lack of sexual both men and women. If the problem of psychological, social and cultural ASSOC. PROF. life. In particular, sexual desire, together with difficulties or How is the correct course of is left untreated, it can lead to more issues that obstruct individuals an inability to reach orgasm. The treatment determined? complicated situations by opening AHMET TUNÇ or couples from establishing and the path to additional issues such health encompasses frequency of these issues is similar The initial evaluation seeks to establish maintaining a healthy and fulfilling in women. One in three women as despondency, pessimism, lack ÖZDEMİR all these elements. sex life. These range from sex- whether the issue is physical or complain of a more or less total of pleasure in life, and lack of self- related fear and anxiety, feelings psychological (or both). Consultations lack of sexual desire at some point esteem. In addition, it can lead to a Sexuality is influenced of guilt or shame, a lack of sexual are held with concerned specialists, Assoc. Prof. Özdemir received during their lives, while 30-50% deterioration in relationships, starting desire and frigidity, an inability to the diagnosis is confirmed and the his medical training at the by social values, experience difficulties reaching with the individual’s partner. establish sexual intimacy, pain or appropriate course of treatment Medical Faculty of Gazi judgments and beliefs orgasm. The third-ranking issue is begins. Treatment possibilities What is the correct approach to contractions during intercourse, University and Ankara Numune what is medically termed vaginismus, range from courses of medication sexual dysfunction treatment? in every society. For erectile dysfunction in men, Hospital where he specialized premature ejaculation or difficulty in a diagnosable condition in which to psychological treatment, sexual People admitted to Sexual in Urology. He went on to this reason, although ejaculating in men, an inability to be a psychological fear or phobia of treatment options, sexual therapy and Dysfunction Centers are treated such issues are aroused or reach orgasm in women, intercourse causes spasmodic surgery. under terms of strict confidentiality receive further specialist or fixations or fears concerning contractions in the muscles at the and thoroughness by urologists, training and experience at the entrance to the vagina in response Can treatment that includes both psychiatrists, gynecologists and widespread among matters like masturbation and individuals in a couple be helpful? European Oncology Institute in men and women homosexuality. We should add to to physical contact or pressure. specialists in other fields as required. Milan, Italy from 2009 to 2010. this list incompatibilities, differences What are the causes of sexual It is easier and quicker to treat an These specialists carry out the Özdemir is a leading member individual who is in a loving, supportive processes of diagnosis and treatment of every age, they of perception and approach that may dysfunction? of a number of medical underlie relationship difficulties in and trusting relationship. But there are in line with the nature of the issue, associations including the are reticent about couples. The causes may be physical also methods of treatment designed to within a framework and philosophy revealing any sexual conditions related to vascular help single people and those who are of coordination, cooperation and Prostate Cancer Association What is the frequency of sexual disease, high blood pressure or not in a stable relationship. understanding. in which he serves as General dysfunction in men? health issues they diabetes, or there may be underlying Secretary. 38 How effective is treatment? Wishing you healthy and happy days… 39 may be facing and The most frequently occurring psychogenic reasons. One cannot sexual dysfunction in men is erectile always make a strict categorization. Regular, persistent treatment renders consulting a doctor. dysfunction. Global research Every condition may contain a solution in the vast majority of cases; ASSOC. PROF. AHMET TUNÇ ÖZDEMİR shows that 55% of men experience elements of both. individuals and couples generally Department of Urology

REFERENCE / 02 www.yeditepehospital.com DENTISTRY

What in your opinion makes Our second distinguishing feature patients choose you? is the excellence of our team. It is not easy to assemble a professional Everyone imagines that all our team of faculty members who are We are a Global patients come from the Asian side of so hard working, self-sacrificing Istanbul near the campus. In fact we and well trained. Healthcare have many patients from other parts services cannot be anything other of the city, other parts of Turkey and than excellent when the team and ABOUT from abroad. Our patients generally infrastructure is world class, able Reference Center in choose us because of our high PROF. DR. to follow the latest developments reputation in dentistry. and utilize the most advanced FİGEN KAPTAN There is no other dentistry faculty technology. and hospital like this in Turkey. And An emphasis on the highest Dr. Figen Kaptan graduated Dentistry only a few throughout the world- standards of hygiene, and a patient- from Istanbul University Our certifications attest to this. focused approach, also have a Faculty of Dentistry in 1991 People choose us because they positive impact on our patients. and received her Phd degree compare our capacities and facilities Patients notice the difference fro the on “Endodontology” from the We spoke to the Dean of Yeditepe University Faculty of Dentistry with other faculties and hospitals. moment they first set foot through same University in 1999. She Our most significant feature is our the door. The ability to receive the has worked as a full-time faculty Professor Figen Kaptan about the Faculty’s work, philosophy and advanced infrastructure. We have best possible treatment without member at Yeditepe University truly remarkable physical capacities. achievements over the past ten years. a long wait means that patient department of Endodontics As faculty members and deans satisfaction levels are high. since 2000. She gained her coming to Turkey from abroad tell us, and as I myself observe when All this makes me very confident that associate professorship in 2006 Could you give us a general What differentiates you from and undergraduate students and I visit dentistry faculties in other even after 20 years nowhere will be and professorship in 2014. Dr. background profile about other hospitals? awarding them points. And of course countries, our infrastructure is better than us. Kaptan was affiliated as the Yeditepe University Faculty of there are also graduate classes head of the department of We are not like other hospitals, unrivalled. Dentistry? too. In any remaining time they Endodontics between 2012- where some duty faculty members 2014 and the Dean of the Our faculty was founded in Istanbul give lessons; our faculty members conduct research and if they have Yeditepe University Faculty in 1996, in the Acıbadem district of themselves run the hospital in the time after that they contribute to of Dentistry since January the city. From 2000 we have been time when they are not actively working capital by treating patients. 2015. She has numerous operating from Yeditepe University’s giving training. Being full-time In other words our priority duty is scientific articles in the field Göztepe Campus. Our prime duty members of staff, they give classes not treating patients but providing of endodontology and the is to provide undergraduate and every morning from 8.00 to graduate and undergraduate graduate training. We carry out both author of book chapters on 10.00. From then until 5pm they training, research and then treating at the same time. smear layer removal, root canal are on clinical duty, helping the patients. medication, root canal irrigation, Your dental hospital works full clinical development of graduate pain management, evidence steam in the same building. What based dentistry, magnification kind of work is carried out there? devices, endodontic treatment Yeditepe University Dental Hospital of traumatized teeth. operates six days a week form 10 am. to 7pm. We serve more than 200 patients every day. Faculty members and graduate trainees work at the hospital.

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REFERENCE / 02 www.yeditepehospital.com DENTISTRY

YEDİTEPE UNIVERSITY DENTAL HOSPITAL

We like it white We don’t like it yellow

Every patient should leave happy. the dentist for routine fillings and the like. We are completing our 16th year at our building on Bağdat Avenue. Some patients have not looked We focus on There is a comment box for our after their general dental health patients at the entrance. In addition, so well, so we prioritize general general dental our Public Relations Department dental health issues second only to the patient’s general state of surveys every patient. Sure, there health and condition. We focus on health as a might be the occasional minor general dental health as a measure comment based on interpersonal to prevent future problems relating measure to factors, but I have never received to the teeth, gums and jaw. We even a single complaint about the work hard to save a single tooth prevent future We don’t like it yellow We like it white treatment a patient has received. If I before proceeding to extract it if ever did, I would have it enlarged and necessary. We save many teeth that post it in the entrance. other dentists have advised should problems be extracted. Some complaints are about the relating to the dental treatment process. Patients Our overall philosophy is that every sometimes expect their treatment one of our patients should leave happy. If you think OK, 99% of my to be completed the day they come. teeth, gums patients are satisfied never mind But some treatments take months. about the other 1%, you will never and jaw. For example in some cases the set yourself apart from the others. completion of surgical procedures And we try to instill this philosophy 42 and the fixing of permanent in our students from their very first prosthetic teeth can take at least year of training. 7-8 months. Some patients find it hard to understand this because up PROF. DR. FIGEN KAPTAN L EADING MEDICINE to that time they have only been to Dean of the Dental Faculty www.yeditepehospital.com REFERENCE / 02 GLAUCOMA

Does it show symptoms? It does not generally show symptoms unless eye pressure reaches the level of 30-35. We Left untreated, should not attribute every case of headache or eye pain to eye pressure. Pain is evident when the pressure level reaches over 35- GLAUCOMA 40, generally caused by a special type of glaucoma called acute open angle closure glaucoma. The more frequently occurring type of glaucoma associated with a family can lead to history and occurring in older patients does ABOUT not usually show any symptoms. Glaucoma is diagnosed by determining high eye PROF. DR. pressure and damage to the optical nerve, RACİHA BERİL permanent loss followed by field of vision tests and analysis of damage to the optical nerve fiber. If eye KÜÇÜMEN pressure is not excessively high, primary open angle closure glaucoma does not Prof. Dr. Raciha Beril Küç​ümen of sight. show any symptoms. The sufferer may be is one of Turkey’s leading unaware of the condition, but it is revealed ophthalmologists, with an through a routine check-up. It generally international background Mostly genetically related but sometimes develops slowly in people over the age of in the field and a specialist due to age, glaucoma (increased tension 40-45. interest in cataract and Does every case of high eye pressure refractive surgery, corneal conditions and vitreoretinal in the eye) can be overcome with long indicate glaucoma? surgery. Professor Küç​ümen term medical treatment or surgery - No, not every case of high eye pressure received specialized as long as it is diagnosed early. Left automatically means glaucoma, and not training at Hamburg untreated, it can cause deterioration of every type of glaucoma involves high eye University’s Department of pressure; some cases are caused by low Ophthalmology following vision or even total loss of sight. pressure. These are called normal and low- graduation from Istanbul pressure glaucoma. People with generally University’s Cerrahpaşa low blood pressure (more common in Medical Faculty, and has had SOME CONDITIONS DON’T nourishing the eye, collecting humor is greater than its drainage. China, Japan and Asian ethnic origin numerous papers published SHOW ANY SYMPTOMS AND metabolic waste and dissolving This affects the inner layers of groups) and who suffer frequent migraine in medical journals around GET LEFT OFF PEOPLE’S itself into the bloodstream from the eye, whose backmost section attacks may experience glaucoma damage the world during her 30-year ROUTINE HEALTH CHECK LIST. the area between the cornea and houses vision cells. There are about to the optical nerve even when their eye career, during which she the iris. The pressure required to a million of these in the retinal has been invited to make Eye diseases are an example.. But pressure is normal. Other people may not prevent the eye deforming into a layer that send sight stimuli to the regular eye check-ups starting in develop glaucoma even though they have presentations at more than kind of inflated ball requires the 24 brain. When intraocular pressure childhood are important. Serious high eye pressure. These groups are called 50 international congresses. hour production and drainage of increases, the retinal nerve fiber Professor Küç​ümen is a conditions like glaucoma, whatever ocular hypertensive. There are a number of this fluid. The intraocular pressure cells are pressed against the sclera member of both the European its cause, can be detected by possible causes. For example, a person has is simply a product of the rate of at the back of the eye and crushed. and the American Societies routine check-ups. We learned high eye pressure but monitoring of their aqueous production and the rate of If the destroyed nerve fiber cells of Cataract and Refractive from Prof. Dr. Raciha Beril Küçümen condition reveals no damage to the optical aqueous drainage. 95% of people’s maintain long term increased Surgery, the American that if left untreated, glaucoma nerve fibers. Eye pressure can sometimes eye pressure is 12-18 mmHg. This pressure in the eye, this causes Academy of Ophthalmology, progresses and can even lead to be measured incorrectly. Because the blindness. is measured using a device called glaucoma. the International Society a tonometer. These days there are tonometer used to measure eye pressure Could you define glaucoma? of Refractive Surgery and What is Eye Pressure? also contact lenses that provide 24 does so based on the idea that normal the European Vitreoretinal cornea thickness is 520 – 550 microns. This Produced 24 hours a day, the hour monitoring of eye pressure. It is generally caused by high Society. intraocular pressure on the optical means that someone with a congenitally aqueous humor is the watery Why is eye pressure important? fluid between the cornea and the nerve. Glaucoma does not actually thicker than usual cornea might have their crystalline lens. It maintains the In order to have healthy anatomic affect vision until its late stages. It eye pressure measured as being higher than normal. That is to say, an eye pressure 44 pressure needed to inflate the eye structure and tissue, eye causes a loss in the field of vision as 45 eye and provides nutrition for the pressure needs to be not too low the retinal nerve fibers are crushed recording of 22-23 mmHg in someone central cornea and lens as they do and not too high. Eye pressure from the edges in. That is why whose cornea is 600 microns thick and has not have their own blood supply. increases when for whatever regular eye check-ups are important no evident optical nerve damage might not It cleans the lens, iris and cornea, reason the production of aqueous in glaucoma cases. indicate any need for glaucoma treatment.

REFERENCE / 02 www.yeditepehospital.com GLAUCOMA L EADING MEDICINE

WITH A TREATMENT BEHIND HER, SHE IS HITTING THE DANCE FLOOR WITH A Big Smile Left untreated, the condition the patient will suffer a progressive loss in their field of vision and eventual blindness

Are some people at higher risk further loss of field of vision varies with respect to the angle of the than others? from patient to patient. In the event region between the cornea and that the ideal eye pressure cannot the iris where the intraocular fluid Primary open angle closure be achieved, or if the patient is glaucoma is a multi-factor genetic is absorbed, predisposes them unable to maintain regular eye drop condition. 40-45% of all patients to the condition. Stressing that use, or suffers side effects from the have unattributable primary this angle can be suddenly closed medication, then surgery may be open angle closure glaucoma. by other factors such as use of considered. There are various types Examination of their eyes indicates certain medications, reading in of surgical intervention including no obvious cause for glaucoma poor light, and swelling of the laser surgery. That said, surgery except for increased eye pressure. lens, Professor Küçümen states is only the preferred course of This is generally an inherited “When the angle closes the action in cases where medication condition. It does not necessarily outlet gets completely blocked has failed to control the condition, get passed from parent to child, but since the fluid continues to to achieve a long term solution in but there will certainly be other be produced the pressure can members of the family with high eye terms of reducing eye pressure. In some cases, new channels that exceed 35-40. This can also cause pressure being treated for glaucoma. considerable pain. It needs to Left untreated, the condition the are surgically opened can get be treated urgently. The second patient will suffer a progressive loss blocked. This may require a second type is more common. Since the in their field of vision and eventual intervention, or renewed medical angle is open there is generally blindness. Treatments aim to stop treatment. Depending on the type of further loss of field of vision and glaucoma, there is no guarantee that no need for urgent treatment in prevent blindness. Existing damage surgery will remove the patient’s this type of glaucoma; treatment cannot generally be reversed. reliance on medication. Elevated can be carried out over the long- eye pressure and glaucoma can also term. Diagnosing glaucoma is What are the treatment develop as a result of eye infections, crucial. Not everyone with ocular methods? surgery and trauma. Surgery is not hypertension or high eye pressure The most common form of glaucoma always effective in treating these suffers from glaucoma. The treatment involves regular eye drops infection- and trauma- related cases, importance of a correct diagnosis and field of vision nerve fiber tests and second or third interventions is that it prevents unnecessary use and monitoring. 90% of glaucoma may be required, as well as renewed of medication. Because someone patients are saved from blindness by use of medication. diagnosed with glaucoma will have regular medical treatment. Regular TYPES OF GLAUCOMA to continue to use medications 46 medical treatment is important, but over the long term.” not everyone can manage this, and Glaucoma is anatomically classified PEDIATRIC in some cases this fails to maintain under two types. The first is the BONE MARROW the targeted eye pressure. The rarely seen open angle closure PROF. DR. RACIHA BERIL KÜÇÜMEN ideal eye pressure range to prevent glaucoma. Some people’s anatomy Ophthalmologist TRANSPLANTATION www.yeditepehospital.com REFERENCE / 02 NEUROLOGY

Sleep Apnea

Sleep apnea could be ABOUT Manifesting itself in breathing difficulties POOR QUALITY SLEEP IMPACTS frequent and prolonged periods when ASSOC. PROF. the reason you wake up and stopping breathing during sleep, ALL AREAS OF LIFE the sufferer stops breathing altogether, sleep apnea is one of society’s frequent sometimes for as long as 10 seconds. BURCU ÖRMECİ feeling tired. but little known issues. If left untreated, The body renews itself during sleep. This leads to a lack of oxygen as well as this condition, which causes the sufferer Therefore one of the absolute ‘musts’ sleep deficiency. A graduate of Akdeniz University to wake up feeling tired, can lead to a for a healthy life is regular, high quality sleep. This allows a person to wake up SPECIALIZED DIAGNOSTIC SLEEP number of other problems including brain Medical Faculty, Assoc. Prof. Dr. feeling fit and refreshed, able to enjoy a TESTS and heart vascular disease. Burcu Örmeci completed her healthy and productive day. Pointing out A ‘polysomnography test’ is used to post graduate program in 1st If you wake up with a headache, dry mouth that a lack of good quality sleep makes diagnose the existence and severity of and feeling tired, you could be suffering a person feel weary and exhausted all sleep apnea. The person stays overnight place in 2008. Specializing in from sleep apnea! A frequently occurring day, Burcu Örmeci explains “This can at the sleep laboratory where they are the field of Neurology, Assoc. sleep disorder, sleep apnea is little known severely impact a person by impairing monitored for a period of seven hours Prof. Örmeci is an instructor in society. Experts have determined that their ability to concentrate throughout under eight parameters: at the Turkish EEG-EMG sleep apnea is even the underlying cause the day. People’s requirement for sleep • Electroencephalography (EEG) Neurophysiology association. of some traffic accidents, because people varies from person to person, but on • Electrooculography (EOG) who do not enjoy good quality sleep suffer average a period of seven to eight hours a loss of concentration and are easily of proper high quality sleep is important • Electrocardiography (ECG) distracted. for a healthy life.” • Electromyography (EMG) • Respiratory effort tests recording We were briefed by Assoc. Prof. Dr. Burcu “According to the MORE FREQUENT IN MEN chest and abdominal movement Örmeci from Yeditepe University Hospital degree of severity, Department of Neurology about the Sleep apnea manifests itself in various • Nasal and oral airflow problem, which can lead to serious health ways, including snoring, stopping • Oxygen saturation sleep apnea problems, principally brain and heart breathing during sleep, severe • Body position vascular disease. daytime fatigue, nervousness, lack treatment might Stressing that the treatment plan is of concentration, depression, lack of determined after the test results have involve the use of sexual desire, high blood pressure, and been analyzed to establish the degree of insulin resistance. Left untreated, sleep severity of the individual’s sleep apnea ‘Positive Air Pressure’ apnea can play a role in future elevated condition, Örmeci told us “According (PAP) equipment, risk levels for brain and heart vascular to the degree of severity, sleep apnea disease. treatment might involve the use of or surgical methods ‘Positive Air Pressure’ (PAP) equipment, Occurring twice as frequently in men or surgical methods carried out by carried out by compared to women, sleep apnea experienced ENT specialists.” signals itself through increased night experienced ENT sweating, especially in the head and Sleep apnea patients are generally neck regions, and a frequent need advised to lose excess weight and to give specialists.” to urinate during the night. Other up smoking and alcohol. Diagnosing and symptoms include morning fatigue, treating sleep apnea syndrome in high headaches and dry mouth. risk patients with diabetes, high blood pressure, high cholesterol levels, and 48 BREATHING STOPS IN THE NIGHT obese people, is of particular importance 49 for their general state of health. Sleep apnea is a cause of irregular breathing and snoring while you ASSOC. PROF. BURCU ÖRMECI are asleep. In addition, there can be Department of Neurology

REFERENCE / 02 www.yeditepehospital.com ALLERGIC RHINITIS

ALLERGIC RHINITIS SYMPTOMS • Sneezing • Runny nose and nasal congestion • Watery eyes and itching • Coughing and sore Don’t let throat • Itchy throat, nose or upper palate ALLERGIC RHINITIS • Sinus pain • Decreased sense of smell and taste • Frequent nose spoil your life scratching • Fatigue, perception difficulties, sleep disorder Prof. Dr. Yavuz Selim Pata, Head of Yeditepe University These symptoms are Hospital’s ENT Department, tells Reference readers sometimes accompanied how to spot and deal with one of the most frequently by wheezing, coughing occurring allergies that may be having a more severe and headaches. impact on your quality of life than you realize.

With symptoms that include also trigger chronic conditions such effective against allergens indoors, season for house dust allergens is sufferers immunotherapy in the sneezing, runny nose, nasal as sinusitis, pharyngitis, middle especially in the pollen season. HEPA the fall. Dust frequency is in inverse form of oral drops against house congestion and teary eyes, allergic ear infection and nasal polyps. The (high-efficiency particulate arresting) proportion to height. Humidity mites, and tablets against pollen rhinitis affects some people all year family medical history is important. filters are much more effective than and warmth increases house dust allergies. These treatments take round while others are affected The sufferer’s personal story and the fiberglass filters used in most mite populations. Recommended into consideration the importance more severely during the spring the issue of which irritants he or ventilation systems. Therefore it measures include using special of ease of use and sustainability months. she has been exposed to, need to be is recommended that you change HEPA filter hoovers, acaricides, for patients, making it easier for researched carefully. filters twice a year. Staying indoors them to complete the treatment. Allergies are simply undesired washing laundry above 60 degrees when the pollen levels are high UV rays that are beneficial in atopic specific immune responses to C, avoiding carpets and curtains, and Caused by technological during the morning hours and as the dermatitis and other dermatological antigens. Allergic reactions occur removing dust-collecting objects. ABOUT developments as well as sun rises and the temperature heats cases have also been shown to be either all year round (perennial) or environmental factors, allergens of use against allergic rhinitis when PROF. DR. YAVUZ up can also help. MEDICAL TREATMENT at certain times of year (seasonal) and allergic rhinitis occur with ever administered nasally. UV-B (5%) and when the sufferer comes into Fungi and spores, on the other hand, SELİM PATA greater frequency. The condition As well as preventive measures, UV-A (25%) and visible rays (70%) contact with the allergen in question. are present throughout the year has been observed more and more medical treatments are also are applied by means of a special House dust mites (D. pteronyssinus, commonly in office workers and indoors and outdoors. Their greater available. Medical treatment does device called a Rhinolight. Professor Pata is one of D. farina), fungi (chaetomium those working in a closed space. intensity also renders air filtering not cure the sufferer, rather it Turkey’s leading specialists in globosum, aspergillus, penicillium, Carpets, air conditioners, computers, systems less effective. They reach Allergic rhinitis-caused sinusitis, alleviates symptoms and reduces ENT diseases, Head and Neck mucor), animal allergens (cats, plants, paper products and chemical peak levels as the sun sets and the abnormal concha growth, and nasal discomfort during allergic attacks. Surgery. Since graduating dogs, rodents, birds) are perennial agents in offices can trigger allergies. temperature falls in the evening. polyps, are all surgically treatable at while tree, plant, grass and flower Decaying plant material encourages Medical treatment for allergic Yeditepe University Hospital. Allergic from Istanbul University rhinitis carried out before the Cerrahpaşa Medical Faculty pollen allergens trigger allergies BLOOD AND SKIN TESTS the development of fungi, meaning rhinitis has a negative impact on only at certain times of year. Fungi that allergic reactions can be more pollen season has a positive impact sufferers’ quality of life and impedes in 1989, Professor Pata has such as alternaria alternarta and The most ideal and effective severe in the presence of house on the sufferer’s social life. The their working and social lives. Early built a formidable reputation cladosporium are also seasonal, as preventive measure against allergies plants indoors, and in gardens. Other most effective treatment for diagnosis, allergy determination, as a proponent of advanced they emit their spores in certain is simply to avoid the source of the potential sources of fungi are torn allergic rhinitis is immunotherapy. preventive measures and starting techniques in his field. seasons. Of all allergic conditions, problem. To be able to do this, it paper in bird cages and shoes that The sufferer is desensitized by treatment all help to prevent the Professor Pata is an active allergic rhinitis is the most common is important to undergo blood and are not well aired. The simplest way being exposed to controlled and onset of chronic diseases later on in member of 11 professional associations with numerous 50 and the one that has the greatest skin tests need to determine the to prevent mold in your fridge is to progressively increasing doses life. 51 affect on sufferers’ noses. It is allergen. Preventive measures can be illuminate the contents a little, even of the allergen to which they are papers published in medical sometimes accompanied by atopic taken at home, but clearly not if the when the fridge is closed. House sensitive. This treatment can be journals both in Turkey and internationally. dermatitis, allergic asthma, and allergen is in the open air. Ventilation dust contains more allergens the hard for the sufferer to maintain. PROF. DR. YAVUZ SELİM PATA allergic rhinoconjunctivitis. It can and conditioning systems can be longer it has been there. The peak Yeditepe University Hospital offers Head Of the Department of Otolaryngology

REFERENCE / 02 www.yeditepehospital.com GASTROENTEROLOGY

When should you undergo a ENDOSCOPIC ULTRASOUND colonoscopy? Gastroenterology Procedures: Endoscopic ultrasound (EUS) is a Colonoscopy is generally indicated in technique whereby an ultrasound the following circumstances: (US) transducer is incorporated into the tip of the endoscope. This 1- Evaluation of unexplained GI provides high-resolution images of bleeding (after an upper GI source Myth and Reality the GI wall and adjacent structures. has been excluded) Endoscopic ultrasound (EUS)-guided 2- Presence of fecal occult blood sampling, including EUS-guided fine needle aspiration (EUS-FNA) 3- Unexplained iron deficiency can be performed in submucosal anemia tumors, pancreatic solid masses and 4- Screening and surveillance for cystic-appearing lesions, and other colonic neoplasia (every 5-10 gastrointestinal tumors. ABOUT years over the age of 50, or Does an ultrasound examination ASSOC. PROF. if there is a family history of colon make sense for you? cancer or colonic polyps 10 years ATAKAN YEŞİL earlier than the index family EUS is generally indicated for: member) Associate Professor Atakan 1- Staging tumors of the GI tract Yeşil has been a member of 5- Clinically significant diarrhea of pancreas, and bile ducts. Yeditepe University Hospital’s unexplained origin team since 2014 as a specialist 2- Evaluating abnormalities of the at our Internal Diseases and GI tract wall or adjacent structures. Gastroenterology Clinic. Ever What is ERCP? 3- Tissue sampling of lesions within or since graduating from Istanbul’s prestigious Cerrahpaşa Medical Remarkable advances have ENDOSCOPY 8- Diarrhea in patients suspected Endoscopic retrograde adjacent to, the wall of the GI tract. Faculty in 2003, Atakan Yeşil been made in gastroenterologic of having small-bowel disease cholangiopancreatography, or ERCP, has pursued his interest in his Endoscopy allows examination 4- Evaluation of abnormalities of the procedures in recent years, with an (eg, celiac disease) is a diagnostic procedure designed pancreas, including masses chosen field of Gastroenterology ever expanding field of application. of the esophagus, stomach, and at some of Turkey’s leading Endoscopic procedures can be to examine diseases of the liver, bile pseudocysts, cysts, and chronic This means that much of the fear duodenum. Diagnostic observations medical centers and institutions, used for diagnostic and therapeutic ducts and pancreas. To minimize pancreatitis. about these procedures is based are made concerning focal benign including specialist training in purposes. Common therapeutic discomfort, ERCP is performed Gastroenterohepatology and on myth. In reality, the quality and or malignant lesions, gastritis ulcers 5- Evaluation of abnormalities of the endoscopic procedures include under intravenous sedation, a background of specialist precision of endoscopic equipment and helicobacter pylori infection. biliary tree. work and research in Internal Helicobacter pylori is a bacteria polypectomy, dilation of strictures, usually without general anesthesia. and devices, which are the basis of stent placement, removal of foreign Diseases. More than 20 of which lives in human stomach and Frequently, therapeutic measures endoscopic diagnosis, has greatly bodies, gastrostomy (for patients CAPSULE ENDOSCOPY award-winning Atakan Yeşil’s can cause gastritis, ulcers and also can be performed at the time of articles have been published in improved, and Yeditepe University who cannot swallow), treatment of ERCP to remove stones in the bile international medical journals. Hospital patients benefit from state- gastric carcinoma. It may also cause GI bleeding with injection, banding, Small-bowel video capsule endoscopy upper abdominal pain, belching, ducts or to relieve obstruction of the is the first-line investigation in patients His career has included senior of-the-art techniques and technology. coagulation, sclerotherapy, and posts at Internal Disease and nausea, vomiting and abdominal bile ducts. with obscure gastrointestinal bleeding. Over 20 years have passed since removal of limited malignant lesions. Gastroenterology Clinics as well bloating. When we reveal the Other common usage areas are as coordinator of a prominent the development of the videoscope. During ERCP, the endoscope will presence of the microbe, it needs to COLONOSCOPY: CATCHING suspected small intestinal tumors and Liver Transplantation Center. Compared to diagnostic procedures pass through your mouth, esophagus be eradicated. PROBLEMS EARLY refractory malabsorptive syndromes. A fluent English speaker using other medical instruments, and stomach into the small intestine. and member of a number endoscopic diagnosis facilitates more What are the ‘alarm symptoms’ Colonoscopy allows examination After finding of common bile duct at of professional associations DOUBLE BALLOON ENTEROSCOPY including the European accurate results through biopsies, and that indicate the need for of the entire colon and rectum, the second part of the duodenum, minimally invasive treatment such as endoscopic examination? and frequently the terminal ileum. Association for the Study of entrance of bile duct will be dilated Double balloon enteroscopy is an Liver Diseases, Assoc. Prof. the use of endotherapy instruments Screening colonoscopy should be and stones will be removed. Yeşil’s particular fields of interest to remove polyps. 1- New onset symptoms starting performed everyone older than effective and safe technique for over the age of 50. small-bowel examination. With this encompass interventional 50 years old. With colonoscopic endoscopy, diseases of the Nowadays, it is possible not only to 2- Family history of esophageal or examination we can detect polyps Who should undergo ERCP? technique, we can diagnose suspected liver, pancreas and anal diagnose whether lesions are benign and remove them. (Polyps can small bowel lesions, as well as, we region, inflammatory intestinal gastric cancer ERCP is generally indicated in: or malignant, but also to make on turn to cancer in 5-10 years; after obtain the biopsies. We sometimes disorders, and peptic ulcer reflux the spot treatment decisions based 3- Unintended weight loss conditions. removal, the cancer risk is close 1-Jaundice perform treatment, depending on the on factors such as their size, depth, 4- Persistent vomiting or vomiting to zero). Follow-up colonoscopies lesion. 52 and how atypical they are. Sedation- with blood should be done every few years, 2-Common bile duct stones 53 inducing a state of drowsiness before 5- Bloody or black stools depending on the polyp type. The the procedure - is frequently used diagnosis of other disease of the 3-To drain the obstructed bile ducts 6- Difficulty in swallowing ASSOC. PROF. ATAKAN YEŞİL to minimize anxiety and discomfort colon (like ulcerative colitis) can be due to tumor of strictures and to Department of Gastroenterology and Internal Medicine during the endosocopy procedure. 7- Iron deficiency anemia made by this method. place the stents Medical Director for Yeditepe Medical Center

REFERENCE / 02 www.yeditepehospital.com INFECTIOUS DISEASES

A NIGHTMARE COMING TRUE? temperature of 38 °C, with elevated white cell and CRP counts. Screening The post-antibiotic era is medical and stool tests have shown he is science’s worst nightmare about to producing Vancomycine-resistant come true. This could spell the end Enterococcus (VRE) which is of modern medicine as we know it. It means dying from tonsillitis or a highly resistant to antibiotics, scratch to the skin, and saying goodbye and life-threatening outside the Why aren’t intestines. The ALS patient has no to patient safety and quality medicine. chance of survival. Our medical Training and education is necessary manuals tell us that there is a new antibiotics working at every level of society including us alternative antibiotic against VRE healthcare professionals. Legislative called linezolid. However these rules and regulations need to be made ‘enterococcus’ are bacteria that live applicable to the new era and science. in the normal intestinal flora of both any more? Let me illustrate what I mean more animals and humans. Moreover, clearly with a sample case: Vancomycine resistance in this Case: a terminal stage ALS patient with sample case shows no pathogenicity a history of frequent hospitalization (ability to cause disease). From the at different hospitals. He has a perspective of its chemical dynamics,

Modern medical science has When Fleming first discovered prolonged and improved people’s penicillin, this antibiotic was able to lives. Just a century ago normal life treat multiple microbes including Years of antibiotic expectancy was 45-50 while now staphylococcus in miraculously small use has led to a we can expect to live almost twice dosages. Today, we are using this as long. This lifespan is essentially antibiotic in much larger dosages number of bacteria down to two medical miracles – against bacteria that have now vaccines and antibiotics. But we are developed a resistance. with antibiotic now faced with an imminent danger The madness of unnecessary resistance. And regarding antibiotics. The ENEMY antibiotic use is now a major issue discovering new has sneaked through a gap in the on a global scale. According to US door and got inside. The number one Center for Disease Control (CDC) antibiotics requires enemy of overall health in society data, prescriptions for 50 million is now the Multiple Drug Resistant doses of antibiotic are issued perhaps decades (MDR) bacteria that threaten to unnecessarily every year. Looking bring the era of antibiotics to an at the data by disease, the leading of research and end. Unfortunately, most people item on the list is antibiotic use studies. (including some healthcare workers) against common colds. In a speech remain unaware of the gravity of the he delivered on 14th March 2012, problem. the head of the World Health Yeditepe University Hospital’s Prof. Organization Dr. Margaret Chan Dr. Meral Sönmezoğlu prepared drew attention to this issue, stating this briefing for Reference readers that it was a global problem in ABOUT hoping to raise your awareness which preferred antibiotics in daily in hospital-acquired (nosocomial) of the situation, brought about use would very soon lose their infections, and genetically spread PROF. DR. MERAL SÖNMEZOĞLU by the scientifically irrational and effectiveness entirely. Generally resistance-bearing bacteria preferred for their ease of use, we unnecessary use of antibiotics. that have rendered themselves The Head of Yeditepe University Hospital Department of Infectious Perhaps the most crucial aspect were confronting a situation in which Diseases and Clinical Microbiology, Professor Sönmezoğlu the loss of favored antibiotics will untreatable. These bacteria are of rational use of medication is has been at the forefront of developments in the field in soon mean that we will be forced to rapidly multiplying; they include Turkey and abroad, having served at a number of pioneering rational antibiotic use; this means use the more toxic, more expensive, MSRA, ESBL (+) gram negatives, institutions including the Copenhagen Bispebjerg Hospital and it needs firstly to be appropriate to and generally intravenously carbapenem resistant pseudomonas St. Bartholomew’s Hospital in London. No fewer than 93 of her clinical needs, able to meet special 54 administered antibiotics as used in studies and research papers have reached a wide audience 55 situations, taken at the proper time carrying the resistant gene, VRE, through their publication in Turkish and international journals. intensive care units. intervals without delays, at minimal BISA, MDR tuberculosis bacilli, Meral Sönmezoğlu is a member of a number of associations cost. In a nutshell – the right way for Another related problem is the role pan-resistant klebsiella, MDR including the International Society for Blood Transfusion. the right patient! played by highly resistant bacteria acinetobacter etc.

REFERENCE / 02 www.yeditepehospital.com INFECTIOUS DISEASES INSURANCE

Linezolid is not actively found in the are being taken off dusty shelves THE ENEMY WITHIN stool and cannot enter the intestine. ; even more worrying, they are Yeditepe University Healthcare Institutions accepts the following insurance plans. There is no medication or antibiotic being pressed back into service. The rational objectives of medical capable of fighting VRE’s capacity to Our failure to win this war renders science in this struggle against the foe For information about specific contract coverage, please contact our Global Services directly. carry in the stool. This medication it a candidate to be the most of antibiotic resistant bacteria are: has a number of potentially fatal side severe medical issue that will face 1. Rational, scientific use effects. It is also extremely expensive future generations, an issue that INSURANCE ASSISTANT INSURANCE but essential as a lifesaving medication carries the same end-of-the-world 2. Urgently to reduce the use of against life threatening infections. It implications for humanity as the antibiotics HTH WORLDWIDE / USA APRIL ASSISTANCE / TURKEY is needed in this case. In the event worst climate change and global 3. Reduction in medical costs it is used, and the VRE develops a warming scenarios. GEOBLUE / USA EUROCROSS / TURKEY secondary resistance, it will no longer 4. Decrease the resistance METLIFE / USA INTER PARTNER ASSISTANCE / TURKEY be of any use against other infections. EDUCATION IS KEY 5. Avoid any decline in patient safety The education and training I am and medical quality MSH INTERNATIONAL / FRANCE FALCK GLOBAL ASSISTANCE / TURKEY LOSING THE STRUGGLE talking about needs to be given to all healthcare professionals and to 6. Establishment and dissemination of The weapons of success in this global HENNER / FRANCE REMED ASSISTANCE / TURKEY facing healthcare professionals in antibiotic control programs war are as follows: this country – namely the violent 7. Use of antibiotics manuals PRESTIGE INTERNATIONAL / ENGLAND EUROP ASSISTANCE / TURKEY Effectiveness: research is needed reaction from patients’ loved into appropriate and inappropriate ones when their demands for an HEALIX / ENGLAND MARM ASSISTANCE / TURKEY antibiotic prescription are not met. PROF. DR. MERAL SÖNMEZOĞLU antibiotic treatment methods Department of Infectious Diseases and for bacterial eradication / clinical Clinical Microbiology Specialist BUPA / ENGLAND ALLIANZ GLOBAL ASSISTANCE / TURKEY The strategic chart below, which regulation. Director of Tranfusion Center shows how resistance has become ADAC / GERMANY EURO-CENTER / TURKEY Accuracy: compatible clinical- an insoluble problem, especially microbiological outcome rates and in Turkey, provides a highly visual CIGNA / BELGIUM TUR ASSIST / TURKEY microbiologic outcome rates (as a educational presentation. result of side effects, super infections ALLIANZ WORLDWIDE CARE / IRELAND ORION ASSISTANCE / TURKEY Interpretation of this table can be and unsuccessful treatment). summarized thus: MEDILINK / LIBYA AID ASSISTANCE / TURKEY rules concerning Appropriateness: There is a 50% probability in infectious disease consultations Turkey that serious infections SAHARA INSURANCE / LIBYA INTERMUTUELLES / FRANCE and hospital antibiotic practices in like pneumococcal meningitis, compliance with the guide manuals. / LIBYA / GERMANY pneumonia and sepsis will TAKAFUL MD MEDICUS not respond at all to penicillin Compliance: Continuous post medical SAHARA INSURANCE / INDIA INTERNATIONAL SOS / GERMANY training changes in practices, issues, derivatives any more. Yet just 30 years ago the method of choice to doctor feedback. TAKAFUL / BAHRAIN AP COMPANIES / RUSSIA treat these infections successfully In spite of all these data and was pure, very cheap, penicillin. technological advances we are rapidly MEDEXA / JORDAN GVA ASSISTANCE / RUSSIA losing this existential battle. There is MALATH / SAUDI ARABIA HEALTHWATCH / GREECE a clear need for new antibiotics that may take decades of research, studies SAUDI ARAMCO / SAUDI ARABIA MEDIGO / GERMANY and trials. The clearest indication of scientific helplessness is that old TAWUNIYA / SAUDI ARABIA antibiotics that we stopped using 50 or 60 years ago because of their high TAKAFUL / UAE toxicity (like colimycin and fosfamycin) AIG RUSSIA / RUSSIA

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REFERENCE / 02 www.yeditepehospital.com NUCLEAR MEDICINE

Nowadays nuclear medicine tests help to diagnose, stage and treat neurological, heart, stomach and intestinal conditions, as well as various types of cancer ABOUT PROF. DR. NALAN ALAN NUCLEAR MEDICINE FACILITATES Therefore the radiation dosages tissue goes into hibernation, continuing size of a pen, this handheld device SELÇUK EARLY DIAGNOSIS administered to our patients are not a to sustaining itself on a reduced is used under sterile conditions in level that could cause any damage to Radiocative supply of blood. When the blood is the operating theater. Areas of the Nuclear medicine is a branch of their health. For example, the amount resupplied with the opening of the patient’s body that hold the radioactive medicine involved in the diagnosis and The Head of Yeditepe of radioactive material used during a arteries, these tissues are revived. PET material are located, enabling the treatment of various diseases using materials University Hospital thyroid scintigraphy is equivalent to screening provides information about gamma probe to pinpoint the location radioactive materials. The use of the what a person might be exposed to the concerned tissue as it relates to the Department of Nuclear words ‘nuclear’ and ‘radioactive’ can are used for of the lesions. Targeted open surgical during a two hour flight or a few hours heart, as well as on by-pass operations. intervention is then carried out. Medicine, Ass. Prof. Nalan make the field sound a bit frightening. sunbathing.” Some centers decide on the efficacy of Alan Selçuk graduated Yet developments in this field play a treatment by-pass surgery only after determining A POPULAR FIELD WITH A LONG from Istanbul University significant role in the early diagnosis USED FOR BOTH DIAGNOSIS AND HISTORY as well as whether or not hibernating tissue is Cerrahpaşa Medical Faculty of a number of conditions. Nuclear TREATMENT present. medicine also helps obtain satisfying Explaining that nuclear medicine is in 2004, since which time Nuclear medicine tests encapsulate diagnosis. treatment outcomes. As well as the BONE STRENGTH one of the most popular fields of since which time she has field’s tests and anatomic imaging, tests directed at a specific organ or specialization, Selçuk states “Doctors prominence through her it can also show tissue and organ certain specific diseases. Procedures One nuclear test is densitometry, choose PET CT devices because of the function together with radiological previously known under the general specifically used in prostate cancer which determines the bone mineral advantages to the patient. research and practical work tests using radioactive material. term scintigraphy now vary according screening. DOA is a unique marker for intensity. Loss of bone minerals can in the field. The recipient of to the organ and objective of the test neuro endocrine tumors. Radiocative lead to fractures; this test determines Nalan Alan Selçuk went on to fill us national and international We sat down with the Head of being carried out. One of these is the patient’s response to treatment. in on the history of the procedure materials are used for treatment awards, Selçuk’s papers have Yeditepe University Hospital PET – Positive Emission Tomography. as well as diagnosis. In cases where Low dosage X rays can determine bone in Turkey. “The history of nuclear Department of Nuclear Medicine, Ass. This test facilitates imaging of normal a prostate cancer lesion has been density in 10 minutes. These tests are medicine is not as long as in other been published in various Prof. Nalan Alan Selçuk who gave us a or pathologic tissue accumulating detected, molecules marked with a generally applied in older aged patients. countries perhaps, but it has international peer group detailed explanation about radioactive intravenously injected metabolic high energy radioactive material called developed rapidly. A laboratory was journals. Nalan Alan Selçuk materials, their effectiveness, and tests SCINTIGRAPHY radioactive material, allowing the lutetium 177 are re-injected into the first established by a specialist in is a member of numerous carried out at Yeditepe University measurement of important bodily endocrinology working in the area of patient to treat the condition. Scintigraphy is the general term for associations working to Hospital using advanced nuclear functions such as blood oxygen, oxygen imaging procedures conducted using thyroid function in the 1950’s in what is medicine techniques and technology. uptake and glucose metabolism. Since THE METHOD OF CHOICE IN radioactive materials with gamma now Haseki Hospital. The story begins promote advanced nuclear ONCOLOGY medical procedures and As Ass. Prof. Selçuk briefs us, the most PET screening is performed in camera equipment. It is used to there. Nuclear medicine became a radioactive materials used in nuclear conjunction with CT scanning, it is also PET CT has a particular usage in diagnose problems in the thyroid specialist field in 1974. Turkey was techniques, including the medicine tests vary according to the known as PET CT. PET CT detects the treating cancer patients. It can also be gland, liver, spleen, stomach and quick to adopt developments in other European Association organ to be examined. “People are exact location of abnormal metabolic used in certain neurologic and heart intestines, kidneys, gall bladder, heart, parts of the world; when compared to of Nuclear Medicine. activities in the body. lungs, veins and bones. Many patients the rest of the world Turkey has kept naturally startled when they see the diseases. 90% of usage is in the field of Her particular areas of have benefited from early diagnosis word radioactive. But the radioactive OBJECTIVE-BASED MATERIAL oncology, 5% neurology, and 5% cardiac well ahead in terms of routine patient dosages we use are extremely low. For cases. PET also plays a significant role achieved using scintigraphy. diagnosis and treatment. “Whatever interest are PET oncology, happens in the rest of the world radionuclide therapy, 58 this reason the possibility of harming The radioactive material used in the in diagnosing coronary artery disease. GAMMA PROBE 59 anyone’s health is recognized as zero. PET screening depends on the organ In some myocardial infarction cases, happens in Turkey.” pediatric nephro-urology and All our work is conducted at the level being examined. For example, while it is thought that all the cells in the Used more and more frequently in neurology. recommended by the International fluorine marked glucose generally infarction area have been eradicated recent years, gamma probe is a kind NALAN ALAN SELÇUK, MD Atomic Energy Agency (IAEA). signifies a tumor, gallium 68 PSMA is whereas in some cases some of the of nuclear medicine detector. The Assistant Professor of Nuclear Medicine

REFERENCE / 02 www.yeditepehospital.com ACTIVITIES

22-30 SEPTEMBER 30 OCTOBER - 25-27 NOVEMBER 24-27 OCTOBER 2016 2 NOVEMBER 2016 2016 2016 USA UAE AZERBAIJAN AZERBAIJAN Healthcare World Press Event For Partners Congress 10-13 OCTOBER 2016 Vision Care Workshop Seminar for Dentistry UZBEKISTAN GEORGIA IRAQ Bone Marrow Transplantation Workshop Press Event For Media and 03-06 OCTOBER 23 OCTOBER Partners 2016 2016 MOLDOVIA Opening Yeditepe Global Services Office in Erbil SERBIA UKRAINE Social Press Event For Media and Responsibility Partners Event KYRGZYSTAN

18-20 OCTOBER 2016 ROMANIA

Kidney Transplantation Seminar Master Class For BULGARIA Oncology Kidney Transplantation Seminar Urology Seminar IVF Masterclass B2B Event For 24 OCTOBER CIS Countries 2016 ISRAEL ALBANIA 60 61 04-07 Social Responsibility BULGARIA DECEMBER 2016 Campaign

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4-Basilica Cistern 8- Süleymaniye (Yerebatan Sarnıçı) Mosque

20 Top-Rated Tourist Sitting high on the hill above The Basilica Cistern is one of Istanbul’s most surprising tourist attractions. Sultanahmet district, the This huge, palace-like underground Süleymaniye Mosque is one of Attractions in Istanbul hall, supported by 336 columns in 12 the most recognized landmarks rows, once stored the imperial water of Istanbul. It was built by the supply for the Byzantine emperors. famed Ottoman architect Sinan The project was begun by Constantine between 1549 and 1575. The Coveted by empires across the centuries, University Healthcare Institutions, or a loved one or the Great but finished by Emperor interior, dominated by its soaring straddling both Europe and Asia, Istanbul is one family member. Although many tourist attractions Justinian in the 6th century. A visit 6-Istanbul 53-meter-high dome, is notable of the world's great metropolises. The city is are located in, or near, the old city district of here is very atmospheric with the Archaeology for its harmonious proportions liberally scattered with glorious remnants of its Sultanahmet, there is a dazzling array of other columns beautifully lit and the soft, and unity of design. long and illustrious history, and the sightseeing things to do throughout the city, including on the steady trickle of water all around you. Museum here may be just the tonic for you, whether you Asian side of the city where Yeditepe University are a patient receiving treatment at Yeditepe Healthcare Institutions is located. NearTopkapı Palace, this important museum brings together a staggering array of artifacts from Turkey and throughout the Middle 1-Hagia Sophia 2-Topkapı Palace (Topkapı Sarayı) East. As well as all the wonderful artifacts on display, don’t miss The Aya Sofya (formerly the the interesting Istanbul Through Hagia Sophia) was the Byzantine the Ages exhibit room in the main emperor’s swaggering statement Archaeology Museum. to the world of the wealth and technical ability of his empire. Through its conversion to a mosque, after the Ottoman armies 9-Spice Bazaar conquered Constantinople, to its (Mısır Çarşısı) further conversion into a museum in the 20th century, the Aya Sofya The Spice Bazaar is the place to get has remained one of Istanbul’s most Turkish delight (‘lokum’), dried fruit, cherished landmarks. 5-Hippodrome nuts, herbs, and of course spice. First built by Mehmet the 3-Blue Mosque Much of the money that helped Conqueror in the 15th century, The ancient Hippodrome, completed construct it came from the taxes the sultans of the Ottoman (Sultan Ahmet Camii) by Constantine the Great in AD 330, the Ottoman government levied on Empire ruled over their was the center of Byzantine public Egyptian-made products, which is dominions from this glorious Sultan Ahmet I’s grand architectural gift to his life and the scene of splendid games why its name in Turkish (Mısır Çarşısı) palace beside the Bosphorus capital was this beautiful mosque, commonly and chariot races but also factional means “Egyptian Market”. up until the 19th century. Of known as the Blue Mosque today. Built between conflicts. At the At Meydanı (park) 7-Grand Bazaar the many highlights here, the 1609 and 1616, the mosque gets its nickname from that now stands on the site is home most popular are the Harem; the its interior decoration of tens of thousands of İznik to a variety of historically significant (Kapalı Çarşı) Second Court, where you can tiles. Directly behind the Blue Mosque is the Arasta monuments. walk through the vast Palace Bazaar; a great place for a shopping stop as the For many visitors, sightseeing in Kitchens and stand in awe at the handicraft shops here sell high-quality souvenirs. Istanbul is as much about shopping dazzling interior of the Imperial as museums and monumental Council Chamber; and the attractions, and the Grand Bazaar is Third Court, which contained where everyone comes. This massive the sultan’s private rooms. The covered market is basically the Third Court also displays an world’s first shopping mall. Entrance impressive collection of relics of to the bazaar is through one of 11 62 the Prophet Muhammad in the gates from where a maze of vaulted- 63 Sacred Safekeeping Room and ceiling laneways, lined by shops and is home to the Imperial Treasury. stalls selling every Turkish souvenir To fully see Topkapı Palace you’ll and handicraft you could imagine, need at least half a day. cover the area.

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10-Dolmabahçe 12-Museum of 14- Rüstem Paşa 16-Galata Tower Palace Turkish and Mosque This Genoese tower was built in the 14th century and is one Islamic Arts Possibly the most perfectly pretty The sumptuous and ornate of Istanbul’s most recognisable mosque in Istanbul, Rüstem Paşa Dolmabahçe Palace shows the clear (Türk ve Islam landmarks. There are great Mosque is home to the most stunningly influence of European decoration panoramic views over the city Eserleri Müzesi) preserved İznik tile panels in the city. and architecture on the Ottoman from the top balcony. Finding the mosque adds to the fun as Empire in the 19th century. Built it’s squirrelled down a skinny lane lined by Sultan Abdülmecid I in 1854, it This museum is a must-see with market stalls and always bustling replaced Topkapı Palace as the main attraction for anyone interested with life, near the Spice Bazaar. residence of the sultans. in Ottoman and Islamic art and the dazzling array of styles of Turkish carpets (along with carpets from the Caucasus 18-Pera Museum 20-Maiden’s and Iran) across the centuries, Tower (Kı​z​ Kulesi) before setting out on a shopping Pera Museum houses one of the mission to purchase your own finest collections of Ottoman floor piece. era painting in the world. The program of regularly changing exhibitions often displays some Situated on the Asian side of the of the art world’s biggest names. city, the same side as Yeditepe University Healthcare Institutions, 17-İ​stanbul​ Üsküdar is a major center of 15-Yedikule Fortress Modern Museum historic treasures and home to the 30 meter high Maiden’s Toweron (Yedikule Hısarı) Proving that Istanbul isn’t just an islet off its shores. In Üsküdar 11-Chora Church about historic sightseeing, this Built in the 5th century by the Emperor thoroughly up-to-the-minute art you may also wish to see the (Kariye Müzesi) Theodosius II, the fortress made up the gallery right on the Bosphorus Mihrimah Sultan Mosque, built by southern section of Constantinople’s with fabulous views holds an Süleyman the Magnificent in 1547 The church (now a museum) defensive walls. When the Ottomans extensive collection of Turkish is rightly world-famous for its conquered the city they used the modern art with an ever-changing for his daughter Mihrimah, and the fabulously vibrant 14th-century fortress for defense, and later as a calendar of exhibitions hosting Yeni Valide Mosque, built in the mosaics and many incredible prison and execution place. Yedikule both local and international artists 18th century by Sultan Ahmet III. examples of Byzantine artistry has been restored in recent years, and throughout the year. covering a wide range of themes you can climb up to the top of the from the genealogy of Christ to battlements for superb views across the New Testament stories. the Sea of Marmara. 19-İ​stiklal​ Street 13-Little Hagia and Taksim Square Sophia Pedestrianized İstiklal Caddesi (Küçük Aya Sofya) (Independence Street) is a bustling modern shopping street with a Built before Emperor Justinian wealth of restaurants and cafés. built the Aya Sofya, the church The lower end of the street can was converted into a mosque be reached by taking the world’s and it still functions as a working oldest underground railway from 64 mosque today. Although its near Galata Bridge, the Tünel, 65 proportions aren’t as grandiose constructed in 1875. There is also as others in Istanbul, the building a quaintly old-fashioned tramway has been beautifully restored that runs along its length right up to and is well worth a visit. Taksim Square at the top of the hill.

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1 Yeditepe University Eye Hospital 2 Yeditepe University Specialty Hospital 3 Yeditepe University Genetic Center 4 İstek Foundation Bring someone 5 Yeditepe University Teaching & Research Hospital 6 Yeditepe University Medical Center to life again 7 Yeditepe University Dental Hospital 8 Yeditepe University

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​YEDİTEPE UNIVERSITY EDITOR GRANT HOLDER Prof. Dr. Faruk Yencilek Prof. Dr. Canan Aykut Bingöl TRANSLATION & EDITING PUBLICATION NAME Andrew Richard Boord Yeditepe Reference DIRECTOR PUBLISH PERIOD Tuğçe Suyabatmaz Aydemir Every three months COORDINATOR MEDICAL EDITOR Havva Yetik Prof. Dr. Sina Ercan CREATIVE HEAD CHIEF EDITOR Gülseren Meral Eren Hasan Arslanyüreği JR ART DIRECTOR INSTITUTION Ali Sait Atay Yeditepe University Hospital Devlet Yolu Ankara Caddesi 102/104 ELMA PRINTING & FINISHING 66 Ataşehir/İstanbul/Turkey www.elmabasim.com +90 216 578 4 578 PHOTOGRAPHY ORGAN [email protected] www.yeditepehospital.com www.yeditepehospital.com Manço Productions TRANSPLANTATION CENTER

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