Karaman Merkez

Researchers are studying the use of Doppler ultrasound to evaluate breast masses by measuring differences in the resistive index (RI) between the mass and surrounding healthy breast tissue. The goal is to find out how these RI differences can help distinguish between benign (non-cancerous) and malignant (cancerous) breast masses. This new approach also uses the Doppler Microvascular Flow method to calculate and compare vascular index values within the breast masses. During the study, the minimum, maximum, and average RI values will be recorded from the breast mass and the surrounding normal tissue, as well as from the opposite healthy breast. The relative difference in RI between the mass and healthy tissue will be calculated. Based on pathology results, participants will be grouped into benign or malignant categories, and threshold RI values for these groups will be determined and compared. Participants will undergo evaluation with Doppler ultrasound to collect the required RI and vascular index measurements. The main outcome being measured is the percentage change in resistive index between the breast mass and surrounding normal tissue over a period of 3 to 4 months. This will help assess the effectiveness of this method in differentiating benign from malignant breast masses.

This research aims to evaluate the safety, performance, and usability of Occlutech accessory medical devices used in cardiac implant procedures. It is an international, multicenter, non-randomized, non-invasive registry study focusing on devices such as the Occlutech Delivery Set (ODS), Occlutech Pistol Pusher (OPP), Occlutech Occlusions-Pusher (OOP), and Occlutech Sizing Balloon (OSB). The study collects data through investigator-completed surveys to monitor device-related outcomes during and after catheter-based cardiac implant interventions. The study involves the use of the specified Occlutech accessory devices by experienced physicians skilled in cardiac catheterization and interventional operations. Investigators complete detailed questionnaires assessing the success of implantation procedures, any adverse events occurring during or after the procedures, user harm related to the accessories, and any device deficiencies. The surveys also evaluate performance, usability, and compatibility of the accessories with other devices. Participants are treated following the implants' and accessories' instructions for use and standard clinical practice. Participants' involvement includes undergoing implantation procedures with these accessory devices, after which investigators collect data via surveys. The study monitors safety events over six months, including any adverse outcomes linked to the accessories or procedures. The collected information helps assess the devices' safety profile and practical use in real-world clinical settings. The total duration of monitoring and follow-up is six months per participant to capture both immediate and longer-term effects.

Parkinson's disease (PD) is a progressive neurological condition that often leads to balance and movement difficulties, including freezing episodes and gait problems. These symptoms increase the risk of falls and reduce daily independence and quality of life. Researchers are evaluating whether adding action observation (AO) and motor imagery (MI) therapies to standard rehabilitation programs can improve balance, functional status, and quality of life in people with PD. The study compares two rehabilitation approaches. In the treatment group, patients watch videos of specific exercises with music for 10 minutes, then mentally visualize these movements for another 10 minutes, followed by performing the exercises while watching the video again. In the control group, patients watch videos of static nature photos accompanied by music and then think about the video content before performing a set of exercises shown only once. Both groups perform similar exercises involving upper and lower body movements. Participants will be assessed before and after a 6-week rehabilitation period. Evaluations include balance and mobility tests such as the Berg Balance Scale, the Unified Parkinson's Disease Rating Scale, the Timed Up and Go Test, and the Five Times Sit to Stand Test. Researchers will monitor changes in these scores to understand the impact of the therapies on motor function and quality of life.

Stroke is a common neurological condition that often leads to long-term disability, affecting motor and sensory skills and reducing patients' ability to perform daily activities independently. This study investigates whether adding action observation (AO) and motor imagery (MI) therapies to standard rehabilitation can improve motor recovery, daily functioning, and quality of life in stroke patients aged 18 to 65 years. Participants will receive either AO and MI therapy or a sham version combined with conventional rehabilitation. In the AO and MI group, patients watch videos of specific upper and lower limb exercises with music for 10 minutes, then mentally visualize performing these actions for another 10 minutes, followed by performing the exercises again while watching. The sham group watches static nature photos with music and then watches a video showing exercises once before performing them. Throughout the 6-week rehabilitation period, researchers will assess motor function using the Fugl-Meyer Assessment and Brunnstrom stages before and after treatment. These measures will help evaluate changes in motor recovery. The study will also monitor participants' balance, functional status, and quality of life to understand how these therapies may contribute to stroke recovery.

This research aims to evaluate the pain relief effects of two nerve block techniques combined with femoral triangle block after total knee arthroplasty (TKA) for patients with knee osteoarthritis. The study compares the popliteal plexus block (PPB) and distal IPACK block, both used to reduce postoperative pain in the back part of the knee. These techniques are part of a multimodal pain management plan following knee replacement surgery. Participants will receive one of two treatments: femoral triangle block combined with popliteal plexus block or femoral triangle block combined with distal IPACK block. Each treatment involves a single dose bolus of 10 ml 5% bupivacaine for each nerve block. These blocks are performed under ultrasound guidance to target specific nerves around the knee to manage pain. Throughout the study, researchers will monitor opioid consumption within 24 hours after surgery to assess pain control effectiveness. Participants will be observed for safety and response to the nerve blocks. The total participation timeframe is based on the immediate postoperative period, focusing on pain management after TKA.

Researchers are investigating how edema, or swelling, after total knee arthroplasty (knee replacement surgery) affects the settings of Transcutaneous Electrical Nerve Stimulation (TENS) devices. The study focuses on comparing the amplitude levels needed for three different TENS frequency modes—Conventional TENS, Low Frequency (LF) TENS, and High Frequency (HF) TENS—before surgery and in the unaffected knee. The main goal is to understand if the electrical resistance of swollen tissue changes and influences TENS amplitude settings used for pain control. The study includes patients undergoing unilateral total knee arthroplasty. Researchers will measure the amplitude at which participants feel tingling, a clear current sensation, maximum tolerance, or muscle contraction for each of the three TENS modes. These measurements will be taken before surgery and then again 2 to 3 days after surgery, comparing both the operated and contralateral knees. This helps assess how edema might affect electrical resistance and TENS adjustment. Participants will be evaluated through these amplitude measurements and monitored for safety and effectiveness of TENS use. The primary outcomes are the differences in amplitude settings for each TENS mode between preoperative and postoperative states. The study considers patient comfort and aims to provide better guidance for TENS use in postoperative pain management after knee replacement surgery.

Ventilator-associated pneumonia (VAP) is a serious infection affecting critically ill patients who receive mechanical ventilation for more than 48 hours. This research aims to investigate how a constructivist education program for nurses and cleaning staff in intensive care units impacts the prevention of VAP. The study compares VAP rates between units where staff receive both constructivist education and routine training versus units where only routine training is provided.

This research investigates whether adding Pain Neuroscience Education (PNE) to standard rehabilitation improves pain management, physical function, and psychosocial outcomes for adults aged 40 to 75 undergoing mini-open surgical repair for medium-sized rotator cuff tears. The study also compares the effects of delivering PNE before surgery versus after surgery. Rotator cuff tears are a common cause of shoulder pain and disability, especially in older adults, and recovery can be slowed by severe pain, fear of movement, and psychosocial factors like anxiety and depression. Participants will be randomly assigned to one of three groups: conventional rehabilitation only, conventional rehabilitation plus PNE before surgery, or conventional rehabilitation plus PNE after surgery. The PNE program includes 2 to 3 educational sessions that explain the biology of pain and strategies to reduce pain-related fear. The rehabilitation program focuses on managing pain, improving range of motion, strength, and functional recovery. Assessments will take place before surgery, immediately after PNE (if given), and at 6 and 12 weeks post-surgery. During the approximately 12-week study, participants will undergo regular evaluations of pain intensity, shoulder function, fear of movement, depression, pressure pain threshold, conditioned pain modulation, sleep quality, postural alignment, and overall functional level. Researchers will monitor safety and measure how well the combined treatments help improve recovery. The study aims to provide important insights into enhancing rehabilitation outcomes and the best timing for pain education around rotator cuff surgery.

Researchers are investigating how having the father present in the operating room during elective cesarean sections affects the mother's quality of recovery after surgery. The study focuses on healthy pregnant women without chronic illnesses, aiming to understand the psychosocial benefits and impacts on recovery and anxiety. The study also considers surgeon stress and uses established scales to measure maternal anxiety and recovery quality. Participants are divided into two groups: one where the partner is present in the operating room after sterile preparations, providing physical and emotional support during the cesarean section; and a control group receiving standard care without partner presence. The surgeries are performed under spinal anesthesia, and the surgeons have significant experience with no chronic health conditions. During the study, maternal recovery is assessed using the Obstetric Quality of Recovery-10 (ObsQoR-10) score at 24 hours post-operation, with additional evaluations at 3 and 7 days. Maternal pain is monitored every 6 hours within the first 24 hours using the visual analog scale, and anxiety levels for both mother and partner are measured before and after surgery using the State-Trait Anxiety Inventory. The study includes written consent, and participants are followed closely to monitor outcomes and safety.

This research aims to study the effects of two different cognitive-behavioral combined programs—one using video games and the other using a kaleidoscope—on the pain, fear, and anxiety experienced by children aged 8 to 10 during venous blood collection, as well as on their parents' satisfaction levels. The study is a randomized controlled trial involving 96 children and their parents, carried out at the Children's Blood Collection Unit of Karaman Training and Research Hospital. The research also seeks to create a comprehensive approach to child health by evaluating both children and their parents. Children will be randomly assigned to one of three groups: a control group with no intervention, a group using a cognitive-behavioral program with video games, or a group using a cognitive-behavioral program with a kaleidoscope. During blood collection, children in the video game group will play video games on their parents' smartphones, providing visual and auditory distraction. Children in the kaleidoscope group will use a one-handed kaleidoscope showing colorful patterns to divert attention. All blood collections will be performed by the same experienced nurse using standard procedures and equipment. Participants will be involved for about five minutes before the procedure during which demographic data will be collected. Pain, fear, and anxiety levels will be assessed using various scales like the Visual Analog Scale, Wong Baker Faces Pain Scale, Child Fear Scale, and Child Anxiety Scale. Parents' satisfaction will also be measured. The study will analyze the data statistically to compare the effects of the two programs on children's experiences and parental satisfaction.