Allergy and Immunology

People with dyspnea, wheezing, crackles, wheeze and coughs – the common symptoms of allergic asthma and drug allergies; post-nasal drip and nasal obstruction, and sneezing as well as watering and irritation of the eyes, which are seen in allergic rhinitis and allergic conjunctivitis; itching, eruptions due to urticaria; swelling of the tongue, lips and eyelids secondary to angioedema may be presented to our department. Besides, the symptoms of respiratory tract disorders, dermal signs, and symptoms, as well as other allergic findings that developed secondary to drug use, are among conditions that require direct admission to our department.
 
The following conditions directly fall into the specialty field treated by the Allergy and Immunology Department:
  • Respiratory tract allergies (asthma and allergic rhinitis),
    • Dermal allergies (atopic dermatitis, chronic hives, and angioedema),
    • Drug-induced respiratory tract, dermal and other allergic reactions.
    • Allergies secondary to bee stings and other insect bites,
  • Food allergies,
    • Anaphylaxis secondary to drug, food or insect allergy with unknown etiology.

Anesthesiology and Reanimation

Patients who suffer from pain can directly be admitted to our department where they are subsequently examined. Final treatment modality is planned after diagnosis is established with further tests or consultations with relevant departments. The pain management method is planned, after which invasive pain management techniques are also discussed. Our department also renders services for surgery, delivery, and outpatient surgeries.
 
  • Preoperative care: Examination, laboratory tests, consultations with relevant departments, imaging techniques.
  • Anesthesia procedures: General anesthesia, spinal and epidural anesthesia, peripheral nerve blocks to relieve pain, central catheterizations.
  • Postoperative care: Patient-controlled analgesia devices are set and supervised; the pain control is ensured in an efficient and quick way in our hospital with the leadership of the pain management team.
  • Safe and effective execution of blood and blood products
Anesthesiology Department is specialized in:

Preoperative care: The preoperative clinical conditions of the patients are evaluated. Requirements of the surgical procedure are determined and necessary preoperative preparations are carried out, such as reserving blood, requesting consultations, giving nutritional advice and management of pain killers and drugs.
Anesthesia for surgical procedures: Anesthesia is administered in cardiac, thoracic, vascular surgery, neurosurgery, orthopedic surgery, and spine, liver and pancreas surgery.

Labor analgesia: The most appropriate pain relief method for mothers undergoing delivery is determined on a case by case basis by our experts; mother and baby are then closely followed up during the delivery. The obstetrics team is supported by the pain management team to make the process as comfortable and safe as possible.

Pediatric anesthesia practices: The surgical process is performed in the least stressful way possible with the support of the parents. Parents can participate during the pre and post-operative periods along with their child. Our experienced pediatric nurses constantly support each family throughout the process.

Cancer surgery: Large teams from different disciplines collaborate for anti-cancer treatment.  Anesthesiology clinic which is an inseparable part of the team make necessary contributions in pain management, as is the case with surgical procedures. In addition, our department's various different specialty fields are listed below.
  • Anesthesia for laparoscopic procedures
  • Anesthesia for robotic surgeries
  • Anesthesia for patients with trauma
  • Geriatric practices for elderly patients
  • Cosmetic surgery
  • Anesthesia administrations for day surgeries and outpatient surgical procedures
  • Sedation
  • Chronic pain treatments
  • Postoperative pain management

Audiology

Audiology and language-speech disorders are within our specialization.
 

Children and adults present in our department with different complaints. Children’s complaints are as follows:

  • Language problems
  • Language delays and disorders
  • Autism
  • Genetics syndromes
  • Specific language impairment (SLI)
  • Head traumas and resultant language disorders
  • Learning disabilities secondary to traumas
  • Right hemisphere disorders (attention deficit, memory impairment)
  • Speech disorders
  • Articulation disorder and phonological disorder
  • Cleft lip and cleft palate, and resultant articulation disorders
  • Orofacial myofunctional disorders
  • Dysarthria
  • Apraxia
  • Voice and Resonance disorders
  • Stuttering
  • Pediatric dysphagia
 
Complaints of adults are as follows:
  • Language disorders
  • Aphasia
  • Head traumas and resultant language disorders
  • Right hemisphere disorders (attention deficit, memory impairment)
  • Dementia
  • Speech disorders
  •  Articulation disorder and phonological disorder
  • Dysarthria, apraxia, and stuttering secondary to head and neck tumors
  • Voice and Resonance disorders
  • Benign voice disorders
  • Speech disorders of tracheostomized or mechanically ventilated patients who have head and neck tumors
  • Swallowing disorder secondary to neurologic conditions like dementia, CVA, ALS, and multiple sclerosis or head and neck tumors
The Audiology Department of the American Hospital performs audiological examinations and assessments for newborns, babies, children, adults, and geriatric patients. For all age groups, we render services for the evaluation of the hearing system, diagnosis, and rehabilitation of hearing loss, selection of hearing aids and hearing training.

We determine candidates for cochlear implant surgery, perform pre-and intra-operative tests, program speech processors regularly after cochlear implant surgery and provide listening and speaking training for children and adult patients.

Tests are performed for each newborn delivered at our hospital to specifically determine their hearing functionality. The newborns who fail in the first screening tests are subject to a re-test and the hearing condition is accurately determined before the newborn is discharged. Our hospital has been using a program that complies with international standards on this issue since 2004. VNG, Caloric test, and Electrophysiologic tests are initiated to provide an alternative diagnosis for patients who are admitted with vertigo and balance disorder.

Following tests are performed for the audiological assessment of children:
  • Behavioral tests, VRA, COR,  conditioned play audiometry, speech audiometry
  • Acoustic immitancemetry
  • Otoacoustic emission
  • The assessment of central hearing through electrophysiologic tests  (click and tonal ABR, ASSR, MLR, LVR, P300, MMN).

Audiological evaluations for adults are as follows:
  • Behavioral audiometry
  • Acoustic immitancemetry (tympanometry, wideband tympanometry, Acoustic reflex)
  • Otoacoustic emission
  • Auditory Brainstem Response (ABR), Brainstem Evoked Response Audiometry (BERA), BERA),
  • The assessment of central hearing (MLR, LVR, P300, MMN)

In addition to those aforementioned examinations, vestibular assessment is completed by the following two patient groups.
  • VNG (Videonystagmography)
  • VEMP (Vestibular Evoked Myogenic Potential)
  • EcochG (electrocochleography)
  • Exercises and therapy for vertigo

Cardiology

Chest pain, left arm/shoulder/neck pain, chest tightness, sweating, shortness of breath, palpitations, fainting.

  • Arterial stiffness (arteriosclerosis)
  • Hypertension, High Cholesterol, High Triglycerides
  • Coronary Artery Disease, Acute Myocardial Infarction, Acute Coronary Syndrome
  • Heart Failure, Cardiomyopathy (CM) - (Ischemic CM, Dilated Cardiomyopathy DCM, Hypertrophic Cardiomyopathy (HCM)
  • Heart Valve Diseases (Mitral Insufficiency, Mitral Stenosis, Aortic Insufficiency, Aortic Valve Stenosis, Tricuspid Valve Disease, and Pulmonary Valve Stenosis)
  • Congenital Heart Defects (ASD / Atrial Septal Defect, VSD / Ventricular Septal Defect, PDA / Patent Ductus Arteriosus, Bicuspid Aortic Valve, Coarctation of the Aorta)
  • Congenital Electrical Disorders
  • Abnormal Heart Rhythm
  • Atrial Rhythm Disorders (Atrial Tachycardia / Atrial Flutter / Atrial Fibrillation, Atrial Extrasystoles)
  • Ventricular Rhythm Disorders (Ventricular Fibrillation, Ventricular Tachycardia, Ventricular  Extrasystoles)
  • Heart blocks and pauses in heart rhythm
  • Pericardial Disease
  • PAH (Pulmonary Arterial Hypertension), Pulmonary Embolism
  • Aortic Aneurysm and Aortic Dissection
  • Peripheral Vascular Disease
  • Carotid Artery Disease

Non-Invasive Cardiology:

  • Electrocardiography
  • Echocardiography
  • Exercise-Stress Echocardiography
  • Transesophageal Echocardiogram (TEE)
  • Cardiac Stress Test ( Treadmill Test)
  • CPET (Cardiopulmonary Exercise Test)
  • Myocardial Perfusion Imaging
  • 24/72 hour Ambulatory Blood Pressure Monitoring
  • 24-72 Hours Holter Monitoring
  • Tilt-Table Tests
  • ABI (Aankle-Brachial Index)
  • EECP (Enhanced external counterpulsation)
 

Interventional Cardiology:

  • Coronary angiography
  • Pressure Wire, FFR Measurements - to accurately determine the degree of narrowing of the artery by measuring pressure
  • IVUS (Intravascular ultrasound) - to accurately determine the degree of narrowing of the artery by using a miniaturized ultrasound probe attached to the specially designed catheter
  • OCT (Optical coherence tomography) - to accurately determine the degree of narrowing of the artery by providing cross-sectional images
  • PTCA (Percutaneous Transluminal Coronary Angioplasty), Balloon Angioplasty
  • Stents, Drug-Eluting Stents
  • Atherectomy (Rotablator etc)
  • Stent placement in peripheral arteries
  • TAVI (Transcatheter aortic valve replacement - TAVR)
  • Mitraclip (a small metal clip, about the size of a large staple, is attached to the mitral valve)
  • Pacemaker Implantation (Pacemaker, Implantable Cardioverter Defibrillator (ICD), Biventricular Pacemaker, MR-Compatible Pacemaker)
  • Electrophysiological (EP) Study
  • Ablation for Arrhythmias

 

 

 

Cardiovascular Surgery

   
  • Cardiovascular Surgery:
           Various techniques are used for coronary bypass surgery:
  • Off-pump or beating-heart surgery: This technique is preferred to prevent heart-lung machine side effects and to ensure a shorter stay at the intensive care unit and subsequent quicker engagement in activities of daily life.
  • Radial artery graft: Using radial artery graft that has better rates of re-intervention in comparison to using the saphenous vein graft.
  • Aortic no-touch technique: This is used to avoid cerebral complications that may be caused by the aortic “touch”.
  • Minimally invasive surgery: A surgeon performs coronary bypass through small incisions in the chest.
  • Awake surgery: This technique is preferred for patients who have contraindications for general anesthesia and/or seek shorter hospital stays.
  • Heart valve surgery:
    • Complex mitral valve repair surgery
    • Specialized surgical techniques that provide high-risk patients with a surgical option.
    • Surgery for selected patients who do not require a complete opening of the chest bone.
 
  • Aortic aneurysm repair and aortic dissection:
    • Complex aortic surgeries are carried out in a low-risk way involving the use of specialized surgical techniques
    • Minimally invasive surgery for selected patients who do not require a complete opening of the chest bone.
 
  • Re-operation:
    • Surgery carried out for patients who have already undergone one or more surgical procedures.
 
  • High-risk heart surgery:
    • Specialized methods reserved for very high-risk patients who are deemed inoperable by other healthcare facilities.
 
  • Congenital heart defect corrective surgery
  • Robotic heart surgery
    
Services provided by our Cardiology and Cardiovascular Surgery Departments are as follows:
  • Non-invasive Cardiology Diagnostic Center
  • Advanced Cardiac Imaging
  • Hybrid Catheterization Labs for Interventional Cardiology
  • Interventional Mitral Valve Treatment Unit
  • Heart Surgery Inpatient Clinic
  • Cardiovascular Intensive Care Unit
  • Coronary Intensive Care Unit
  • Telemetry Monitoring
  • Cardiac Rehabilitation Unit
  • Arterial Diseases and Venous insufficiency

Check Up

Our department offers preventive healthcare services rather than complaint-oriented treatment and it aims to keep patients healthy by adopting pre-emptive measures to reduce the risk of compromised health in the future.
 

Our check-up department is not limited to only a field of specialty; we prefer to focus on the holistic evaluation of patients in a more inclusive manner. We cooperate with cardiology, clinical laboratory, radiology and nuclear medicine departments for check-up programs. Moreover, our patients are served with the support of all relevant departments, especially nutritional health, endocrinology, gastroenterology, physiotherapy as well as general surgery.
 

This medical examination process starts with a preliminary rendezvous with one of our doctors where personal risk factors and needs are determined. After the best program is selected for patients, all necessary tests and examinations are initiated. A second discussion with the same doctor is then scheduled, at which all of the results of the tests and examinations are reported; the results are reviewed and the patient is informed about necessary measures.
 

  • General check-up
  • Sleep health
  • Heart health
  • Nutrition
  • Dermal health
  • Endocrine disorders
  • Female/Male health

Clinical Laboratory

  • Clinical Laboratory Certification
  • Laboratory Information Management System
  • Blood Test
  • Urine Test
  • 24-Hour Urine Collection
  • Stool Test
  • Stimulation and Suppression Tests
  • Drug Level Monitoring
  • Information Regarding Blood Donation
  • Information Regarding Blood Sampling
  • Use of Vacuum Tube
  • Laboratory Journals
  • C-Reactive Protein (hsCRP)
  • Epstein-Barr Virus  (EBV)
  • Monitoring Osteoporosis Therapy by Measurement of ß-CrossLabs (ß - CTx)
  • Fetal Fibronectin (fFN)
  • Flu and Avian Influenza
  • Insulin-like Growth Factor 1 (IGF-1) / Somatomedin-C (Sm-C)
  • Newborn Metabolic Screening Programme
  • Anemia and Clinical Laboratory
  • Hyperprolactinemia and Macroprolactin
  • Transferrin Receptor – TfR
  • Vitamin B12 Deficiency in the Elderly
  • Laboratory Request Forms
  • Emergency Laboratory Test Request Forms
  • Clinical Laboratory Test Request Forms
  • Inpatient Test Request Forms
  • Microbiology Laboratory Request Forms
  • Allergen (specific IgE) Request Forms
  • Maternal NTD/DOWN Screening Information and Request Forms
  • Critical Test Results / Information
  • Critical Test Values that Should be Reported

Dermatology (Skin Disorders)

Our department includes certain fields, such as dermato-oncology, dermato-allergy, cosmetic dermatology, dermatologic surgery, pediatric dermatology, laser treatments, hair diseases, and autoimmune bullous diseases. Therefore, our patients should attend the Dermatology Department for all skin related complaints. This includes a wide spectrum of ailments such as itching, various skin rashes, moles, persistent scars and allergic rashes, as well as nail and hair diseases. Also, our branch practices preserving skin health without the occurrence of a disease, delaying effects of ageing with cosmetic practices, as well as treatment of spots and hair loss. Extraction of certain skin tumors, biopsy, treatment of warts and nail surgery are also within our expertise parameters. Dermal allergic diseases and hives are one of the major areas of dermatology and patients should attend our department for all allergic skin tests. All kinds of nevi are evaluated and mapped with our clinic’s dermoscopy device and interventions are performed, if necessary, after risk assessments have been established.
Our sub-services include cosmetic dermatology, dermatologic surgery, dermato-oncology, dermato-allergy, laser treatments, pediatric dermatology, phototherapy, and dermoscopy.

Emergency Department

First aid and emergency care are available at the Emergency Department of the American Hospital for a wide spectrum of diseases and injuries that can be severe enough to be life-threatening.

Since patients presented to our department with injuries and diseases which have various underlying causes, our department specializes in a very wide range of medical disciplines:

  • General Surgery
  • Gynecology and Obstetrics
  • Pediatrics
  • Cardiology
  • Anesthesiology and Reanimation
  • Cardiovascular Surgery
  • Radiology
  • Internal Medicine
  • Orthopedics
  • Aesthetic, Plastic and Reconstructive Surgery
  • Vascular Surgery
  • Interventional Cardiology
  • Interventional Radiology
  • Neurosurgery (Brain, Spinal Cord, and Nerve Surgeries)
  • Neurology
  • Urology
  • Otolaryngology
  • Ophthalmology
  • Pediatric Surgery
  • Dermatology
  • Gastroenterology
  • Pulmonary Medicine
  • Thoracic Surgery
  • Oral and Maxillofacial Diseases

Physicians from the aforementioned departments arrive at our hospital as early as possible when they are called for emergencies related to their departments.

Endocrinology, Diabetes and Metabolism

Endocrine diseases may involve all systems of the body. Patients may present with various complaints that originate from the heart, digestive system, eyes or nervous system. Therefore, a comprehensive and detailed examination of patients is crucial.
 
Numerous complaints, including but not limited to fatigue and tiredness, involuntary weight gain or weight loss, menstrual disorders, abnormal hair growth, and infertility in women; sexual complaints, cardiac rhythm disorders, and changes in physical characteristics in men can originate from diseases of the thyroid gland, adrenal gland, pituitary gland, and gonads. 

Hypertension can be secondary to a disease that originates from or involves the endocrine system.

Diabetes mellitus and organ disorders can be caused by diabetes leading to changes in body weight, polydipsia, polyuria and can cause burning sensations and/or numbness in hands and feet as well as vascular diseases of the heart and brain. 

The Endocrinology Department should also examine patients with osteoporosis and other metabolic bone diseases.

Sexual development disorders and gender identity disorders are followed up and treated in cooperation with other departments.
The endocrine system consists of many organs that secrete different hormones. These hormones affect different target organs in various ways. Organs that form the endocrine system are the pituitary gland, thyroid gland, parathyroid gland, pancreas, adrenal gland, testis, and ovaries. Organs that are not featured on this list which demonstrate different functions such as heart, kidneys, intestine, and brain can behave like “endocrine organs” by secreting hormones. Therefore, endocrinology is a discipline that evaluates the body as a whole and affects all systems. We continuously and regularly cooperate with other departments such as the endocrine surgical department, nuclear medicine department, radiology, and pathology.
  • Diabetes mellitus
  • Thyroid gland and its related diseases, thyroid cancer
  • Hypothalamus; pituitary gland diseases
  • Parathyroid gland and its related diseases
  • Osteoporosis and Disorders of Calcium and Bone Metabolism
  • Lipid Metabolism Disorders
  • Adrenal Gland Disorders
  • Gonadal (ovary and testes) Disorders

Gastroenterology and Hepatology

Patients admitted to our department suffer from issues concerning the digestive system organs, starting from the esophagus including the stomach, small intestines, colon, liver, pancreas as well as the gallbladder. These complaints include, but are not limited to swallowing difficulty, feeling of obstruction while swallowing, stomach aches and abdominal pain, heartburn and gastric discomfort, vomiting, constipation, and distension.
Irritable bowel syndrome which is a common disease in our society, reflux, gastritis, constipation, hemorrhoids as well as gastrointestinal motility disorders, inflammatory bowel disease, Hepatitis B, Hepatitis C, diseases of the pancreatic duct and bile ducts are meticulously treated by our department’s physicians.

Removing polyps from the large intestine, mucosectomy, endoscopic submucosal dissection (ESD), and endoscopic treatment of achalasia are performed at our department which is a leader in Turkey for this variety of procedure.
  • Emergency interventions such as hemostasis, extraction of foreign bodies, management of stenotic segments,
  • Liver biopsy,
  • Measuring pressure and acidity from the esophagus (pH meter and manometer, impedance) are included in the spectrum of the sub-services available.

General Intensive Care

In our department that is managed by our team of anesthesiologists and reanimation specialists, we serve our patients utilizing all relevant medical disciplines under the title “General Intensive Care Unit”.
The complaints that we directly deal with include all impairments in vital signs- pulse, respiratory rate and pattern, blood pressure and mental status.
All supportive systems are available for organ failure scenarios; mechanical ventilation, cardiovascular support, renal support, intra-aortic balloon pump, artificial heart-lung support, plasma and blood replacements as well as liver support systems.

General Surgery

Our department deals with a very wide spectrum of complaints that may be related to many medical disciplines. Some of these complaints are as follows;
 
  • Difficulty swallowing
  • Gastroesophageal reflux
  • Abdominal pain
  • Vomiting
  • Abdominal mass
  • Gastrointestinal bleeding (occult or severe)
  • Dyspepsia, abdominal distension
  • Constipation, obstructed defecation, fecal incontinence
  • Jaundice
  • Cutaneous and subcutaneous mass
  • Obesity
  • Breast lumps
  • Nipple discharge
  • Physical trauma
  • Neck mass
  • Inguinal hernia, umbilical hernia or incisional hernia
  • Breast health and diseases
  • Endocrine disorders
  • Metabolic surgery (obesity surgery)
  • Esophageal and gastrointestinal disorders
  • Colorectal and anal/perianal diseases
  • Liver, pancreas, gallbladder and bile duct diseases
  • Trauma Surgery
  • Abdominal wall hernia
  • Urgent surgery
  • Thyroid and parathyroid surgery
  • Adrenal surgery
  • Breast surgery and breast reconstruction
  • Bariatric and metabolic surgery (obesity surgery)
  • Liver surgery
  • Gallbladder surgery and surgical extraction of bile duct stones
  • Pancreas surgery
  • Esophageal surgery and swallowing disorders
  • Gastric surgery
  • Small intestine, colon, rectum and anal region surgery
  • Stoma care training
  • Abdominal wall hernia surgery
  • Nutritional support
  • Oncologic surgery

Home Health

Evde bakım gerektiren hastalar için iç hastalıkları, nöroloji, fizik tedavi ve rehabilitasyon, genel cerrahi de dahil olmak üzere tüm uzmanlık dallarında hastane dışı yapılabilecek muayene ve işlemler bölümümüz tarafından planlanıyor.

Evde sağlık hizmetleri, hastane tedavisi gerektirmeyen kronik hastalığa sahip, yakın tıbbi bakıma muhtaç, kısa süreli akut tedavi ihtiyacı olan, yatağa bağımlı, rehabilitasyon gereken hastalar gibi birçok hasta grubunu içerir. Bu nedenle her geçen gün artan bir hasta spektrumuna sahiptir. Felç geçirmiş birisi, demansı olan bir yaşlı hasta, ortopedik ameliyat geçirmiş rehabilitasyon hastası, evde bakıma ihtiyaç duyanlara örnek olarak verilebilir.

  • Yoğun bakım hemşirelik hizmetleri,
  • Kanserli hastaların genel takibi,
  • Ağrı tedavileri,
  • Pansuman, idrar kateteri, NGT, yara ve  stoma bakımı gibi hizmetler,
  • Geriatrik hastaların takibi,
  • Postoperatif hastaların tedavi ve takipleri,
  • Yeni doğan hizmetleri,
  • Fizik tedavi, rehabilitasyon, konuşma ve uğraşı terapileri,
  • Enjektabl (iğneyle verilmeye elverişli) tedavilerin uygulanması,
  • Kan alma ve laboratuvar tetkikleri,
  • Evde görüntüleme (USG ve röntgen),
  • Evde uyku tetkikleri,
  • EKG ve EEG gibi uygulamalar,
  • Terminal dönem hasta bakımı,
  • Kuadriplejik (kolları ve bacakları ile gövdesi felçli hasta), hemiplejik (vücudunun sağ ya da sol yarısında felç görülen hasta) ile diğer nörolojik hastaların bakımı ve takibi,
  • Demansı olan hastaların bakım ve tedavileri,
  • Yatağa bağımlı hastaların bakımı ve tedavileri hizmet verdiğimiz alt servisleri oluşturuyor.

Gynecology and Obstetrics

Our fields of specialization are:

  • Obstetric (delivery)
  • General and preventive gynecology
  • Endoscopic surgery (laparoscopy, hysteroscopy, and robotic surgery)
  • High-risk pregnancies and prenatal diagnosis, counseling, and treatment
  • Reproductive endocrinology and assisted reproductive technology (IVF)
  • Gynecologic oncology
  • Urogynecology
  • Adolescent gynecology
  • Endometriosis-adenomyosis, myomas
  • Congenital anomalies of uterus and ovaries
  • Aesthetic and cosmetic gynecology
  • Laser department
The Obstetrics and IVF Center at the American Hospital is a distinguished clinic in terms of service quality and range, as it can respond to all complaints concerning female health and it has already gained the trust of many patients with its rich history of expert diagnosis and treatment as well as long-term follow-ups.

Gynecologic complaints consist of menstrual irregularity or absence of menstruation, inguinal and abdominal pain, polycystic ovary syndrome, excessive hair growth, acne, hair loss, ovarian cysts, myomas, polyps, vaginal discharge, sexually transmitted diseases, vaginal cysts, abscesses or wounds as well as genital warts, sexual dysfunctions, vaginismus, hot flushes, vaginal dryness and menopause. Moreover, other common reasons for admission include uterine prolapse, vaginal prolapse, and urinary incontinence.

Severe inguinal pain during periods, pain during sexual intercourse, painful bowel movements, obstructed defecation, rectal bleeding, blood in urine, sharp pains while breathing during periods, fatigue, irregular menstrual cycles and heavy menstrual bleeding (menorrhagia), as well as endometriosis and adenomyosis form the conditions that lead to admission at our clinic.

Patients are admitted to the Assisted Reproductive Technology Unit with certain conditions, including but not limited to the inability to achieve pregnancy despite no use of contraception, inability to achieve pregnancy despite multiple in vitro fertilization attempts, recurrent miscarriages, failure of embryo implantation, lack or absence of eggs/sperm, polycystic ovary syndrome, varicocele, erectile dysfunction or ejaculatory problems, vaginismus, hereditary genetic disorders, uterine malformation, and intrauterine adhesions.
 
Ovarian cysts and tumors, endometrial cancer, ovarian cancer, cervical cancer, vaginal cancer, vulvar cancer, precancerous lesions in the vagina, precancerous cervical lesion, abnormal Pap smear result, and are genital warts form the gynecological oncology conditions that lead to admission at our clinic.

Prepregnancy counseling, supervision of pregnancy, prenatal yoga, nutrition and awareness education, vaginal delivery or C-sections, supervision of puerperal and psychological counseling are regarded as areas that fall into the field of obstetrics. Antenatal diagnosis, diagnosis, and supervision of high-risk pregnancies and genetic counseling services are available at the Perinatology Unit.

Our department collaborates closely with the Obstetrics and Gynecology Department and the Genetics Department at Koç University.
 

General and Preventive Gynecology:

  • Smears
  • HPV typing, HPV vaccination
  • Abnormal Pap smear tests and follow-ups
  • Treatment of warts
  • Cryotherapy
  • Colposcopy
  • Vaginal laser treatments
  • Two- and three-dimensional ultrasound in the diagnosis of endometriosis and adenomyosis,
  • Advanced laparoscopic surgery (recurrence of myoma, lumps and deep endometriosis, hysterectomy -removal of the uterus-, reproductive organs prolapse),
  • Hysteroscopy

Obstetrics:
  • Advanced level ultrasound
  • Fetal DNA test in maternal blood
  • Chorionic villus sampling (CVS)
  • Amniocentesis
  • Cordocentesis
  • Multifetal pregnancy reduction
  • Counseling and termination, if required, based on the decision of council for abnormal pregnancies
  • Inpatient and outpatient supervision of high-risk pregnancies
  • Counseling and follow-up at the neonatal intensive care unit
  • Prenatal yoga, nutrition, psychological counseling, puerperal support,

Endoscopic Surgery:
  • Laparoscopy (hysterectomy, myomas, ovarian cysts, endometriosis surgery, oncological surgery)
  • Hysteroscopy (polyps, myomas, intrauterine adhesions, congenital uterine anomalies, T-uterus, and isthmocele surgery)
  • Robotic surgery (hysterectomy, myomas, ovarian cysts, endometriosis surgery, oncological surgery)

Gynecologic Oncology:
  • Smears
  • HPV typing, HPV vaccination
  • Management and follow-up of precancerous pathologies of the cervix
  • Surgical treatment and management of gynecological cancers
  • Fertility saving surgery in cancer treatment
  • Cytoreductive surgery (reducing the number of tumor cells)
  • Medical oncology councils
  • Treatment counseling to conserve fertility before anticancer treatments.

Urogynecology:
  • Urinary incontinence
  • Pelvic organ prolapse

Aesthetic and Cosmetic Gynecology:
  • Urinary incontinence
  • Vaginal rejuvenation
  • Labiaplasty (vulval surgery)
  • Vaginal laser

Hand Surgery

Although the hand is a small part of the human anatomy, some numerous diseases and disorders fall into the field of hand surgery. These diseases and disorders are as follows:
  • Injuries and diseases of brachial plexus (the network of nerves that sends signals from your spinal cord to your shoulder, arm, and hand)
  • Congenital hand deformities
  • Dupuytren's contracture
  • Firearm injuries to the hand and wrist
  • Connective tissue or ligament (the connective tissue that attaches bones in the joints) ruptures in the hand and wrist
  • Calcium deposits in the hand and wrist
  • Rheumatoid arthritis in the hand and wrist
  • Instability (weakness) of the hand and wrists
  • Nonunion fracture or malunion fractures of the wrists and hand bones
  • Fractures and dislocations of the hand and wrist
  • Hand and wrist contractures (a deformity of joints secondary to abnormal contraction of the muscles)
  • Hand and wrist tendonitis (inflammation)
  • Soft tissue and bone infections of the hand and wrist
  • Sharp injury of the hand and arm
  • Problems secondary to burns of the hand and arm
  • Ganglion cyst
  • Benign or malignant osseous and soft tissue tumors located in the hand and wrist
  • Carpal tunnel syndrome
  • Death of bone tissue death (bone necrosis/osteonecrosis)
  • Cubital tunnel syndrome
  • Cerebral palsy associated disorders
  • Scaphoid (one of eight small bones that make up the “carpal bones” of the wrist) fractures
  • Nerve injuries
  • Tendon Injuries
  • Trigger finger
One may be admitted directly to our department regarding complaints and diseases of the hand. Here are the following complaints that we treat:
  • Hard nodules just under the skin of the palm, one or more fingers become permanently bent in a flexed position
  • Congenital hand anomalies & malformations in the hands or arms of the baby (fingers fail to separate, more than five fingers on one hand, small or missing fingers) 
  • When a baby exhibits weakness in the arm, or cannot move it
  • Pain, bruising, swelling, deformity, inability to move hands and/or wrists following falls, traumas, accidents
  • Pain in the wrists
  • Lumps noticed in the hands and wrists
  • Restricted movement, inability to fully move or use the hands or wrists
  • Redness, sense of burning and pain in the hands and wrists
  • Morning stiffness and inability to move the hands and wrists
  • Involuntary movements in the hands and wrists, resulting in reduced sleep
  • Malformations and deformities of the hands and wrists
  • Swelling in the hands and wrists
  • Visual and functional problems in the hands and wrists secondary to burns
  • Loss of strength and motor skills in the hands
  • Numbing, tingling, stinging, felting, stiffness, fatigue and sense of burning in the hands, digits, and arms
  • Pain in any part of the hand
  • Injuries secondary to a cat, dog or human bites
  • Loss of sensation and function, inability to move hands and wrists and open wounds secondary to laceration, burns or shredding
  • Paralysis persisting since early childhood due to cerebral factors
  • Locking, swelling, pain, and instability to move the fingers

Hematology

Conditions written below are covered by our department:

  • Acute lymphoblastic leukemia
  • Acute myeloid leukemia
  • Amyloidosis
  • Anaemia
  • Aplastic anaemia
  • Autoimmune hemolytic anaemias,
  • Autoimmune thrombocytopenia
  • Benign hematologic disorders
  • Bleeding disorders
  • C1 esterase inhibitor deficiency
  • White blood cell disorders
  • Chronic lymphocytic leukemia
  • Chronic myeloid leukemia
  • Chronic myelomonocytic leukemia
  • Cryoglobulinemia
  • Cutaneous T-cell lymphoma
  • Large granular lymphocyte disorders
  • Leukemia
  • Lymphoma
  • Macroglobulinemia
  • Multiple myelomas
  • MGUS (Monoclonal gammopathy of undetermined significance, a condition that causes the body to create an abnormal protein)
  • Myelodysplastic syndromes
  • Myelofibrosis
  • Myeloproliferative disorders
  • PNH (Paroxysmal nocturnal hemoglobinuria)
  • POEMS syndrome (-Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal protein, Skin changes- a rare blood disorder)
  • Polycythemia vera
  • Sickle cell anaemia (SCA)
  • Systemic capillary leak syndrome (SCLS)
  • Systemic mastocytosis (SM)
  • Thalassaemia
  • Thrombocytopenia
  • Thrombocytosis
  • Von Willebrand disease (VWD)
  • Waldenström macroglobulinemia
  • Essential thrombocythemia
  • Fanconi syndrome
  • Hairy cell leukemia
  • Hemoglobinopathies
  • Hemophilia
  • Hereditary hemolytic anaemias
  • Hodgkin disease
  • Non-Hodgkin’s lymphoma
  • Hypereosinophilic syndrome (HES)
  • Idiopathic thrombotic purpura (ITP)
  • Iron deficiency anaemia
  • Vitamin deficiency anaemia
  • Fatigue, tiredness (anaemia)
  • Frequent infection (immune system)
  • Bleeding (thrombocytopenia)
  • Swollen lymph nodes
  • Non-healing mouth ulcer
  • Hemorrhagic or infected wounds on the skin
  • Biological therapy of hematologic malignancies
  • Blood and stem cell donation
  • Blood transfusion
  • Cancer treatment
  • Chemotherapy
  • Experimental treatments
  • Growth factor products
  • Immunotherapy
  • Targeted therapy
  • Immunosuppressive therapy
 
 

Infectious Diseases

Fever is the most important reliable indicator of the presence of infectious diseases and it can be defined as “body temperature equal to or above 38 °C Celsius Degrees”. Signs and symptoms may vary according to the infected organ or tissue. For example, urinary tract infections are manifested by dysuria and frequent urination while respiratory tract infections display symptoms such as cough, sore throat, fatigue, and arthralgia.
 

  • Urinary tract infection
  • Pneumonia
  • Infective endocarditis (infection in the heart valves)
  • Meningitis

Viral Infections
  • Influenza
  • Other respiratory tract infections
  • HIV infection (AIDS)
  • Hepatitis A
  • Hepatitis B
  • Hepatitis C.
  • Dengue Fever, Chikungunya Fever
  • Zika virus, Epstein–Barr virus (EBV), Cytomegalovirus (CMV), Herpes simplex virus
  • Immunization before travel (vaccination and medications to prevent the diseases)
  • Diagnosis and treatment of infection after travel (Zika, Chikungunya fever, Dengue Fever, Malaria, etc.)
  • Diagnosis and treatment of febrile diseases
  • Diagnosis, treatment, and follow-up of Hepatitis A, B and C, and HIV that may progress into chronic manifestations
  • Diagnosis and treatment of Lyme disease
  • Diagnosis and treatment of meningitis, brucellosis, heart valves infections, urinary tract, and kidney infections
  • Rational use of antibiotics
  • Prevention of nosocomial infections: We are among an extremely limited number of healthcare centers globally in terms of practicing prevention of nosocomial infections, thanks to cutting edge equipment for isolation measures, sterilization/disinfection conditions and sterile procedures, trained personnel and the Infection Control Team that closely follows all infection control processes.
  • Tropical diseases: We successfully diagnose and treat tropical infections that vary according to the origin and rarity.
  • Travel Health: Our department offers Travel Medicine services not only with prevention measures before and during travel, but also with treatment services after travel, vaccines for infectious diseases and counseling services for other prevention issues.
  • Vaccination of Adults: Vaccination is required throughout everyone’s lifespan. Our hospital informs patients about the vaccines that should be administered during adulthood.

Internal Medicine

Our patients generally approach our department for the treatment of common chronic diseases that are treated at our primary care settings. These include hypertension, diabetes mellitus, asthma, COPD, arthritis, gastrointestinal problems or thyroid dysfunction as well as abdominal pain, back pain, arthralgia, cough, tiredness, and shortness of breath.

Our department diagnoses and treats all acute and chronic diseases, including ones that require critical and long-term care, at various healthcare settings, including the inpatient and/or outpatient clinics.

Medical Oncology

While cancer causes a very wide range of  complaints, including but not limited to pain, weight loss, eating problems, and postural and balance disorders; patients with no remarkable signs of the disease may also need diagnosis and treatment at our department.
Our clinic covers special areas of Internal Medicine and Medical Oncology and renders services with 2 faculty members, 3 physicians, 1 general practitioner, 4 dietitians, and 1 clinical psychologist. Our sub-services include inpatient clinic, outpatient treatment unit, outpatient services, psycho-oncology, nutrition and dietetics, and social services.

Neonatal Intensive Care Unit

Ventilation, parenteral/enteral nutrition (feeding through blood vessels or the mouth), measures taken against infections and treatment of infections are available for infants with medical problems, who stay at the neonatal intensive care unit, along with necessary care for babies with surgical requirements.
Our department deals with respiratory distress, hyperbilirubinemia (newborn jaundice), infections, nutritional problems and conditions that require surgical management along with problems arising from premature birth.
  • Bedside transfontanelle ultrasonography
  • Functional Echocardiography
  • Amplitude-integrated EEG
  • Cooling for newborns with hypoxic ischaemic encephalopathy
  • Total parenteral nutrition
  • Respiratory support utilizing a mechanical ventilator
  • Phototherapy

Nephrology

Common problems related to sodium and water homeostasis include low sodium in the blood or edema, weight gain, hypertension, and low or high sodium or potassium in the blood. Other reasons for admissions include the decreased output of urine, fluid retention, dyspnoea, nausea, vomiting, lack of appetite, bad taste in the mouth, weight loss and anaemia all of which are potentially related to the aforementioned health problems as well as renal failure and acidosis. Moreover, other complaints include high protein and/or blood in the urine, hypertension secondary to nephritis, edema, impaired renal functions, high urea and creatinine concentrations in the blood.
 

The Nephrology Department deals with medical diagnosis, treatment and follow-up of all kidney and urinary tract diseases, including but not limited to acute and chronic kidney failure, hypertension, nephritis that cause protein loss into the urine and blood in the urine, kidney infections, kidney diseases secondary to diabetes mellitus or hypertension, chronic glomerulonephritis and polycystic kidney disease as well as kidney stones and other cystic kidney diseases. Gout attacks that are common and related to kidney diseases and kidney stones are other conditions that we deal with.
 

Neurology

Our department specializes in the following titles and content:

  • General Neurology: We undertake the examination and treatment of patients who are admitted with any and all neurological symptoms.
  • Cerebrovascular diseases: Emergency, inpatient and outpatient practices for disorders of blood vessels that feed the brain (brain hemorrhage, vascular occlusions) are performed in cooperation with Radiology and Interventional Radiology (Neuroangiography) departments.
  • Epilepsy: Diagnostic and treatment practices are performed by experienced neurologists and a specialist epileptologist. Modern research, recording, and treatment methods are used in formulating the medication and surgical strategies for epilepsy.
  • Headaches: Modern treatment methods are used and interventional treatments when necessary are employed for migraine and other common varieties of headache.
  • Neurodegenerative diseases: Modern treatment methods are utilized for Parkinson’s disease and similar neurodegenerative disorders while specialized faculty members make invaluable contributions to the team.
  • Demyelinating disease of the central nervous system: These types of diseases, especially Multiple Sclerosis, develop as a result of impaired immune systems and they are treated by neurologists who are specialized in this field.
  • Spinal cord diseases and nerve root disorders: Diagnostic and therapeutic practices are performed in collaboration with Neurosurgery, Orthopedics, Physical Medicine and Rehabilitation Departments for degenerative diseases of the spinal cord.
  • Peripheral nerve diseases: Peripheral nerve diseases that are developed during the course of other common and generally underlying diseases are named using advanced diagnostic methods (EMG-SEP) and are appropriately treated. Some of these diseases, such as Guillain-Barré syndrome (GBS), require emergency treatment methods. Those practices (plasmapheresis, immunoglobulin therapy) are carried out immediately.
  • Muscle Diseases: Our experienced neurologists work closely with our specialist faculty member who is globally renowned in the field of muscle diseases. Modern diagnostic modalities (muscle biopsy, EMG, neurogenetic tests) are used and patients are accurately guided through genetic consultancy issues in the light of diagnostic and therapeutic methods.
  • Neurological complications of systemic diseases: These diseases are very common in daily neurology practices. Specialized neurologists and faculty members provide expert consultation services. Diagnosis and treatment of neuro-oncologic problems that emerge during the course of oncologic diseases are one of the fields that constitute a large portion of our overall work. Neurologists with extensive experience render services in this field.
  • Electrodiagnostic neurology: EEG, EMG, attracts a strong demand in the diagnosis and treatment of various neurologic diseases. Studies in this field are conducted by specialized clinical neurophysiologists.

The Neurology Department primarily deals with the following complaints:

  • Headaches
  • Vertigo
  • Diseases associated with loss of consciousness
  • Speech disorders
  • Comprehension disorders
  • Memory impairments
  • Visual impairments
  • Motor system disorders (diseases that cause difficulty in movement)
  • Muscle weaknesses
  • Muscle atrophy
  • Involuntary muscle movements
  • Sensory processing disorder
  • Numbness
  • False sensorial comprehension (such as cold or burning sensations)
  • Coordination and balance disorders
  • Tremors
  • Drop attacks
  • Urinary retention and incontinence
  • Diseases associated with high fever
Epilepsy: Accurate diagnosis and sufficient cooperation are important in this disease. We also meet patients who are extremely resistant to therapy. Surgical intervention may be required in some of these cases.

Stroke: Treatment of acute strokes can save lives and minimize future disability rates if  patients admit themselves to the hospital within the first 4.5 hours. The American Hospital has all the necessary equipment for the treatment of acute strokes if patients can get to the hospital within a suitable time frame.

Migraine: Migraines are one of the most common ailments in every society accounting for a major portion of all headaches complaints. Accurate diagnosis, personalized treatments, and follow-ups are all important to prevent loss of work and ensure general quality of life.

Myasthenia gravis: Myasthenia gravis is a neuromuscular disorder that causes weakness in the skeletal muscles, which are the muscles your body uses for movement. It occurs when communication between nerve cells and muscles becomes impaired. Myasthenia can be successfully treated if it is diagnosed early; however, if it is not recognized quickly it may result in death; as a result, our hospital shows special dedication and focus when it comes to this issue.

Multiple Sclerosis and other demyelinating diseases: Multiple Sclerosis is a disease associated with eyesight disorders and overall body weakness, loss of sense and numbness in arms and legs as well as dizziness secondary to improper functioning of the immune system, resulting in an attack on the nerve cells. Diagnostic tests can be quickly performed on Multiple Sclerosis patients and patients with similar autoimmune central nervous system diseases, and personalized treatments and especially innovative biological treatments can be performed successfully at our hospital.

Peripheral nervous system disorders: Nerves that originate from the spinal cord are collectively referred to as the peripheral nervous system. Acute neuropathies that may be life-threatening and chronic neuropathies can be quickly and effectively treated at our hospital.
 

Neurosurgery

Neurosurgery Department is specialized in brain, spine and spinal cord surgery.
 
All complaints regarding the brain and spine are linked to our department.
 

We provide services in all divisions associated with neurosurgery:

  • Vascular surgery
  • Tumor surgery
  • Pediatric neurosurgery
  • Endoscopic surgery (brain and spinal cord)
  • Spine surgery
  • Functional neurosurgery
  • Epilepsy surgery
  • Gamma Knife

Nursing Care

  • Nursing Care
  • Midwifery
  • Emergency Medical Technician
  • Paramedics
  • Sleep Technicians
  • Monitor/Cardiology/Sterilization Technicians
  • Perfusionists
  • Anesthesia Technicians
We are directly linked to all patient feedback concerning care and safety.
We deliver our services to adult and pediatric inpatient and outpatient clinics, Emergency Department, operating theaters, coronary and adult intensive care units and with all other medical disciplines.
All new employees of the nursing care services receive theoretical and practical orientation training at the beginning of their employment simulating processes that they will face in the hospital. Once a year all healthcare professionals are educated and trained with basic life support techniques. In addition, department-specific education and seminars are organized regularly.
 
Annually we coordinate a scientific congress for International Nurses Day jointly with Koç University School of Nursing and SANERC (Semahat Arsel Nursing Care Education and Research Center). All domestic and international leaders of relevant areas are invited to this event; in the spirit of collaboration and reciprocity, we share up to date healthcare knowledge with colleagues from other parts of Turkey.
Professional nursing was established after the First World War in Turkey. Admiral Bristol was a crucial figure in the education of nurses in Turkey; he founded the first Turkish Nursing School in İstanbul on May 20, 1920. Bristol also founded the American Hospital in 1920 and the two institutions became bound by the unifying incentive to heal the sick; the hospital required trained nurses to provide professional care and the school relied on the hospital for work and experience.

Directly after the school was initially founded, the educational period lasted 2 years and 6 months, but it was extended to 3 years in 1929 and 4 years in 1957. The school educated leading nurses in all areas concerning the nursing profession and it was considered exemplary throughout the sector. Our respected teacher Esma Deniz was among the first five graduates of the Nursing School in 1923 and she founded the Turkish Nurses Association in 1943 and successfully managed the association for 19 years. The association was regarded as an active member of the International Council of Nurses in 1949. The American Hospital has always been proud of dear Esma Deniz, who was a leading nurse and a staunch advocate of women’s rights. Anna Rothsock was the first Director of Nursing Care Services at the American Hospital and she was also the first principal of the Nursing School.

Since its foundation, our hospital has maintained a superlative quality of patient care in line with the public’s highest expectations while employing a humanist approach based on integrated health with a focus on nursing. The positions of Nurse managers have almost always been occupied by foreigners; they have made significant contributions to the development of nursing care, as they introduced North America standards. The Managers of Nursing Care Services Department ensured complete cooperation between the hospital and the school, as they had concomitantly occupied the positions of Principals of the Admiral Bristol Nursing School (1920-1999) and Managers of the Hospital.

Koç University established the Nursing College in 1999 to provide education to nurses in the 2000s; these modern practitioners were trustworthy, rational, possessed analytical thinking, displayed confidence, respected individualism and other cultures, and predictably carried the science of nursing to a more advanced level.
Contributions from the Vehbi Koç Foundation to the profession of nursing commenced with the establishment of the Nursing Fund in 1974. Since its foundation, The Nursing Fund contributed to the continuous education of nurses with publications and textbooks along with the organization of conferences and seminars; more than 2000 nursing students have been awarded educational grants. SANERC (Semahat Arsel Nursing Education and Research Center) was founded in 1992 and made significant contributions to nurses with both domestic and international courses, training, symposiums, and congresses.

Nursing is no longer an exclusively female profession in Turkey; recently the profession has become increasingly diversified with men also represented in abundance. The Honorable Semahat Arsel, Chairwomen of Vehbi Koç Foundation, has always contributed to the development and improvement of the nursing profession with her material and moral support. We express our infinite thanks to Honorable Semahat Arsel on behalf of all nurses who have worked at the American Hospital and throughout the Turkish medical sector.

Nursing Care Service Units at the American Hospital:
 

Considering healthcare’s swift-evolution, units of special nursing care services were established at the American Hospital to determine nursing care standards, boost the quality of nursing care services as well as occupy top-tier roles throughout patient care requiring cooperation with other health professions and to add qualifications of efficiency and professionalism to nursing care services. Such units are as follows:

  • Educator Nurse
  • Infectious Control Nurse
  • Diabetes Nurse Educator
  • Nutrition Nursing
  • Hemodialysis Nursing
  • Occupational Health Nursing
  • Stoma Care Educator Nurse
  • Blood Transfusion Procedure Nursing
 

The nursing care services staff is formed by Nurses, Midwives, Emergency Medicine Technicians, Anesthesia Technicians, and Paramedics. We have 588 healthcare professionals in the nursing care services unit.

The level of knowledge gradually increases in all branches of health sciences and the delivery of health and care services also evolves quickly. Nurses need to adapt to such rapid changes in order to keep up with the inherent dynamism required in nursing care services.

As is the case with all professions, critical thinking is one of the basic components in nursing practices. Critical thinking not only adds dynamism to nursing care, but it also boosts the quality and efficiency of services.
Any and all education support required by our nurses to create a patient-oriented and performance-based management and service approach, to coordinate the healthcare and perform the basic healthcare service is provided by the nursing care services management in line with the principle of equal opportunity.

Education is formulated, executed and reviewed by professional education and development nurses at our hospital. Planned discussions with nursing department managers, precise surveys, employment of cutting edge devices and equipment, sentinel event notices, assessment of nurses who have decided to participate in the education process, mandating of eduction goals; and education schedules and curriculum organization are all executed in line with our pre-established schedule.

Orientation and In-service Training
  • Basic Nurse Orientation Program Certificate Programs
  • CPR (Cardiopulmonary Resuscitation / First Aid)
  • CPR, Refresher Training
  • ACLS (Advanced Cardiac Life Support)
  • ACLS, Refresher Training
  • Basic ECG
  • Critical Care Nursing Certificate Program (SANERC)
  • NRP (Neonatal Resuscitation Program) Education (Ministry of Health)

Basic Orientation Programs

A two-week program that consists of theoretical and practical aspects. The Basic Nurse Orientation Program is available for nurses who have already participated in the general orientation program which is organized by the Human Resources Department. This program addresses nursing practices, CPR, infection and isolation methods, use of devices, patient safety and communication. An examination is held before and after the program. “Basic Nurse Orientation Program Participation Certificate” is awarded to all nurses who pass the exam at the end of the program. First Aid (CPR) education and training that comprises of one-day theoretical and practical sections is available from the Basic Nurse Orientation Program. CPR re-certification training is organized once a year or when the content is upgraded. Nurses who participate in and succeed with the Basic Nurse Orientation Program, receive obligatory and special department education in line with their areas of focus.

Department-specific Orientation Programs
  • Emergency Nursing Orientation Program
  • Critical Care Nursing Education Program
  • Gastroenterology Nursing Education Program
  • Central Sterilization Unit Education Program
  • NICU
  • Paediatrics Nursing Education Program
  • Perioperative Nursing Education Program

CPR (Cardiopulmonary Resuscitation / First Aid)

Covering both the theoretical and practical this training takes one-day to complete. CPR certifications are repeated once a year and/or when CPR information is updated. An examination is held before and after the program. CPR Education Program Participation Certificate is awarded to all participants who pass the exam. This education is not only mandatory for our nurses, but for all healthcare personnel who work with patients at the hospital (laboratory technician, physiotherapist, pulmonary therapist, radiology technicians, etc.).

ACLS (Advanced Cardiac Life Support) Education is a program that covers one-day theoretical education and one-day practical training for our nurses who work at the Intensive Care Units, Emergency Department, and the Catheterization Laboratory.

Basic Electrocardiogram (ECG) Education

This 5-day education is available for nurses and technicians who work at all departments that require monitor supervision.

The training covers the following main areas:
  • Anatomy and physiology of the heart
  • Derivation
  • NSR and sinus arrhythmia
  • Atrial arrhythmia
  • Junctional dysrhythmias
  • Ventricular arrhythmias
  • AV blocks
  • Pacemaker insertion

Nursing Care Services Department at the American Hospital takes into consideration the following factors when engaged in the Human Resources processes of employment and promotion.

  • Philosophy and concepts of the modern nursing profession are adopted.
  • Safeguarding the mission, vision, values, policies, and rules of the nursing care services department; making sure that the organization is protected and the associated principles are adopted by all employees.
  • Striving continuously to improve the image of the organization and nursing care in general; always demonstrating an exemplary standard through verbal or non-verbal communication originating from colleagues and affiliated personnel.
  • Acting in a continuously willing and enthusiastic manner to deliver quality, personalized and empathic nursing care, taking on appropriate responsibilities, while demonstrating an ability to develop skills and broaden knowledge closely following professional literature to achieve such goals.
  • Creating and maintaining positive interactions with members of other healthcare teams and colleagues with the use of good communication skills.
  • Being willing to participate in a team, having the qualifications of a leader, being able to act as a representative of the senior management of the hospital, being able to solve departmental and interdepartmental problems and complaints, reporting unsolved problems in line with hospital protocols while offering well-crafted solutions.
  • Making rational and objective decisions, striving to support continuous self-improvement and the development of surrounding colleagues.

 

Please visit our Human Resources web page for details. 

Nuclear Medicine and Molecular Imaging

Nuclear Medicine and Molecular Imaging helps other departments to reveal underlying causes of medical problems based on functional data taken from organs and bones. Therefore,

  • Benign and malignant tumors
  • Different varieties of cancer
  • Bones
  • Brain
  • Endocrine disorders
  • Gallbladder
  • Cardiovascular disease
  • Lung diseases
  • Lymphoma,
  • Neuroblastoma
  • Neuroendocrine tumors
  • Pediatric diseases
  • Prostate cancer
  • Kidney
Thyroid diseases (thyroid cancer, Graves’ disease) and relevant complaints are the reasons for admission
For oncology patients, Nuclear Medicine and Molecular Imaging is required to differentiate benign lesions from malignant tumors, to determine stage of cancer, to determine the grade of each tumor and its invasion into organs, to investigate metastasis, detect relapse, choose treatment option, to evaluate response to the treatment (chemo- or radio-sensitivity), to locate the primary tumor and to deliver the accurate dose to the correct body part.

Our clinic treats thyroid cancer, prostate cancer, neuroendocrine tumor, neuroblastoma, primary or metastatic liver tumors and some forms of lymphoma and provides palliative therapy for bone metastases along with radionuclide therapies.

Intraoperative Gamma Probe is applied to manage head & neck tumors and urogenital tumors, although predominately breast cancer and malignant melanoma are exposed. After the sentinel lymph node that is fed by cancer tissue is marked with a radioactive substance, it is possible to expose and excise this node with a probe system during surgery.
  • PET (Positron Emission Tomography) and CT (Computerized Tomography) for diagnosis
  • Scintigraphic (SPECT/CT, SPECT scans)
  • Bone densitometry (DEXA)
  • Urea breath test
  • Intraoperative Gamma Probe
  • Labeled WBC scintigraphy
  • Radioiodine (low-dose and high-dose)
  • 177Lu-PSMA (Lutetium - 177 prostate-specific membrane antigen)
  • Lutetium 177 peptide receptor
  • Actinium-225
  • Radium-223
  • I-131 MIBG (radiopharmaceutical used for both imaging and treating certain types of neuroendocrine tumors)
  • Radioimmunoassay (RIA) Laboratory (where autoantibody, hormone and tumor markers in human serum are analyzed with specific methods)
  • Radiopharmacy laboratory (where multiple molecules are prepped for imaging and treatment) can be listed as sub-services and methods we provide.

Nutrition and Dietetics

  • Medical nutrition treatment of inpatients,
  • A nutritional treatment plan for patients who are included in the cancer program,
  • Malnutrition,
  • Enteral and parenteral nutrition,
  • Nutritional education for lactation,
  • Education concerning food-drug interaction,
  • Planning medical nutritional treatment specific for each patient at the Outpatient Nutrition Clinic,
  • Medical nutrition treatment according to the pressure ulcers treatment protocol,
  • Monthly menu planning for inpatients and personnel are some examples of practices that are within our mandate.
Nutrition and Dietetics Department of American Hospital responds to our patients' complaints and solves them quickly. Reasons for addressing our department are as follows:
  • Overweight or underweight nutritional counseling,
  • Nutritional therapy for diabetes,
  • Carbohydrate counting,
  • Nutrition during pregnancy and breast-feeding,
  • Children’s nutrition,
  • Nutrition for athletes
  • Preoperative and postoperative medical nutritional therapy for gastrointestinal surgery:
    • Esophagectomy (esophagus surgery)
    • Gastric bypass surgery
    • Pancreas surgery
    • Colorectal surgery
  • Medical nutritional therapy for conditions related to the digestive system;
    • Crohn’s Disease
    • Ulcerative colitis
    • Diverticular disease
  • Medical nutritional therapy for newly diagnosed patients who are involved in the cancer program;
    • Eating during chemotherapy
    • Eating during radiotherapy
  • Preoperative and postoperative medical nutritional therapy for bariatric surgery
  • Medical nutritional therapy in hematologic cancers

Operating Room

There is one “preoperative preparation room”, one “anesthesia recovery room” and one “outpatient reanimation room” as well as 12 operating suites equipped with a special ventilation system called Laminar Flow situated in the Operating Department of the American Hospital. Healthcare services are rendered by an experienced staff of 15 anesthesiologists, 37 surgical nurses, 32 anesthesia technicians, two perfusionists, 16 sterilization technicians and 18 assistant healthcare personnel as well as 6 depot and material management personnel and nine operating room patient representatives in the department.

 

Ophthalmology

Common eye diseases and disorders, cataract and intraocular lens surgery, glaucoma (high intraocular pressure), pediatric eye health and strabismus, retina, cornea, ocular immunology and uveitis, oculoplasty, contact lenses and rehabilitation of the visually impaired patients are among our department’s medical specialties.
Cataract and Intraocular Lens Surgery: Globally acknowledged technique ‘phacoemulsification under topical anesthesia (numbing drops inserted into the eye)’ is used for cataract surgery. In this method, the eye is numbed with drop anesthesia rather than an anesthetic injected around the eye, and cataract surgery is performed through a very small incision, measuring approximately 2 mm in size, made on the clear layer of the eye (cornea) and an appropriate intraocular lens is placed inside the eye. This operation lasts approximately 10 minutes and does not require a hospital stay; visual acuity that is equal to the values before the development of cataracts is restored and patients can engage in activities of daily life within a short period of time. Moreover, the innovative “multifocal intraocular lenses” that are also called “small lenses” designed to provide focus of both distance and near objects and “multifocal toric intraocular lenses” that allow predictable astigmatic correction are successfully used along with standard aspheric intraocular lenses that ensure the clearest distance acuity after completion of surgery. After cataract surgery is completed, patients can clearly see distance and near objects without the need to wear eyeglasses. Moreover, intraocular lenses (phakic lenses) are successfully implanted for patients who are not eligible for laser therapy to correct myopia, hyperopia or astigmatism.

Glaucoma Unit:  Glaucoma, also called high intraocular pressure, is globally recognized as the most  prolific “irreversible cause of blindness”. Usually, it does not cause any recognizable early symptoms as it progresses slowly and causes loss of vision from the periphery to the center. Early diagnosis is crucial when it comes to treating glaucoma; unfortunately symptoms are usually noticed by patients after their eyesight has been significantly compromised. We use the most advanced diagnostic devices with an extremely high level of accuracy at the earliest possible stage in our glaucoma unit. We can meet provisions of maximum standards in diagnosis and follow-up of patients with glaucoma by using the latest generation of Optic Coherence Tomography (OCT) that measures the thickness of the nerve layer in the retina easily, and a computerized visual field device that measures the ability to see blue light on a yellow background and other effective devices that evaluate eye tear canals and any changes in the iris. Medical treatments are supported by all advanced laser or surgical therapies!

Pediatric Eye Health and Strabismus: It is necessary to diagnose refractive errors, especially misalignment of the eyes, and lazy eyes as well as the loss of vision secondary to various reasons originating from early childhood in order to commence with appropriate treatment. In our Pediatric Eye Health and Strabismus Unit, our experienced ophthalmologists use state-of-the-art devices to diagnose all pediatric eye problems at an early stage and necessary treatments are initiated. Medical and surgical treatments are also available for misaligned eyes for patients of any age.

Retina Unit: Optic Coherence Tomography (OCT), Fundus Fluorescein Angiography, Indocyanine Green Angiography, and green and yellow lasers are used in our unit to diagnose and treat all retinal diseases that are secondary to vascular factors, ageing, inflammation or other etiologies. All up-to-date treatments, including intravitreal injections, micropulse, and photodynamic therapy, are available for the age-related macular disease that is also called “Yellow Spot Disease” and now globally recognized among the most important causes of loss of vision. Moreover, diabetic retinopathy, retinal detachment, macular hole, epiretinal membrane and other retinal diseases that require surgical treatment can be successfully treated with “vitrectomy” and other surgical techniques at the Retina Unit.

Cornea Unit: Advanced diagnostic devices are used to evaluate infections and inflammations of the cornea -the foremost transparent layer of the eye-, structural deformities such as keratoconus or ectasia as well as changes in the transparency of the cornea secondary to various causes. All up-to-date medical treatment and surgical techniques are available that range from cross-linking to laser and partial or complete corneal transplantation.

Ocular Immunology and Uveitis: Uveitis refers to the inflammation of the eye’s uveal tissue. Uveitis is believed to be the fourth leading cause of blindness among the working population (ages, 20–60 years) in Western countries. These diseases can be caused by infections, such as the Herpes virus, toxoplasmosis, tuberculosis syphilis, and inflammation of the eyes secondary to autoimmune conditions, such as rheumatoid arthritis, Behçet’s disease, ankylosing spondylitis, and sarcoidosis. A physician who is experienced in treating uveitis evaluates each patient and provides a clear diagnosis, appropriate medical treatment and follow-ups are then planned at the unit. Although the primary treatment of uveitis is medical, surgical treatments can be employed to manage complications of uveitis, after inflammation is brought under control.

Ophthalmic Cosmetic Surgery: Deformities located in the eyelids and around the eyes have significant effects not only on one’s facial appearance but also on normal eyesight function. We may correct any and all eyesight problems and dysfunctions that are dependent on age, tumors, and trauma of the eyelids as well as thyroid diseases. Tear duct problems that may cause continuous excessive watering and diseases that affect the structures around the eyes can be diagnosed and treated. Naturalistic prosthetic eyes that can move are implanted at our unit for patients who have lost an eye.

Contact Lens Unit: Any and all contact lenses (standard, astigmatism, multifocal – that correct both farsightedness and nearsightedness-, cosmetic, daily, monthly and long-term) can be applied at our unit and users of contact lenses are educated on healthy use of said lenses.

Rehabilitation Unit for Visually Impaired People: We aim to restore eyesight that is required for activities of daily life with special eyeglasses, devices and rehabilitation methods for patients with severe loss of vision due to certain reasons, such as age-related macular disease (yellow spot disease), retinitis pigmentosa, diabetic retinopathy, glaucoma or retinopathy of premature.

Oral and Dental Health

All dental treatments are available for geriatric patients with severe coordination disorders (Alzheimer, Dementia, etc.) as well as small children, adults and children with mental retardation or physical and mental disabilities. The fully equipped dental unit within the operating theatre is located in the department, where dentistry services can be performed under general anesthesia.
 
Missing teeth are treated by using adjacent teeth without requirement of a surgical procedure in our Prosthesis Clinic. Damaged teeth are reconstructed, the gaps are filled that are secondary to loss of one or more teeth, numerous dental problems that have negative influences on a patient’s smile are corrected with a cosmetic approach and porcelain crowns and laminates are utilized.

The Endodontics Clinic deals with the treatment of diseases located in the dental pulp that contains the nerve, blood vessels, and other connective tissues that surround the dental roots. All teeth can be treated without any extraction thanks to innovative disinfection agents used in endodontics and advancements in digital radiography and assistive tools. This pain-free procedure is performed under appropriate anesthesia. Teeth are restored with aesthetic fillers, porcelain inlay or porcelain crowns in proportion with the solid tissue that is left behind after treatment.

Pediatric Dentistry (Children’s Oral and Dental Health) Clinic deals with any and all treatments, including fillers and root canal treatment, for deciduous teeth and permanent teeth. Moreover, certain preventive practices are performed in this clinic. For example, fissure sealants are used to prevent decay in grooves and small pits on the chewing surfaces of permanent teeth that are susceptible to caries. On the other hand, comprehensive and exclusive dental therapies are carried out in combination with or without sedation or under general anesthesia for children with physical and mental disabilities.
 
The teeth, jaw and face region is evaluated in a holistic manner, its development is followed up and existing anomalies are treated in the Orthodontics (Child and Adult) Clinic that also provides pre- and post-operative treatment services, such as correction of malpositioned teeth, elimination of disorders related to jaw and face, correction of disorders resulting from wrong habits (thumb sucking, pacifier, baby bottle, lip biting etc.) and treatment of hereditary disorders, such as cleft lip and palate.
 
Periodontal diseases that are first manifested by gingival bleeding are treated at the Periodontology (Gum Diseases and Treatments) Clinic. It is necessary to remind patients that regular dentist visits, good mouth care and hygiene and most importantly, timely treatment based on early diagnosis play important roles in the success of treatment for diseases that involve teeth and tissues which surround the teeth.
Advanced Implantation Clinic: Advanced implantology and jaw surgery procedures are carried out by an expert, professional teamwork; a bone transfer is followed by implant therapy and fixed prosthesis for patients who have been edentulous for a long time due to severe loss of jaw bone mass.
 
Cosmetic Dentistry Clinic: This unit evaluates the face in a holistic manner, including anatomic structure of teeth, jaw and mouth and speech as well as chewing systems, before formulating a customized approach for each patient. In addition to the cosmetic process that is called “Smile Rejuvenation”, dental implants are used to correct functional problems. This treatment covers tooth whitening, cosmetic laminate porcelain crowns, cosmetic fillers, full mouth restorations, implants, laser gum contouring, gum lightening and Botox.

Laser Clinic: Piezoelectric bone surgery devices are used for the procedures that focus on the solid tissue of teeth, while laser surgery is preferred for soft tissues. Better outcomes are obtained especially with diode laser beams for surgical procedures of soft tissue and gingival area, and treatments are performed in a pain-free manner without blood loss.
 
Advanced Oral & Maxillofacial Surgery Clinic: Dentists, orthodontists, oral and maxillofacial surgeons, plastic surgeons and ENT surgeons collaborate in the surgical treatment of congenital or acquired disorders of the mouth, jaw, and adjacent organs, as well as the treatment of cancer, and tumors that require advanced oral, maxillofacial, facial surgery, fractured jaw, cosmetic procedures and developmental jaw disorders.

Temporomandibular Joint Clinic: A multidisciplinary treatment unit that deals with the diagnosis and treatment of patients who complain of pain and abnormal sounds in the temporomandibular joint and difficulty in opening the mouth and chewing. In this clinic, treatment options range from a simple intraoral apparatus to total TMJ prosthesis depending on the diagnosis.

Orthopedics and Traumatology

Our department deals with shoulder and elbow joints conditions, spinal injuries and diseases, congenital and acquired musculoskeletal disorders in children (long, flat bone and spine), hand and wrist disorders, injuries and microsurgery, adult hip and knee joint diseases, sports injuries and surgery, foot and ankle surgery, soft tissue and bone tumors, deformity and extremity lengthening in both children and adults, fractures & dislocation in both children and adults.
 

Not only arthritis (calcification in the joints) but also more complex conditions such as trauma, osteonecrosis and every kind of orthopedic disease (complications and revision surgery) secondary to prior hip and knee prosthesis surgeries are successfully treated in the Hip and Knee Joint Diseases Unit. Numerous joint replacement (hip knee prosthesis, arthroplasty) procedures are performed with a success rate of over 90 percent. Our team consists of staff specializing in innovative approaches when it comes to total hip replacement and total knee replacement procedures who employ minimally invasive techniques and use cutting-edge materials.

Pain, swelling, mass lesions, limited movement, heat increase, worn articular cartilage around hip and knee joints, congenital hip and knee joint diseases, Perthes disease, osteonecrosis (aseptic necrosis) in the hip and knee, rheumatic diseases, congenital hip dislocation (CHD), infections, hip impingement, disarrangement of hip-knee joint, articular cartilages related to ageing, intraarticular fracture of hip are among the hip and knee disorders treated at our clinic.

Oncologic Orthopedics Unit renders patient-specific diagnosis and treatment services with the assistance of the tumor council with the participation of various disciplines in diagnosis and treatment of benign and malign tumors located in the arm, leg, foot, hand, pelvis, and joint cavity. This field deals with all tumors originating from soft tissues and bones, as well as the tumors that spread to the bones from other organs (metastasis).

Sports Surgery Unit deals with the investigation, prevention, and treatment of every type of disorder concerning the musculoskeletal system as a result of sports-related activities. Comprehensive treatment and rehabilitation for sports injuries are provided for professional athletes and amateur athletes from any age group and at any participation level. Comprehensive treatments are provided which focus on the general health of athletes in cooperation with other departments such as nutrition and dietetics, endocrinology and neurology. In addition to knee, shoulder, ankle disorders, and general trauma, spinal and hand injuries are meticulously treated  in cooperation with other orthopedics sub-branches to ensure that each patient is fully healed in the shortest possible time before returning to their sports activities.

Surgical and non-surgical treatments are performed for diseases concerning mentioned joints and surrounding structures at the Shoulder and Elbow Surgery Unit. This area of medicine requires special knowledge and experience due to the complex anatomy of the shoulder and elbow.

The Foot and Ankle Surgery Unit has a staff specializing in the treatment of ankle arthritis, tendon dysfunctions/ruptures, flatfoot (pes planus) deformity, foot deformities, every variety of fractures and dislocations, diabetic/Charcot deformity and symptomatic forefoot deformity. The most effective non-operative methods can be utilized to treat these disorders at our clinic in close cooperation with our physiotherapists. When surgical intervention is necessary, advanced techniques such as ankle replacement, complex ankle arthrodesis, arthroscopy, tendon reconstruction can be successfully performed at our clinic.

All spine diseases that are visible during childhood and adulthood are treated with the most appropriate personalized methods following evaluation by our Orthopedics and Traumatology specialists as well as experienced spine surgeons at Spine Surgery Unit. Treatment options range from minimally invasive day surgery procedures to complex spinal reconstructions in some cases. Our department has an expert highly skilled  team that can perform procedures such as cervical and lumbar disc replacement, microendoscopic decompression or fusion, kyphoplasty procedures or complex spine surgery for deformities of pediatric and/or adult patients.

Orthopedic Trauma Unit renders services 24/7 for diagnosis and treatment of fracture, dislocation and soft tissue injuries in the pelvis, leg, ankle, foot and shoulder areas as a result of both low-energy traumas (fall at home, sports injuries, etc.) and high-energy traumas (motor vehicle accidents, falls from great heights, gunshot injuries). Advanced and complex reconstructive treatments are performed at our clinic for unhealed (non-union) fractures or incorrectly healed fractures (mal-union).

The follow-up of child patients and the provision of related solutions with other branches as well as families until each child’s growth period has concluded is the main focus of the Pediatric Orthopedics Unit. Cerebral palsy and other pediatric neuromuscular diseases, disorders such as Pes Equinovarus (PEV- Clubfoot), gait disorders and deformities, pediatric fractures, congenital dislocation of the knee can be evaluated and treated by experienced pediatric orthopedics team using state-of-the-art techniques.
 

Otolaryngology (ENT) - Head & Neck Surgery

  • Diagnosis and treatment of ear disorders, rare hearing problems, tinnitus, ear discharge, ruptured eardrum (tympanic membrane perforation), and Bell's palsy.
  • Diagnosis and treatment of vertigo
  • Diagnosis of runny nose, nasal obstructions and sinus disease along with functional and cosmetic nose job
  • Upper respiratory tract infections
  • Differential diagnosis and treatment of headaches
  • Tonsillar hypertrophy and adenoid vegetations
  • Diagnosis and surgical treatment of head & neck tumors
  • Minimally invasive tumor surgeries
  • Treatment and surgery for congenital ENT diseases and airway abnormalities
  • Diagnosis and treatment of thyroid cancer and correction of complications that are secondary to thyroid surgery
  • Treatment of congenital or acquired airway stenosis
  • Diagnosis and treatment of snoring and sleep apnea
  • Diagnosis and treatment of bad breath and gastroesophageal reflux
  • Diagnosis and treatment of vocal cord disorders
  • Diagnosis and treatment of salivary gland disorders
  • Audiology Unit
  • Hearing tests
  • Tests to evaluate vertigo and postural imbalances
  • Speech and Swallowing Disorders Unit
  • Sleep Unit
Otology – Neuro-otology (Ear Diseases)
Covers conditions affecting the external, middle, and inner ear diseases and central auditory pathway disorders.
  • Otitis media (middle ear infection)
  • Otitis externa (inflammation of the external ear canal)
  • Ruptured eardrum (tympanic membrane perforation)
  • Otosclerosis (abnormal growth of bone of the middle ear)
  • Congenital hearing loss
  • Bell's palsy
  • Tinnitus
  • Vertigo
  • Ear tumors

All ear surgery can be carried out under a microscope and/or with endoscopic techniques; a significant part of these operations does not require a visible incision on the ear. For conductive hearing loss, bone cement ossiculoplasty, titanium prosthesis, bone-conduction hearing aid, and middle ear implant are used, while sensorineural hearing loss can be successfully improved with the use of the state-of-the-art implants, such as cochlear implants (bionic ear) and auditory brainstem implant. One audiologist and two audiometrists work full time at the Audiology Unit that houses cutting edge devices to diagnose hearing loss, tinnitus and vertigo.  

Rhinology (nose and sinus problems)
Rhinology deals with all congenital, infectious and developmental diseases as well as tumors of the nose and paranasal sinuses.
 
  • Deviated septum
  • Inferior turbinate hypertrophy
  • Nasal allergy
  • Sinusitis
  • Rhinoplasty (nose job)
  • Nose and paranasal sinus tumors
 
Deviated septum and adenoid vegetation are treated with up-to-date techniques and innovative technology such as radiofrequency meaning that nasal packs are no longer required after most operations. Endoscopic sinus surgery technique is performed during the treatment of sinusitis, and surgical navigation is used in all necessary cases. Endoscopic sinus surgery is also performed for skull base tumors, transsphenoidal surgery, blocked tear ducts and cerebrospinal fluid leak.
 
Pediatric Otolaryngology
This unit deals with congenital, inflammatory, traumatic and developmental diseases as well as pediatric tumors.
 
  • Tonsillar hypertrophy and adenoid vegetations
  • Otitis media (middle ear infection)
  • Anotia (congenital deformity that involves the complete absence of the pinna, the outer projected portion of the ear, and narrowing or absence of the ear canal)
  • Congenital or acquired airway stenosis
  • Head and neck tumors
 
Tonsillar hypertrophy and adenoid vegetations are amongst the most common diseases found in children. The most cutting-edge techniques, such as laser and thermal welding, are used in the surgical treatment of these diseases. Anotia can be corrected with a cartilaginous graft that is obtained from the child’s ribs or with a prosthesis. Congenital or acquired airway stenosis is treated by our surgical team who have global experience using the most up-to-date techniques available.
 
Head and neck tumors
Handles any and all benign and malignant tumors that originate from the head and neck area.
 
  • Lip
  • Tongue
  • Tonsil
  • Larynx
  • Esophagus
  • Thyroid
  • Neck
 
A multidisciplinary approach is required for head and neck tumors, as is the case with all other tumors. Treatments are planned vigilantly after patients’ cases are discussed in detail by the tumor council that is made up of physicians from many departments; otolaryngologists, medical oncologists, radiation oncologists, and radiologists are all part of the membership.
 
Snoring and Sleep Apnea
Snoring and sleep apnea (sleep disorder in which breathing repeatedly stops and starts) are among those diseases that negatively affect a patient’s quality of life and overall health. These conditions are triggered by many factors and they should be addressed in a holistic manner. A Polysomnography (sleep study) is used to evaluate the functionality of a patient’s nose; palates or jawbones are surgically treated to correct airway stenosis in selected patients.

Voice disorders
Hoarseness is caused by diseases that originate from or limit movements of the vocal cords. Vocal cords and their functions are evaluated with a special device, called a videolaryngostroboscopy, and all cases that require surgical treatment can undergo microsurgery or laser surgery.

Face and Neck Traumas

Facial Plastic Surgery
 
 
 

Pediatric Surgery

We render healthcare services in the fields of pediatric surgery and pediatric urology.
All complaints and procedures regarding the surgical treatments of the entire body of children (thoracic surgery, abdominal surgery, urological surgery, genital surgery, and circumcision) form the group that is directly linked to our department.

Pediatrics

Divisions of our department include general pediatrics, pediatric allergies, pediatric endocrinology, pediatric cardiology, pediatric nephrology, pediatric neurology, pediatric gastroenterology, pediatric hematology and oncology as well as the newborn unit.
All signs and symptoms of febrile illnesses, respiratory tract infections, gastrointestinal disorders, urinary tract and kidney infections, neurological diseases, blood diseases, pediatric cancers, pediatric allergies, and neonatal diseases comprise the group of admission complaints received by our department.
The sub-services include outpatient clinic, inpatient clinic, A&E, newborn room and the neonatal intensive care unit.
Our pediatricians carry out educational activities voluntarily in order to inform families about the birth process and the subsequent post-natal issues. These educational programs are reviewed every year by considering the details that are mostly asked by parents in order to support the physical, mental and developmental health of our children.

Physical Medicine and Rehabilitation

The Physical Medicine and Rehabilitation Department is directly linked to the following conditions:
  • Joint aches
    • Shoulder pain
    • Elbow pain
    • Wrist-hand pain
    • Hip pain
    • Knee pain
    • Ankle-foot pain
  • Neck pain
  • Low back pain
  • Pain and numbness in arms and legs
  • Back pain
  • Engagement in activities of daily life after orthopedic surgeries
  • Osteoarthritis (calcification)
  • Numbness
 
 Herniated discs
  • Herniated cervical disc
  • Herniated thoracic disc
  • Herniated lumbar disc
  • Engagement in activities of daily life after spinal surgeries
  • Myalgia
  • Fibromyalgia
  • Stroke
  • Paraplegia
  • Gait disorders
  • Parkinson’s disease
  • Multiple Sclerosis
  • Loss of function secondary to cancer
  • Loss of function due to side effects of chemotherapy and radiotherapy
  • Lymphedema
Our department is specializing in the following modalities:
 
  • Orthopedics Rehabilitation
    • Sports injuries
    • Rehabilitation after fracture
    • Ligament and tendon ruptures
    • Rehabilitation after joint replacement surgery
    • Rehabilitation after shoulder surgery
    • Rehabilitation after elbow surgery
    • Rehabilitation after hand surgery
    • Rehabilitation after knee surgery (anterior cruciate ligament reconstruction surgery, meniscus, cartilage surgery)
    • Rehabilitation after hip surgery
  • Rehabilitation for Spine
    • Disc disease
    • Spondylolisthesis
    • Scolioses
    • Posture disorders
    • Spine tumors
  • Myalgia Syndromes
    • Fibromyalgia syndrome
    • Myofascial pain syndrome
 
  • Treatment and Rehabilitation of Osteoarthritis
    • Osteoporoses
    • Rehabilitation of temporomandibular joint
    • Rehabilitation of rheumatoid diseases
 
  • Neurological Rehabilitation
    • Rehabilitation after stroke
    • Rehabilitation of traumatic brain injury
    • Rehabilitation of spinal cord
    • Rehabilitation of polyneuropathy
    • Spasticity – Botulinum toxin
    • Entrapment neuropathies (Carpal tunnel syndrome, cubital tunnel syndrome)
    • Movement disorders (Parkinson's)
    • Rehabilitation of Multiple Sclerosis
    • Guillain-Barré Syndrome
    • Amyotrophic Lateral Scleroses (ALS)
    • Brain and spinal cord tumors
 
  • Rehabilitation after cancer
 
  • Lymphedema
  • Cardiac Rehabilitation
  • Geriatric Rehabilitation
    • Exercise therapy
    • Education to prevent falls
Our department has branch-specific workgroups for certain conditions. Protocols are developed for such conditions that are acknowledged and exemplified by local and international organizations. Such sub-services and special workgroups are as follows:
 
  • Certain conditions that are related to spinal health, such as low back pain and neck pain are evaluated in detail in line with our knowledge, skill, and experience. This evaluation covers protective approaches, pain management, joint follow-up of the patient with the Algology Department, unique exercise protocols that are developed according to the surgical technique after spinal surgeries and re-engagement into daily life activities.
  • The treatment protocols that are jointly developed with the Hand Surgery Department are planned and performed according to the surgical technique in a customized manner; for example, if required hand splints are applied by hand therapists in our department after the completion of each surgery.
  • Treatment programs are planned to manage the disease or the complications of treatment in our rehabilitation of cancer patients. This personalized program that takes specific characteristics of the cancer disease into consideration has rich content, such as treatment of lymphedema and postural disorders, soft tissue contractures secondary to radiotherapy, fatigue syndrome that develops after chemotherapy, polyneuropathy and all other complications resulting from immobility.
  • Complex decongestive treatment – the up-to-date treatment modality for lymphedema that is secondary to conditions that involve lymphatic circulation – such as (manual lymphatic drainage, bandaging and exercise therapy, is performed by our specialist therapists. 
  • Treatment protocols that increase performance are combined with athletes' rehabilitation programs and other treatment approaches that are specific for sports injuries; the type of athlete and the uniqueness of each patient are always factors considered when implementing said treatment.
  • Exercise programs are planned and supervised for patients during the aftermath of obesity surgery.
  • The prevalence of adolescent idiopathic scoliosis is 2.3% present in the age range from 10 to 15 years according to the Turkish Adolescent Idiopathic Scoliosis Prevalence Study. We have an expert team at our department that specializes in scoliosis diagnoses, treatment, and follow-ups. 
  • Geriatric rehabilitation has become increasingly important especially due to extended life expectancy. Moreover, limited activities of daily life secondary to age-related conditions, such as loss of postural balance and coordination, gait disorders and audiovisual losses are evaluated with a customized approach; subsequently, treatment plans in line with each patient’s requirements are formulated. 
  • Ergonomics is extremely important to prevent occupational diseases of the musculoskeletal system. The Ergonomics Work Group of our department not only educates outpatients, but it also supports the arrangement of work environments for employees and employers along with corporate visits.
  • Medical massage therapy has emerged as adjuvant therapy for acute and chronic pain resulting from spine and soft tissue injury. This approach ensures both physical and emotional wellness and it is planned according to each diagnosis and performed by expert therapists, who are trained and educated in special medical massage therapy.
  • We collaborate with the Rheumatology Department when it comes to the rehabilitation of rheumatoid diseases. Our rehabilitation programs aim to maximize the quality of life and independence of our patients who are reliant on medical treatment.
  • The goal of our cardiac rehabilitation programs is to enable our patients to engage in their lives without estrangement from social life despite the limitation of their daily activities.
The Physical Medicine and Rehabilitation Department boasts a rich source of documentation to inform patients about the diseases that fall into the specialty areas focussed on by our clinic. Our documentations and practices are listed below:
  • Shoulder, elbow, knee, and ankle rehabilitation protocols guideline book 
  • Hand rehabilitation guideline book 
  • Principles to protect lumbar health
  • Principles to protect cervical health
  • Joint evaluation forms
  • Patient education brochures
  • Online patient follow-up and evaluation infrastructure
  • Weekly scientific meetings held at the department
  • Participation in weekly multidisciplinary meetings with orthopedics, breast cancer, and oncology departments
 
 

Plastic, Reconstructive and Aesthetic Surgery

Lists our department’s fields of specialty in various branches:

Aesthetic Surgery:

    • Nasal aesthetic and functional surgery (rhinoplasty, concha bullosa, deviated septum surgery, etc.),
    • Eyelid, ear, lip, forehead-face-neck aesthetics, bichectomy
    • Breast aesthetics (augmentation, reduction, lifting, gynecomastia, nipple aesthetics, etc.)
    • Body aesthetics (abdominoplasty, liposuction, post-bariatric 360 degrees abdominal aesthetic, etc.)
    • Arm lift, thigh lift, arm liposuction, leg liposuction
    • Aesthetics genital surgery (labiaplasty, hymenoplasty, vaginal tightening, penile surgery)
    • Fat injections (face, leg contouring, buttock augmentation)
 
  • Non-Surgical Aesthetic Procedures:
    • Botox (wrinkle, excessive sweating, masseter, gummy smile, mesobotox)
    • Filling (lips, nose, jaw, eyelids, face, hands, genitals, etc.)
    • Mesotherapy (skin rejuvenation,  treatment of dark eyelids, light filling)
    • Dermaroller, laser, plasma applications
    • Stem Cell, PRP
 
  • Reconstructive Surgery (covered by insurance):
    • Skin lesions (cysts, nevi, warts, lipomas, every kind of lesions)
    • Skin cancer (melanoma, basalioma, epidermoid carcinoma, etc.)
    • Breast cancer (breast reconstruction, implant, microsurgical breast reconstruction, latissimus dorsi, DIEP)
    • Poland syndrome
    • Cancer, tumors of the facial bones and jaw, scalp tumors
    • Congenital anomalies (cleft lip-palate, skull anomalies identified as craniosynostosis, anotia, prominent ear, giant nevi, etc.)
    • Hand deformities (polydactyl, syndactyly, etc.)
    • Hemangioma, vascular malformations, droopy eyelid, velopharyngeal insufficiency
    • Facial traumas (soft tissue, facial fractures, mandible fractures, forehead, orbital floor fractures)
    • Treatment for facial paralysis
    • Hand and tendon lacerations
    • Dupuytren’s contracture, carpal tunnel syndrome
    • Wound care, scar treatment, keloid scars, bedsores, foot, and leg wounds
    • Vaginal reconstruction, hypospadias, penile anomalies
    • Burn rehabilitation
    • Reconstruction of all kinds of tissues with microsurgery (face, jaw, breasts, vagina, esophagus, hands, arms, legs, feet, etc.)
Our patients’ complaints are listed under specific topics:

Aesthetic Surgery:
  • Ageing of the face including wrinkles, general sagging skin, sagging around the neck, droopy brow, decrease in skin quality
  • Eyelid problems, excess skin, wrinkles, droopy eyelids
  • Aesthetic problems of the nose and breathing problems, aesthetic and respiratory problems secondary to prior surgeries
  • Asymmetry, thinness, barcode lines on the lips
  • Prominent ear, ear deformities, torn earlobe
  • Small or large, sagging breasts, asymmetrical breasts, nipple anomalies, breast sagging in men
  • Skin cracks, sagging, herniation after delivery or weight loss in women
  • Excess in abdomen, arms, legs, and back, wide hips
  • Small, flat, sagging buttocks
  • Excessive sagging in breasts, arms, face, neck, legs, and abdomen following gastric surgeries
  • Small, asymmetrical, deformed and loose genital organs, hymenoplasty, penis enlargement
 
Non-Surgical Aesthetic Procedures:
  • Wrinkles, crowfeet, barcode lines on face, wrinkles on the forehead
  • Dark circles, sagging, swelling in the eyelids
  • Deteriorated in skin quality, facial spots, scars
  • Permanent lines, asymmetries on the face, request of non-surgical nasal aesthetics
  • Request of augmentation of genital organs, bleaching
  • Temporomandibular joint pain, tooth grinding, and erosion
  • Abnormal sweating
 
Reconstructive Surgery (covered by insurance):
  • Skin lesions (cysts, nevi, warts, lipomas, every kind of lesions)
  • Skin cancer (melanoma, basalioma, epidermoid carcinoma, etc.)
  • Breast and nipple reconstruction after breast cancer
  • Absence of breast
  • Cancer, tumors of the facial bones and jaw, scalp tumors
  • Temporomandibular joint problems
  • Congenital anomalies (cleft lip-palate, skull anomalies identified as craniosynostosis, anotia, prominent ear, giant nevi, etc.)
  • Hand deformities (polydactyl, syndactyly, etc.)
  • Hemangioma, vascular malformations, droopy eyelid, velopharyngeal insufficiency
  • Facial traumas (soft tissue, facial fractures, mandible fractures, forehead, orbital floor fractures)
  • Treatment of facial paralysis
  • Hand and tendon lacerations
  • Dupuytren’s contracture, carpal tunnel syndrome
  • Wound care, scar treatment, keloid scars, bedsores, foot, and leg wounds
  • Vaginal reconstruction, hypospadias, penile anomalies,
  • Burn rehabilitation
  • Reconstruction of all kinds of tissues with microsurgery (face, jaw, breasts, vagina, esophagus, hands, arms, legs, feet, etc.)

Sub-services in our department are:

  • Aesthetic surgery
  • Reconstructive surgery
  • Tumor surgery
  • Microsurgery
  • Hand surgery
  • Oral and maxillofacial surgery
  • Non-surgical aesthetic interventions

Psychiatry

Our department focusses on mental health conditions of adults, children and adolescents such as depression, anxiety disorders, bipolar mood disorders, physical symptoms related to stress, post-traumatic stress disorders, dissociative disorders, eating disorders, attention deficit and hyperactivity, personality disorders, sexual dysfunctions, interpersonal relation problems, family and marriage psychiatry, geriatric psychiatry, schizophrenia and similar psychotic disorders as well as complex post-traumatic stress disorder of adults due to mental trauma in childhood. Concerning patients with additional physical conditions, we focus on the psychiatric aspects and any appropriate management of associated physical conditions as well as the continuous cultivation of connections with other relevant hospital departments.
Mental symptoms include tediousness, insomnia, unwanted thoughts, obsessions, problems in human relations, anger management problems, uncontrollable behavior, concentration deficit and loss of motivation.

Such complaints can be chronic in nature or follow a periodical pattern, such as in panic attacks or depressive episodes.

Mental problems may, sometimes, lead to physical complaints (neurotic hypertension, stress-related fainting, psychosomatic diseases, etc.). They can also be manifested by indirect signs, such as excessive eating and alcoholism.

Mental problems in children and adolescents can manifest with temper tantrums, nutritional problems, self-destructive behavior, school and education problems and difficulties in adaptation. Many adult disorders, such as anxiety, depression, post-traumatic stress disorders, and dissociative disorders, are also seen in children and adolescents and they follow a similar clinical picture.

Our department does not only help people who suffer from such symptoms but also provides patients with counseling for psychological conditions that lead to various problems in human relations as well as behavioral and mental problems.
  • Mood disorders (depression and bipolar disorder)
  • Anxiety disorders (panic disorder and generalized anxiety disorder)
  • Psychotic disorders (schizophrenia and other psychoses)
  • Attention deficit and hyperactivity (in children and adults)
  • Dissociative disorders related to mental trauma
  • Post-traumatic stress disorder
  • Obsessive-Compulsive disorders
  • Stress-related physical symptoms (neurotic hypertension, fainting due to psychological reasons, psychosomatic diseases, etc.)
  • Adolescence problems
  • Eating disorders
  • Problems in adults secondary to mental traumas in childhood
  • Sexual dysfunctions
  • Marriage and family problems
  • Legal competence reports
 
According to the treatment method:
  • Medication treatment
  • Individual psychotherapy
  • Family therapy
  • Marital therapy
  • Play therapy (children)
  • Behavioral therapy
  • Cognitive therapy
  • Psychoanalytic - psychodynamic psychotherapy
  • Trauma-oriented psychotherapy
  • EMDR (Eye Movement Desensitization and Reprocessing)

Psychology

With our admitted patients we evaluate the psychological effects of the personality, relevant environmental conditions, as well as periodical and chronic problems. Following evaluations are performed by relevant experts:

  • Family-couple therapy
  • Cognitive behavioral therapy
  • Sex Therapy
  • Psychodynamic therapy
  • EMDR (Eye Movement Desensitization and Reprocessing) therapy
  • Mindfulness-based cognitive therapy
  • Psychometric assessments

Psychological support is not only available for outpatients who have scheduled appointments, but also for inpatients who regularly attend psychotherapy sessions.
 

Disorders directly linked to our division are:

  • Sexual dysfunctions
  • Mood disorders (depression, postpartum depression, etc.)
  • Anxiety disorders (panic disorder, phobia and obsessive-compulsive disorder, etc.)
  • Personality disorder and behavioral disorder
  • Reaction to stress and adjustment disorder (post-traumatic stress disorder, etc.)
  • Eating disorders

The sub-services provided by our department are:

  • Nutrition and Dietetics
  • General Surgery
  • Gynecology
  • Neurology
  • Obesity surgery
  • Psychiatry
  • Psycho-oncology
  • Smoking Cessation Clinic
  • In Vitro Fertilization Unit
  • Urology

Pulmonary Medicine

The conditions that affect pulmonary health are usually manifested with coughing, chronic coughing, shortness of breath, exertional dyspnea, fever, secretion, hemoptysis, chest pain, back pain, fatigue, weight loss, tiredness, allergic reactions causing patients to sneeze, runny nose, rashes, itching, snoring, day-time sleeping and smoking. The patients with such complaints or addictions may directly be admitted to our department.
The Pulmonary Medicine Department is mainly specializing in pulmonary diseases, tuberculosis, allergy-immunology, and respiratory sleep disorders. However, we are also rendering healthcare services for obstructive lung diseases (asthma, COPD, bronchiectasis), allergic lung diseases, pulmonary embolism, pulmonary vascular diseases (pulmonary hypertension), pneumonia (lung infection), pleurisy, scanning, diagnosis, and treatment of lung cancer, interventional bronchoscopy (cryotherapy, argon therapy, EBUS), sarcoidosis, idiopathic pulmonary fibrosis, and interstitial lung diseases such as environmental diseases. Additionally, those who want to stop smoking may also refer to our department.

Radiation Oncology

The divisions we serve and our practical approaches are as follows:
  • Intensity-Modulated Radiotherapy (IMRT) and Volumetric Modulated Arc Therapy (VMAT): This innovative procedure which perfectly reflects in dose modulation cutting-edge technology is defined as a planning method. Typically, combinations of multiple intensity-modulated fields coming from different beam directions produce a customized radiation dose that maximizes tumor dose while also minimizing the dose to adjacent normal tissues. Tiny beams enter the body at various angles focussing on the cancer area with great precision while providing a much more potent dose than comparable radiation treatments while the peripheral healthy tissue is exposed to a very low dose by contrast. The planning phase for this treatment takes longer comparatively speaking, as the IMRT system requires a particularly meticulous approach.
 
  • Stereotactic Radiosurgery (SRS): This method is especially preferred for the treatment of small lesions. It involves the delivery of high radiotherapy doses, ranging from 3 Gy to 24 Gy (Gy, dose unit), at once or in a fractionated manner. The principle of the approach is the delivery of radiation beams at varying angles to the same target in order to minimize the dose delivered to surrounding healthy tissues, while the target is irradiated at maximal dose utilizing exact anatomical locations provided by high-tech imaging modalities. Stereotactic radiotherapy implies treatment divided into fractions, while stereotactic radiosurgery involves delivering radiation doses all at once.
 
  • Stereotactic Body Radiotherapy (SBRT): It implies radiosurgery that is targeted to any organ apart from the brain. This method employs very high doses that are focussed on each lesion target.
 
  • Four-Dimensional Computed Tomography simulator: Big Bore Onco CT is a four-dimensional scanner that acquires 16-slice helical Computed Tomography (CT) images. The Tumor LOC feature enables radiation oncologists to determine the localization of tumors quickly; coordinates of tumors are determined with movable lasers marking the central zone of each tumor. Our CT device is equipped with respiratory gating and thus, tumors and target volumes can still be effectively imaged even if they move which is particularly possible with lesions located in the lungs or upper abdomen.
 
  • Four-Dimensional Radiotherapy (4DRT): Treatment is planned after the target volume is determined with Four-Dimensional Computed Tomography (4DCT). Since the respiratory-gated four-dimensional plan is made at our center, radiotherapy can be administered while the patient is inhaling or exhaling. Integrated volume can be treated in all respiratory phases in small and less mobile tumors.
 
  • Brachytherapy: Brachytherapy (internal radiation therapy) is a form of radiotherapy where a sealed radiation source is placed inside or next to the area requiring treatment. If the radiation is contained in a temporary implant, it is removed from the body at an appropriate time, while permanent radioactive sources lose their potency and turn inactive. Brachytherapy can be utilized as a single curative measure or it can sometimes be combined with radiotherapy to increase the rate of success. Brachytherapy is regarded as a standard radiotherapy method and is included in the majority of high-quality international treatment protocols. The globally popular HDR Brachytherapy device is used regularly at our hospital.
 
  • Dosimetric equipment: MD Anderson Cancer Center quality control programs are performed at daily, weekly, monthly and annual intervals for each therapy device and 4DCT scanner in our unit. We use dosimetric equipment that is approved by the MD Anderson Cancer Center, including specially customized models, for quality checks and dose measurements. All quality control programs are monitored online and meticulously checked by the MD Anderson Cancer Center.
Radiotherapy involves planned and controlled use of ionizing beams at pre-determined regional doses. Radiotherapy is one of the treatment modalities that is required by more than half of patients and it is administered for curative, adjuvant, palliative and prophylactic purposes.

Radiation is generated by LINAC which is a linear accelerator. Electrons are crushed against a metal barrier creating strong X-rays, called photons. Photon beams are delivered to a port that is located on the treatment table which can provide a 360 degrees dispersal. A fraction refers to a single radiation procedure.

Radiotherapy provides an optimal effect in the treatment of tumors while preserving all healthy tissue surrounding the said tumor. For such precision, careful planning is required. Simulation is the first stage of the planning process; this procedure can be defined as testing the immobilization devices that are used to incapacitate the patient during treatment while tomography images are acquired. Simulation can also be considered as the trial phase of the radiotherapy process. Simulator-derived data helps calculate the specific dose before the treatment commences.
Radiotherapy is one of the most vital methods of treating cancer as well as many non-cancerous conditions and is employed in more than half of all cancer cases. Combined with chemotherapy, radiotherapy is preferred by many doctors as a safe and efficient means to cure many varieties of cancer.
 
It can be the first-line option for the treatment of certain tumors, especially existing originating in the lung, prostate, skin and head and neck as well as early-stage Hodgkin’s disease, non-Hodgkin’s lymphoma or cervical cancer. It is also commonly used after surgery in the treatment of breast, endometrial, testicular, bladder, thyroid, pancreatic and brain cancers.

Neoadjuvant radiotherapy is frequently used for rectal and soft tissue cancers.

For pediatric cancers, personalized treatments are planned in line with the aforementioned multidisciplinary approach and guidelines.
The potential side effects of radiotherapy vary according to many variables. Our patients are informed by their primary doctor about the side effects that may develop during and after the treatment. These side effects are mostly transient and they disappear after said treatment is complete. We may use medication that can relieve or alleviate the complaints. Side effects should be regarded as transient problems that develop in almost all patients rather than unfavorable negative indications that the treatment in question is problematic.

Radiotherapy influences the healthy cells that are located within the target volume. Location and dimensions of the target volume are also important and side effects are more common with larger volumes. Daily dose, total dose, and concomitant medications may vary the side effects of radiotherapy. Physical condition and age of the patient as well as employed radiotherapy techniques are all directly linked to the manifested side effects.

Dermal side effects are directly proportional to the dose increase and they develop during the late phases of the treatment. The risk of side effects is higher for armpit, neck, anus and mouth cavity, as the skin tissue in those areas is particularly thin; with the thinner skin folds it is difficult to ensure hygiene and ventilation. Side effects that are initially manifested by mild redness, similar to a sunburn, may develop into open and purulent wounds. Radiotherapy over the head and neck area may negatively influence the teeth and subsequently the risk of caries increases. Therefore, regular dentist visits are very important. Mouth tissues are susceptible to radiation and resulting sores are more likely; this fact indicates the necessity of proper oral care. Other common conditions include dry mouth and difficulty swallowing secondary to decreased production of saliva.

A patient’s taste may be effected and skin wounds can be visible during neck radiotherapy. Alcohol and smoking should be avoided throughout the treatment due to exacerbating effects. Other side effects include lack of appetite, changes in voice, hair loss, difficulty swallowing secondary to radiotherapy of the chest wall, nausea, and vomiting as well as fatigue, tiredness, shortness of breath and dry cough. Diarrhea is among the most common side effect if the radiotherapy is focussed on the stomach, abdomen, and pelvis. Gastric cramps and bloating can be associated with nausea, vomiting, lack of appetite, weight loss and dysuria.
Radiation oncologists plan treatment that involves the total number of treatment days, sessions and the radiation dosages. They will be responsible for determining the medical problems that may develop during the treatment and the elimination of such problems.
High-dose radiotherapy is usually divided into fractions due to the radiobiological features of healthy and cancerous cells. Although this condition varies according to the diagnosis, treatment requires an interval of 4 to 8 weeks on average. Prolongation of the treatment allows us to eliminate the effects of radiation on the body.
A patient is delivered radiotherapy at doses from 20 to 78 Gy (1 Gy = energy of 1 Joule absorbed in 1 kg of tissue) depending on the diagnosis, stage, and purpose of the treatment. It is possible to comprehend relevant aspects of radiotherapy if it is clarified that the dose of X-ray exposed to acquire images in a modern mammography device is approximately 1/10,000 of 1 Gy. The total dose of radiotherapy is given in small daily doses usually for 5 days of the week.
 Doctors, radiotherapy technicians or patient’s family members should leave the patient’s room in order to avoid radiation exposure during radiotherapy. Although the patient stays alone in the room, s/he is followed up on the monitor as the room contains cameras. Patients and doctors can also communicate through a duplex internal microphone system.
Patients do not feel pain or ache secondary to external radiotherapy typically. They do not feel any physical discomfort other than small disturbances caused by brachytherapy. Medical support is always available in close proximity if pains and aches caused by side effects do emerge.

Radiology (Medical Imaging)

Since diagnosis, treatment, and follow-ups of all diseases that develop in the human body are closely linked to the services of the radiology department, almost all patients are referred to us. Radiologists at the American Hospital are specialized according to various imaging modalities, such as Magnetic Resonance Imaging (MRI), Computerized Tomography (CT), Ultrasound (US), Mammography and Conventional X-ray, but they are also classified by their knowledge and experience of certain diseases. Playing a critical role in the quality of medical imaging, our technicians are also specializing in certain imaging techniques, as is the case with our radiologists. Accordingly, imaging techniques are efficiently and safely used, while accurate approaches are adopted for patients with specific problems. The department is specialized in diseases of the brain and central nervous system, musculoskeletal system, breast, prostate gland and urinary system, liver, bile ducts and pancreas as well as lungs, cardiovascular system, thyroid gland, and other endocrine organs.

Our sub-services are listed below:

  • Diagnostic Imaging: Conventional Radiography, Ultrasound, Computerized Tomography, Magnetic Resonance Imaging, Mammography, Angiography
  • Interventional Radiology: For vascular pathologies, organ pathologies, vascular pathologies of the nervous system and oncologic interventional radiology

Reproductive Health (IVF)

Patients who are admitted to the Reproductive Endocrinology and Infertility (REI) Department with certain complaints, including but not limited to the inability to get pregnant despite a lack of contraception or inability to get pregnant despite multiple in vitro fertilization attempts. Other reasons for admittance include recurrent miscarriages, failure of embryo implantation, lack or absence of eggs/sperm, polycystic ovary syndrome, varicocele, erectile dysfunction or retrograde ejaculation, vaginismus, hereditary genetic disorders, uterine malformation, and intrauterine adhesions.

In reproductive endocrinology and assisted reproductive technology:

  • In Vitro Fertilization
  • Microinjections
  • Intrauterine insemination (IUI)
  • Surgical testicular sperm extraction (PESA, TESE)
  • Genetic screening and embryo diagnosis
  • Fertility-protecting surgeries to protect against anti-cancer treatments to safeguard conditions that threaten sperm or oocyte counts and cryopreservation of egg, sperm or embryo
  • Diagnosis and treatment of uterine malformation and uterus problems (intrauterine adhesions, fibroids, polyp) with 3D ultrasound

Rheumatology

Inflammatory rheumatoid disorders:

  • Crystal arthritis (gout, pseudogout)
  • Rheumatoid arthritis (RA)
  • Ankylosing spondylitis
  • Reactive arthritis
  • Connective tissue disease (Systemic lupus erythematosus (SLE), systemic sclerosis, polymyositis, dermatomyositis)
  • Vasculitis (Behçet’s disease, temporal arteritis, etc.)
  • Familial Mediterranean Fever (FMF)

Non-inflammatory rheumatoid diseases:
  • Fibromyalgia
  • Arthrosis
  • Soft tissue rheumatisms
  • Osteoporosis
  • Arthritis (swelling, redness, pain, warmth and limited motion of one or more joints)
  • Arthralgia and lumbar pain which is more intense in the morning
  • Pain in the joints (especially hands and feet) which is worsened by immobility
  • Morning stiffness
  • Recurrent mouth and genital sores
  • Skin rashes
  • Dermal sensitivity to sunlight
  • Recurrent fever and abdominal pain with no clear cause
  • White discoloration and cyanosis in the fingers during cold weather
  • Hair loss
  • Dry mouth and dry eyes
  • Fatigue, weight loss, fever
  • Recurrent redness and irritation in the eyes
  • Sudden-onset visual problems
  • Muscle weakness (while ascending and descending stairs, sitting down and standing up)
  • Dry cough, dyspnea
  • Clot formation at an early age

Service Line

The Service Line management model aims to facilitate the standardization of patient care by organizing functional workflow systems and algorithms. Our unit monitors certain data, including the length of hospital stays, complication rates, patient re-admission after discharge. Intended data is subsequently derived from these combined factors and processed in order to contribute to a general increase in employee satisfaction with dual management by solving requests from departments that maintain autonomy over administrative issues, such as equipment, personnel, and marketing.

It is also thought that the individual and collective sense of belonging will be enhanced by instructing the system about the detailed roles of medical and administrative personnel who operate as part of the Service Line. With the Line’s continued employment we can witness increased progress in the following areas;
 
  • Flow integrity in patient care processes
  • Patient-oriented approach
  • Increasing awareness and involving our patients in the process
  • Standardization in patient care
  • Post-discharge follow-up
  • Dual management with the Line Director and Operation Manager
  • Focusing on continuous quality improvement
  • Tracking the medical results of our patients with Digital Conversion
  • Data analysis of financial and medical processes
  • Indirect financial benefit

Sleep Disorders Unit

All conditions that are essential for a healthy sleep falls into our field of expertise. We offer patients the opportunity of comprehensive diagnosis and treatment in cooperation with Otorhinolaryngology (ENT), Pulmonary Medicine, Neurology, Psychiatry, Cardiology, and Internal Medicine departments.

Complaints among the reasons for admissions in our department are:

  • Snoring
  • Sleep apnea (sleep disorder in which a person will repeatedly stop breathing when asleep)
  • Insomnia (difficulty falling and/or staying asleep)
  • Parasomnias (sleepwalking, bruxism -teeth grinding-, night terrors)
  • Sleep disorders among shift workers
  • Circadian rhythm disorders (a malfunction in the "internal body clock" or a mismatch between the "internal body clock" and the external environment regarding the timing and duration of sleep)
  • Periodic Limb Movement Disorder (repetitive cramping or jerking of the legs or limb during sleep)

Smoking Cessation Center

Smoking causes the death of more than 7 million people every year due to the more than 7000 excessively toxic and carcinogenic components that exist in tobacco products. These components take the lead in preventable death causes. Tobacco products have numerous negative effects on health due to active and second-hand smoking. It is known that smoking is the underlying cause of 90% of deaths secondary to lung cancer. The risk of heart attack increases ten-folds for smokers and the risk of inducing strokes also increases due to the negative effects on blood circulation and vessels. Smoking causes certain diseases in the lungs, such as chronic bronchitis and emphysema (COPD), which substantially lowers the quality of life with considerable shortness of breath and shortens life expectancy.

In addition, smoking can cause cancer of the mouth, tongue, pharynx, esophagus, pancreas, urinary bladder, kidney, prostate, cervix, colon and liver.

Smoking causes miscarriages, premature delivery and low birth weight in women and infertility and erectile disorder in men. Reliable studies show that one of every three smokers dies before the expected projected lifespan.
The heart rate and blood pressure normalize 20 minutes after you quit smoking. The risk of heart attack decreases after the first day and blood circulation normalizes after 2 weeks. Lung functionality starts to improve after 3 months and the risk of heart disease and lung cancer decreases by half between one year and 10 years, respectively, and the risk of heart disease is equal to non-smokers after 15 years have elapsed.
One person dies due to smoking-related causes every 6 seconds approximately. This equals a mean figure of 5.4 million individuals in a year. It has been estimated that 175 million individuals will die due to smoking between 2005 to 2030 if this progression continues. If we review the figures in our country, 85,000 people die due to active smoking every year. For second-hand smoking, the figure is 15,000 people per year. 14.5 million people, including 252,000 children, use tobacco products every day in our country.

Of the 7000 materials included in a cigarette, 2000 are toxic and 70 are carcinogenic.

One of these materials, nicotine, causes addiction; nicotine is absorbed through the cheeks, especially in the first 10 seconds of smoking and reaches the brain starting the cycle of physical and behavioral addiction. Addiction develops quickly; only 100 cigarettes are sufficient for it to be established.

Smoking is responsible for 9 out of every 10 cancer-related deaths, 6 out of every 10 lung-related deaths and 3 out of every 10 deaths secondary to cardiovascular diseases.

Second-hand smoke is more poisonous than the smoke directly inhaled by a smoker from a cigarette; with chronic lung diseases and recurrent respiratory tract infections, children tend to be affected the worst by second-hand smoke.
 

When it comes to ingesting smoke there is no safe quantity ultimately; our only suggestion is to never use tobacco products in any capacity. In this context, newly established products such as electronic cigarettes and IQOS products, which heat but do not burn, are simply advertising tools that target adolescents. They are regarded as products that aim to maintain the addiction to tobacco products and they are proven as health hazards, even though they are promoted as “less hazardous” options. These products cannot be regarded as feasible alternatives to the clear benefits drawn from the total cessation of smoking. It should always be remembered that electronic cigarettes are addictive products, which mimic the appearance and behavior of regular smoking and contain carcinogenic and volatile organic agents producing negative effects on the lungs.
 

Addiction to smoking can be effectively broken; a smoker can commence the action of “cessation of smoking” voluntarily and comprehensively with medical and motivational support. Informative, supportive and encouraging assistance is essential during the first 7-15 days when the physiological and behavioral withdrawals are at their most severe. This support is structured according to the needs and concerns of each patient and it also makes the action of cessation of smoking considerably more enduring. Studies show that 7 out of every 10 individuals consider quitting; half of these individuals try to quit smoking every year. It has been observed that individuals who cannot locate properly structured support at the necessary time relapse the following year. However if an individual learns to live with the withdrawal caused by the physiological addiction and recognizes the habits secondary to psychological addiction, s/he may positively complete her/his part in the cessation of the smoking process.

 

Speech Disorders

Speaking’ technically means the pronunciation of letters and words. People with speech problems;
  • May not be able to pronounce letters correctly.
  • May have hoarseness or a raspy voice.
  • May stutter, pause while talking, and may inexplicably leave unnecessary pauses between words or repeat words unnecessarily.
 
The language provides words and sentences that we choose to employ in order to express our opinions and voice our requests. A person with a language disorder may suffer from problems in;
  • Speech comprehension
  • Expression
  • Reading
  • Writing
Dysphagia implies the inability to correctly swallow food; instead, food objects can enter into the trachea or lungs resulting in pneumonia or choking secondary to surgery, stroke or injury. If a swallowing disorder is suspected, the patient in question should be urgently referred by their primary physician to a language and speech pathologist and a swallowing test should be performed to determine the severity and cause of the disorder as well as provide valuable information to determine subsequent treatment options.

 

Thoracic Surgery

Patients may be admitted to the Thoracic Surgery Department due to a range of complaints. These complaints are as follows:

  • Mostly, patients have one or more of the following complaints - cough, dyspnea, hemoptysis and chest pain and others with problems detected in imaging tests following initial examinations by other departments
  • Abnormalities detected in the imaging tests of the thoracic cavity within the scope of routine health examinations
  • Excessive sweating on the palms of the hands and in the armpits with no clear underlying cause,
  • Complaints such as pain and dyspnea secondary to thoracic traumas
Surgical treatments are performed to examine the organs and tissues associated with the thoracic cavity include the chest wall, lungs, mediastinum, diaphragm and esophagus.
There are no sub-services regularly provided by our department. However, we do perform  necessary procedures and interventions, especially involving patients who are looked after by the intensive care unit and have health problems that are related to our department.

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