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Autologous ovarian tissue transplantation: Preoperative assessment and preparation of the patient
(Wolters Kluwer Health, 2024) Turan, Volkan; Öktem, Özgür
Importance: Ovarian tissue cryopreservation (OTC) is an innovative and established fertility preservation method. More than 150 live births have been reported worldwide to date with the use of this strategy. OTC is one of the options to preserve fertility in prepubertal girls and for women who have time constraints and/or contraindications for ovarian stimulation for oocyte/embryo freezing before cancer treatment. The success rate of the ovarian tissue transplantation (OTT) depends on many interrelated factors. Therefore, preoperative evaluation and preparation of the candidate patients for the procedure are of paramount importance. Objective: In this review, our aim was to provide a guide for the clinicians, which demonstrates step-by-step assessment and preparation of the patients and ovarian tissue samples for transplantation. Evidence Acquisition: We searched for published articles in the PubMed database containing key words, such as OTT, OTC, preoperative assessment, primordial follicle density, and cancer, in the English-language literature until May 2024. We did not include abstracts or conference proceedings. Results: OTT is still a developing method as an effective fertility preservation approach. It is essential to perform a thorough preoperative evaluation of the patient to improve the success rates of transplantation. Conclusions and Relevance: Preoperative evaluation and preparation of women for ovarian transplantation surgery should include safety management to prevent reimplantation of malignant cells, transplanting ovarian tissue with minimum follicle loss and the decision of the best transfer site.
Non‑cirrhotic portal fbrosis/idiopathic portal hypertension: APASL recommendations for diagnosis and management
(Springer Nature, 2024) Shukla, Akash; Rockey, Don C.; Kamath, Patrick S.; Kleiner, David E.; Singh, Ankita; Vaidya, Arun; Koshy, Abraham; Goel, Ashish; Dökmeci, A. Kadir; Meena, Babulal; Philips, Cyriac Abby; Sharma, Chhagan Bihari; Örmeci, Necati; Sarin, Shiv Kumar
Since the Asian Pacific Association for the Study of the Liver (APASL) published guidelines on non-cirrhotic portal fibrosis/idiopathic portal hypertension in 2007, there has been a surge in new information, especially with the introduction of the term porto-sinusoidal vascular disorder (PSVD). Non-cirrhotic intra-hepatic causes of portal hypertension include disorders with a clearly identifiable etiology, such as schistosomiasis, as well as disorders with an unclear etiology such as non-cirrhotic portal fibrosis (NCPF), also termed idiopathic portal hypertension (IPH). This entity is being increasingly recognized as being associated with systemic disease and drug therapy, especially cancer therapy. An international working group with extensive expertise in portal hypertension was assigned with formulating consensus guidelines to clarify the definition, diagnosis, histological features, natural history, and management of NCPF/IPH, especially in the context of PSVD. The guidelines were prepared based on evidence from existing published literature. Whenever there was paucity of evidence, expert opinion was included after detailed deliberation. The goal of this manuscript, therefore, is to enhance the current understanding and help create global consensus on the issues surrounding NCPF/IPH.
The effect of rapamycin treatment on mouse ovarian follicle development in dehydroepiandrosterone-induced polycystic ovary syndrome mouse model
(Zygote, 2024) Yıldırım, Ecem; Önel, Tuğçe; Aguş, Sami; Günalan, Elif; Yılmaz, Bayram; Aydın, Mehmet Şerif; Yaba, Aylin
Polycystic ovary syndrome (PCOS) is a complex reproductive and endocrine disorder affecting 5–10% of women of reproductive age, but the pathophysiology of PCOS still remains unknown. Here, the aim of our study was to analyze the effects of rapamycin treatment that may regulate impaired hormonal levels and folliculogenesis in dehydroepiandrosterone (DHEA)-treated PCOS mouse. We hypothesized that rapamycin may ameliorate the negative effects of PCOS in DHEA-induced PCOS mouse model. The target of rapamycin (TOR) gene product is a serine/threonine kinase that has been implicated in the control of cell growth, proliferation and autophagy, and rapamycin is a potent inhibitor of mTORC1 pathway. In this study, for the first time, mTORC1 and activation products are presented at protein and mRNA levels after rapamycin treatment in DHEA-induced PCOS mouse ovary. We showed that rapamycin treatment may regulate follicular development, hormonal levels and provide ovulation in DHEA-induced PCOS mouse. Additionally, we assessed decreased primordial follicle reserve, increased number of primary and secondary follicles, corpus luteum structure forms again after 10 days of rapamycin treatment. This study presented here suggests rapamycin treatment regulates hormonal phenotype and folliculogenesis in the ovary and also mTOR signalling pathway in granulosa cells of DHEA-induced PCOS mouse ovary which may have potential to attenuate understanding the mechanism of dominant follicle selection and anovulatory infertility.
Perceived social support and depression, anxiety andstress in pregnant women diagnosed with foetal anomaly
(John Wiley & Sons, 2024) Mecdi Kaydırak, Meltem; Balkan, Elif; Bacak, Nilgül; Kızoğlu, Filiz
Aim: To examine the relationship between perceived social support level and depression, anxiety and stress in pregnant women diagnosed with foetal anomaly. Design/Methods: This descriptive and correlational study was conducted in an advanced prenatal evaluation unit of a university hospital between December 2021 and May 2022. The study data collected from 131 pregnant women through a personal information form, depression, anxiety and stress scale (DASS-42) and multidimensional scale of perceived social support (MSPSS). Results: Most of the pregnant women were in the second trimester of pregnancy, and more than half had been advised by a healthcare professional to terminate their pregnancy. Overall, the pregnant women reported moderate levels of social support, while their depression, anxiety and stress levels varied. There was a weak negative correlation between perceived social support from family, friends and multidimensional sources with stress, but the effect rate was low. Conclusion: Most pregnant women diagnosed with foetal anomaly have normal levels of depression, stress and anxiety. There is a weak negative correlation between perceived social support and stress, with family and friend support affecting stress levels at a low rate. Professional support should be provided, and both the woman's mental health and social support mechanisms must be evaluated. Impact: This study highlights the importance of social support in managing stress among pregnant women with foetal anomalies. While most women had normal levels of depression, anxiety and stress, increased social support from family and friends was shown to reduce stress. The findings underscore the need for healthcare professionals to assess and strengthen mental health and social support systems in this vulnerable population, informing interventions to improve psychosocial outcomes. Reporting Method: This descriptive and correlational study adhered to the CONSORT guidelines for reporting non-randomised trials. Patient or Public Contribution: No patient or public contribution.
Effect of obesity and NAFLD on leukocyte telomere length and hTERT gene MNS16A VNTR variant
(Springer Nature, 2024) Kandemir, İbrahim; Yetim Şahin, Aylin; Oyacı, Yasemin; Khudiyeva, Shahri; Şahin, Memduh; Aksakal, Melike Tuğrul; Pehlivan, Mustafa; Baş, Firdevs; Pehlivan, Sacide
It is known that telomere length (TL) (evaluated with T/S ratio) is shortened in the presence of obesity. In this study, we aimed to investigate how obesity in adolescents and non-alcoholic liver disease (NAFLD) within the obese group affect TL and the clinical significance of the human telomerase reverse transcriptase (hTERT) gene MNS16A VNTR variant in terms of NAFLD. Adolescents with exogenous obesity and healthy controls (aged 10-19 years) who applied to our adolescent outpatient clinic between May-October 2023 were included in this study. We performed upper abdominal ultrasonography to investigate the presence of NAFLD in adolescents with obesity and divided into two groups: those without hepatosteatosis (obese NAFLD (-)) and those with hepatosteatosis (obese NAFLD (+)). We recorded body weight, height, waist circumference, and blood pressure measurements and measured the T/S ratio (telomere sequence copy number/gene single copy number) by the Quantitative Polymerase Chain Reaction method. The groups were compared using frequentist and Bayesian methods. Eighty-three obese adolescents [63 NAFLD(+) 20 NAFLD(-)] and 69 lean controls were included in the study. Pairwise comparisons revealed that T/S ratio was significantly lower in the obese NAFLD (-) group than the obese NAFLD (+) and the control group (p = 0.025, p = 0.007, respectively). T/S ratio was lower in the LL allele group than in the other alleles (p = 0.022) and slightly higher in the obese group with metabolic syndrome compared to the obese group without metabolic syndrome (p = 0.072). hTERT-MNS16A-VNTR gene variant LL allele had a negative correlation with T/S ratio among the obese adolescent group. Patients with LL alleles had higher ALT, GGT, HOMA-IR, and ALT/AST. Diastolic blood pressure had a significant correlation with the T/S ratio. The T/S ratio was shorter in the obese adolescent group compared to healthy ones but was higher in the NAFLD (+) obese compared to the NAFLD (-) obese. ALT level and ALT/AST ratio were higher, T/S ratio was lower in the hTERT MNS16A VNTR variant LL allele group among obese adolescents. In addition, there was a significant correlation between the T/S ratio and diastolic blood pressure in obese adolescents.
Superficial siderosis: A case report of underdiagnosed disorder
(Springer Nature, 2024) Talibov, Tural; İnci, Meltem; Barburoğlu, Mehmet; Sencer, Altay; Çoban, Oğuzhan
Superficial siderosis (SS) is caused by subpial hemosiderin deposition due to chronic low-grade bleeding into the subarachnoid space. Dural tears are the most common etiology. Slowly progressive gait ataxia and hearing impairment are common clinical manifestations. Brain magnetic resonance imaging (MRI) shows linear superficial hypointensity on the T2 weighted images and gradient echo. The therapeutic approach is surgical repair of the bleeding source. The patient presented with progressive hearing loss and ataxia. Neurological examination revealed bilateral hearing loss, nystagmus, dysarthria, brisk deep tendon reflexes, and severe ataxia. Brain MRI showed linear superficial siderosis in the cerebrum, cerebellum, and brain stem. Spinal MRI showed ventral epidural cerebrospinal fluid (CSF) collection and disc-osteophyte complex. Six months after the surgical repair of the dural defect, the patient's neurological examination demonstrated improvement in ataxia and dysarthria. The patient was able to walk without any assistance. Surgical repair of the underlying bleeding source may be beneficial in preventing the progression and improving the symptoms of superficial siderosis SS. This case suggests that SS symptoms are potentially reversible by surgical treatment of the underlying spinal CSF leak after a long disease course.
Anatomical and morphometric features of the profunda brachii artery
(Medrang, 2024) Şanlıtürk, Yüsra Nur; Zeybek, Nurşen; Gayretli, Özcan; Öztürk, Adnan
When the literature is examined, studies evaluating the profunda brachii artery (PBA) are limited as most studies only investigate the artery’s origin. In 44 upper extremities belonging to 24 human anatomical specimens, single and double PBAs were observed in 39 and five cases, respectively. In cases with a single PBA, the origin was the brachial artery (BA) in 35 cases and the posterior circumflex humeral artery in four cases. In cases with double PBAs, the artery’s origin was the BA. Morphometric measurements of single and double arteries originating from the first branch BA were evaluated separately and compared according to sex and side. Our study, in which the PBA was examined morphologically and morphometrically, contributes to the literature anatomically and radiologically in treating humerus fractures and lateral arm-flap applications by surgeons.
The course of the phrenic nerve in the neck region and its relationship with adjacent anatomical structures in the thoracic inlet
(Springer, 2024) Yıldız, Nilay; Nteli Chatzioglou, Gkionoul; Coşkun, Osman; Kale, Ayşin; Gayretli, Özcan
Pupose: This study aims to reveal the relationship of the phrenic nerve (PhN) with its neighboring structures in the lower neck region more comprehensively than previous studies and to minimize nerve damage by enabling invasive procedures in this region to be performed with high accuracy. Methods: Forty-one heminecks were evaluated. The relationship between the PhN and the anterior scalene muscle (ASM), internal thoracic artery (ITA), branches of subclavian artery (SA) and subclavian vein (SV) was examined. Results: It was observed that the PhN was located medial to the ASM in all cases. The distances were higher in male cadavers. The PhN was found to enter the thorax lateral to the ITA in 15/41 and medial to it in 25/41 sides. In 17/41 cases, the closest SA branch to the PhN was the thyrocervical trunk (TT) and in 24 cases the ITA. The PhN was located behind the SV in 38 cases and in front of it in 2 cases.The accessory PhN was found in 4/41 sides. There was no significant difference in morphometric findings between genders (p > 0.05). However, significant differences were observed between the parameters (p < 0.05). Conclusion: The anatomy and variations of the PhN are of great importance in surgical interventions and invasive procedures in the neck region. The study provides important information to reduce the risk of damage to the PhN in surgical procedures. In addition, knowledge of the anatomical variations of the nerve may contribute to more successful results in nerve grafting and other surgical applications.
Overcoming barriers to cervical cancer prevention inAfghanistan: The imperative for an HPV vaccination andscreening program
(Wiley, 2024) Sadat, Rowaida; Saçıntı, Koray Görkem; Topçu, Elif Göknur; Saeed, Saeeda
The critical situation of cervical cancer screening and human papillo-mavirus (HPV) vaccination in Afghanistan demands urgent attention,especially in view of the ongoing political unrest and humanitarianchallenges faced by the country. Recent data underscore the urgentneed for immediate action to address this pressing issue.
Managing CDH1 cancer risks in a child: Complex decision making in a family with hereditary diffuse gastric cancer
(Wiley, 2024) Ağaoğlu, Nihat Buğra; Hatırnaz Ng, Özden; Zemheri, İtir Ebru; Ünal, Büşra; Gerenli, Nelgin; Tosun, İlkay; Yazıcı, Hülya; Özbek, Uğur; Kamihara, Junne; Rana, Huma Q.
Germline pathogenic variants (PVs) in CDH1 cause hereditary diffuse gastric cancer. The management of CDH1 cases with a positive family history includes total prophylactic gastrectomy or intensive surveillance. In this study, we report a 16-year-old boy with intramucosal gastric signet ring cells in the setting of a germline CDH1 PV and a family history of early-onset gastric cancer. The approach to managing both the proband and their 9-year-old sister, who also had the CDH1 PV, presented a challenge to both clinicians and the family. Herein, we present the complexities of managing gastric cancer risk when a CDH1 PV is identified in childhood in the setting of a family history of early-onset gastric cancer.
Therapeutic effects of mesenchymal stem cell conditioned medium in rat varicocele model
(Korean Society for Sexual Medicine and Andrology, 2024) Şerefoğlu, Ege Can; Kolbaşı, Bircan; Bülbül, Muhammet Volkan; Karabulut, Seda; Çakıcı, Çağrı; Gündoğdu Özdemir, Reyhan Zeynep; Keskin, İlknur
Purpose: This study aimed to examine the therapeutic effects of injection of conditioned medium of adipose-derived mesen chymal stem cells (ADMSC-CM) in a surgically created varicocele model in comparison with varicocelectomy. Materials and Methods: Twenty-eight male Wistar Albino rats were randomly divided into four groups: sham group, varico cele group, varicocelectomy group, and ADMSC-CM injection group. Sperm parameters were analyzed in samples taken from the epididymis after treatment. Malondialdehyde and superoxide dismutase (SOD) levels in blood samples were exam ined by biochemical analysis. The testicular tissues were stained with hematoxylin-eosin for histological examination (John sen’s Score). Additionally, Western Blot analyzes were performed to detect Claudin-11 levels, the functional protein of the blood-testis barrier, in testicular tissues. Results: Varicocelectomy and ADMSC-CM treatments significantly improved mean sperm parameters (concentration, pro gressive motility, motility, normal sperm morphology) (p≤0.05 for all). Both treatment groups had increased SOD levels along with a decrease in malondialdehyde levels (p≤0.05 for all). No significant difference was observed between the ADMSC CM group and the varicocelectomy group in preserving normal testicular histology according to Johnsen’s Score (p=0.114). Levels of Claudin-11 were significantly higher in the varicocelectomy and ADMSC-CM groups compared to the varicocele group (p≤0.05 for all). Conclusions: The therapeutic effects of ADMSC-CM in varicocele model may involve secretion of anti-inflammatory and re generative factors from ADMSC. ADMSC-CM injection appears to be a promising new strategy in the treatment of varicocel
The Homeostasis-Enrichment-Plasticity (HEP®) approach for premature infants with developmental risks: A pre-post feasibility study
(Multidisciplinary Digital Publishing Institute (MDPI), 2024) Balıkçı, Aymen; May-Benson, Teresa A.; Sırma, Gamze Çağla; Kardaş, Ayten; Demirbaş, Duygu; Arıcikul Balıkçı, Ayşe Firdevs; İlbay, Gül; Sözen, Hatice Gülhan; Beaudry-Bellefeuille, Isabelle
Background: The environmental enrichment (EE) framework has inspired several early intervention (EI) approaches. This study evaluated the feasibility, safety, caregiver acceptance, and satisfaction of implementing the HEP Approach intervention, a novel EI model based on the EE paradigm. Outcome measures for motor development, individual functional goals, sensory functions, caregiver-provided environmental affordances, and motivation for movement were examined. Methods: A pre-post-study design examined 18 premature infants (<33 weeks six days gestation) with a corrected age of 4–10 months. A 21-item Likert scale survey assessed the feasibility, safety, acceptability, and satisfaction of implementing the HEP Approach intervention. The Peabody Developmental Motor Scales-2, Test of Sensory Functions in Infants, Affordances in the Home Environment for Motor Development, and Infant Movement Motivation Questionnaire were used for outcomes. The goal attainment scale measured progress toward parent goals. The HEP Approach consisted of 12 one-hour sessions implemented over three months. Results: Most participating parents found the HEP Approach intervention feasible, safe, acceptable, and satisfactory. GAS scores demonstrated significant gains with a mean t-score of 67.75 (SD = 2.00). Results found significant improvement (p ≤ 0.05) in all outcome measures. Conclusions: Results suggest that the HEP Approach intervention is safe, feasible, and acceptable to implement. Outcome measures were meaningful and sensitive in identifying improved motor development, individualized parental goals, sensory functions, caregivers’ use of environmental opportunities, and movement motivation in premature at-risk infants. Results suggest further studies on the HEP Approach are feasible, and highlight the potential of this intervention to inspire and guide future research in this field.
Trends and regional differences for fertil ity preservation procedures in women with breast cancer
(Elsevier, 2024) Turan, Volkan; Bedoschi, Giuliano; Lee, Dong-Yun; Barbosa, Caio Parente; Oliveira, Renato de; Saçıntı, Koray Görkem; Sönmezer, Murat; Lambertini, Matteo; Massarotti, Claudia; Schaub, Amelia; Wang, Erica; Gayete-Lafuente, Sonia; Dunlop, Cheryl; Anderson, Richard A.; Bang, Heejung; Oktay, Kutluk H.
Introduction : Breast cancer is the most common malignancy in women of reproductive age and chemotherapy protocols impair fertility, frequently necessitating fertility preservation (FP) referral. Embryo, oocyte, or ovarian tissue cryopreservation are established FP modalities in women with breast cancer but there are few data on their uptake over time. In this study our aim was to determine the regional time trends and utility differences for fertility preservation methods of reproductive tissue cryopreservation. Methods : This multicenter study included 1,623 women diagnosed with breast cancer from seven tertiary centers in six countries (Brazil, Italy, Scotland, South Korea, Turkey, USA). Participant centers provided the details of FP cryopreservation approaches broken down annually from 2012 to 2021. Women with newly diagnosed breast cancer, aged 18-45 years who were referred for FP at participating centers and had normal ovarian function at the time were included. Results : We found a mean increase of 7% per year (p=0.002, adjusting for centers) in the number of women referred for FP. Of those who were referred (n=1623), a mean 38.7% underwent FP (n=629), with a range of 12% in South Korea) to 95% in Brazil. The number of women undergoing ovarian stimulation for FP continually increased until 2021, with oocyte cryopreservation being the most common procedure throughout the study period (p=0.014 for time trend). The proportion of random start ovarian stimulation cycles increased each year from 58.3% in 2012 to 86.8% in 2021, (p=0.005 for time trend, and p=0.04 for 2012 vs. 2021). Conclusions : The utility of FP has steadily increased for young women with breast cancer over the last decade, although regional differences significantly influence FP practices. The findings of our study could have value for policy making in FP care for young women with breast cancer at the local, regional, or global level. Micro abstract Breast cancer is the most common malignancy in women of reproductive age and chemotherapy protocols impair fertility, frequently necessitating fertility preservation referral. The utility of fertility preservation has steadily increased for young women with breast cancer over the last decade, although regional differences significantly influence fertility preservation practices.
Clinical implications of aberrant anatomy of the common hepatic duct in liver surgery: a systematic review and meta‑analysis
(Springer, 2024) Valenzuela‑Fuenzalida, Juan José; Avalos‑Díaz, Constanza; Droguett‑Utreras, Antonia; Guerra‑Loyola, Javier; Nova‑Baeza, Pablo; Orellana‑Donoso, Mathias; Suazo‑Santibañez, Alejandra; Oyanedel‑Amaro, Gustavo; Sanchis‑Gimeno, Juan; Bruna‑Mejias, Alejandro; Nteli Chatzioglou, Gkionoul
Introduction: Knowledge of anatomical variants that affect the hepatic duct (HD) are of particular clinical relevance during hepatobiliary surgical procedures. More specifically, the aberrant anatomy of the common HD is the most common anatomical variation affecting the biliary tree. Below, we describe different classifications of anatomical variants that affect this canal. According to Huang's classification, variations are determined depending on the insertion of the right posterior hepatic duct (RPHD). Materials and methods: Medline, Scopus, Web of Science, Google Scholar, CINAHL, and LILACS databases were investigated until January 2024. The methodological quality was assessed with an anatomical studies assurance tool (AQUA). Pooled prevalence was estimated using a random effects model. For the subgroup analysis, Student's T-test was used. Results: The prevalence rate of aberrant hepatic duct (AHD) was 15% (confidence interval [CI] of 7-22%). The first subgroup had cadavers and images. For the cadavers, the prevalence was 15.83% (CI: 11.22-18.3%), while the images had a prevalence of 22.06% (CI: 18.12-25.33%). This subgroup analysis showed no statistically significant difference between these groups (p = 0.127). The second subgroup comprised the continents where the included studies were from. In this subgroup, no statistically significant differences were found (p = 0.613). Finally, regarding the right or left laterality of the HD variant, there were no statistically significant differences (p = 0.089). Conclusion: A AHD corresponds to a finding that can occur in a significant percentage of our society, which could be an accidental discovery during surgeries or present asymptomatically throughout life and be a cadaveric discovery later. We believe it is important for surgeons to have prior knowledge of the possible variants of HD to prevent possible complications during and after surgery.
Overexpression of CDC25A, AURKB, and TOP2A genes could be an important clue for luminal a breast cancer
(Galenos Publishing House, 2024) Kaya, Murat; Abuaisha, Asmaa; Süer, İlknur; Alptekin, Melike Sultan; Abanoz, Fahrünnisa; Emiroğlu, Selman; Palanduz, Şükrü; Cefle, Kıvanç; Öztürk, Şükrü
Objective: Breast cancer (BC) is highly heterogeneous and one of the most common cancers. Luminal A (LUM A) is a subtype of BC with a better prognosis than other BC subtypes. The molecular mechanisms underlying the initiation and progression of the LUM A subtype are still unclear. Big data generated from microarray and sequencing systems can be re-analyzed, especially with the help of various in silico tools developed in recent years, and made applicable for in vitro and in vivo research. This work aimed to identify genes that may play a role in the progression of LUM A subtype of BC using both computational and laboratory-based methods. Materials and Methods: Overlapping genes associated with BC were identified from the The Cancer Genome Atlas database, GSE233242, GSE100925 geodata sets, and the geneshot tool. The network functional analysis between overlapping genes was determined with STRING 12.0. Expression levels of overlapping genes in BC were investigated with the TNMplot (https://tnmplot.com/analysis/) in silico tool. The effect of overlapping genes on the overall survival of LUM A cancer patients was defined using the Kaplan-Meier plotter tool. Expressions of genes identified using bioinformatics data were investigated via quantitative real-time -polymerase chain reaction (qRT-PCR) in LUM A tumor and adjacent tissue samples. The data were evaluated using the t-test. Both the sensitivity and specificity of selected genes have been determined using the receiver operating characteristic curve. Results: In silico investigation showed that eleven genes were possibly associated with BC. Among them CDC25A, AURKB, and TOP2A were considerably increased in LUM A samples according to qRT-PCR results. An overall survival analysis also showed that overexpression of these three genes could reduce the overall survival of LUM A patients. Conclusion: The genes CDC25A, AURKB, and TOP2A may play crucial functions in LUM A pathogenesis. Therapeutic strategies that diminish the expression of these connected genes may enhance the prognosis of LUM A patients.
A global survey on the use of the international classification of diseases codes for metabolic dysfunction‑associated fatty liver disease
(2024) Zhang, Huai; Targher, Giovanni; Byrne, Christopher D.; Kim, Seung Up; Wong, Vincent Wai-Sun; Valenti, Luca; Glickman, Myer; Ponce, Jaime; Mantzoros, Christos S.; Örmeci, Necati; Zou, Zhuo-Lin
Background: With the implementation of the 11th edition of the International Classification of Diseases (ICD-11) and the publication of the metabolic dysfunction-associated fatty liver disease (MAFLD) nomenclature in 2020, it is important to establish consensus for the coding of MAFLD in ICD-11. This will inform subsequent revisions of ICD-11. Methods: Using the Qualtrics XM and WJX platforms, questionnaires were sent online to MAFLD-ICD-11 coding collaborators, authors of papers, and relevant association members. Results: A total of 890 international experts in various fields from 61 countries responded to the survey. We also achieved full coverage of provincial-level administrative regions in China. 77.1% of respondents agreed that MAFLD should be represented in ICD-11 by updating NAFLD, with no significant regional differences (77.3% in Asia and 76.6% in non-Asia, p = 0.819). Over 80% of respondents agreed or somewhat agreed with the need to assign specific codes for progressive stages of MAFLD (i.e. steatohepatitis) (92.2%), MAFLD combined with comorbidities (84.1%), or MAFLD subtypes (i.e., lean, overweight/obese, and diabetic) (86.1%). Conclusions: This global survey by a collaborative panel of clinical, coding, health management and policy experts, indicates agreement that MAFLD should be coded in ICD-11. The data serves as a foundation for corresponding adjustments in the ICD-11 revision.
Safety and effectiveness of controlled ovarian stimulation and oocyte retrieval during prepubertal and peripubertal period
(Springer, 2024) Sönmezer, Meltem; Gemici, Ali; Şükür, Yavuz Emre; Turan, Hande; Alimoğulları, Ebru; Avşar, Betül; Atabekoğlu, Cem Somer; Özmen, Batuhan; Turan, Volkan; Sönmezer, Murat
Purpose Is it safe and efective to perform controlled ovarian stimulation (COS) and oocyte retrieval (OR) in prepubertal and peripubertal patients? Methods In this retrospective cohort study, data of 20 pre-/peripubertal patients who underwent COS and OR for the purpose of oocyte cryopreservation (OC) between 2008 and 2023 were reviewed. Following COS, all OR procedures were performed transabdominally using a vaginal ultrasound probe. Ovarian reserve was assessed by serum FSH, LH, estradiol, AMH, and antral follicle counts (AFC) in all subjects. All mature oocytes were vitrifed. Results Mean age of the patients was 15.05±1.87, mean AMH was 0.84±0.8 ng/ml, mean FSH was 6.39±3.95 IU/L, mean estradiol was 61.6±51.9 pg/ml, mean LH was 4.69±3.46 IU/L, and mean AFC was 5.5±5.82. Among the patients, 12 had regular menstrual cycle, 5 had irregular menstrual cycle, whereas 3 patients still did not have their menarche yet. The indi cations for OC were as follows: primary ovarian insufciency (n=7), ovarian surgery for ovarian tumors (n=5) or ovarian torsion (n=1), mosaic Turner syndrome (n=2), acute lymphoblastic leukemia (n=1) anaplastic B-cell lymphoma (n=1), Ewing’s sarcoma (n=1), Noonan syndrome (n=1), and Thalassemia (n=1). The mean number of oocytes retrieved, MII oocytes frozen, and maturation rate were 5.11±5.0, 3.92±4.48, and 75.1±25.6%, respectively. Stepwise linear regression analysis demonstrated a positive correlation between AFC and number of total oocytes retrieved and number of MII oocytes. In the case diagnosed with Noonan syndrome, all 7 retrieved oocytes were MI and all frozen at MI phase. No patient had any complication related to COS or OR. Conclusion Even though number of the enrolled subjects is limited and mean AMH is lower in our cohort, we demonstrated that performing COS and OR is safe in pre-/peripubertal patients. If required, transabdominal route can be performed in this age group for OR. AFC appears as a prognostic factor for stimulation outcome in this age group. Pediatric patients or young adolescents at risk for primary ovarian insufciency should not be discouraged from utilizing OC.
Interpersonal conflicts in nursing through the lens of senior nursing students: A qualitative study
(Elsevier, 2025) Aydoğdu, Ana Luiza Ferreira; Dişbudak, Büşra
Background Unmanaged interpersonal conflicts emerge as significant obstacles for the nursing team during daily duties. Observations and discussions with nursing undergraduate students determined the need to explore their perspectives on conflict management in greater depth. Objective To investigate the perspectives of senior undergraduate nursing students on conflicts experienced by nurses during clinical practice, as well as the strategies employed to manage these conflicts. Design This is a qualitative descriptive study. Participants The study involved written interviews with 31 senior undergraduate nursing students from a university in Istanbul, Turkey. Methods Data were collected between November 23, 2023, and December 4, 2023. Thematic analysis was used. Results Four themes emerged: (1) Causes of conflicts, (2) Methods for resolving conflicts, (3) Nurse managers' approaches, and (4) Student learning through observation. The themes were organized under 13 sub-themes: ineffective communication, absence of a singular goal, misunderstanding in role boundaries, and lack of professionalism (first theme); transparent communication, absolute loss, integration, and softening (second theme); autonomy in conflict resolution and seeking other professionals to manage conflicts (third theme); positive side of the conflict, negative side of the conflict, and how I would act if I were the nurse manager (fourth theme). Conclusions Nursing students know that staff nurses and nurse managers play crucial roles in conflict management. Communication issues were identified as significant causes of conflicts. Open communication and the active involvement of nurse managers were determined as essential for effective conflict resolution. Positive outcomes of conflicts included changes in attitudes; however, conflicts were also acknowledged as contributors to workplace stress. The study underscores the importance of equipping nurses with conflict resolution skills through practical educational approaches.
Nutritional analysis of vegan recipes: From social media to plate
(Wiley, 2024) Yoldaş, Tuba; Kaya, Gözde Sultan; Parmaksız, Ayhan; Işıklar, Handan; Günalan, Elif
The study aimed to determine the nutritional composition of vegan recipes shared on the Instagram social media platform and to compare these ingredients with their non-vegan/omnivorous versions. Turkish and English vegan recipes of meatballs (n = 53), burgers (n = 12), pizza (n = 15), pasta (n = 38), cake (n = 58), and cookies (n = 52) were obtained from Instagram. They all met the criteria of being shared as #vegan labeled, presented detailed information about ingredients, and only included plant-based ingredients. Afterward, non-vegan/omnivorous recipes (n = 228) were determined as equivalent to the vegan recipes in each food group, and a total of 456 recipes were evaluated. The amounts of macro- and micronutrients per 100-gram serving were obtained by the Nutritional Data System (BeBiS). According to the outcomes, the most significant differences in nutritional composition were found between vegan and non-vegan meatball recipes. The levels of cholesterol and B12 were significantly lower in English vegan recipes of meatballs, pasta, cake, and cookies compared to their non-vegan versions (p < .05). Consuming different vegan foods throughout the day could provide complementary nutrient intake and sustainable optimal health. Nevertheless, recipe-based updates could be an innovative approach in future vegan studies. In addition, analysis of vegan recipes could be considered to modulate vegan supplementation programs.
Does facial growth pattern affect the perception of lower facial asymmetry?
(The EH Angle Education and Research Foundation Inc., 2024) Basal, Ece; Çevik, İsmail; Acar, Yasemin Bahar; Özdemir, Fulya
Objectives To investigate the influence of vertical facial type on esthetic perception of lower facial asymmetry as evaluated by orthodontists, dentists, and laypeople. Materials and Methods Three adult females were selected with normal growth patterns (NGP), vertical growth patterns (VGP), and horizontal growth patterns (HGP). Frontal photographs were made symmetric and digitally altered, rotating the lower facial third clockwise, ranging from 0° to 6° in 1° increments. A web-based survey was designed with 24 images (eight images for each model) in random order. Each image was rated using a scale ranging from 0 (unattractive) to 10 (the most attractive) by 75 orthodontists, 73 dentists, and 78 laypeople. Kruskal-Wallis test was used to determine whether differences among groups were significant. Pairwise comparisons were made with Mann-Whitney U test. The significance level was set at P = .05. Results In NGP, orthodontists and dentists could recognize slighter deviations (2°), while deviations in VGP and HGP under 3° were not recognized by all groups. Severe deviations (≥4°) were distinguished better in HGP by orthodontists and laypeople. In VGP and NGP, there was no significant difference over 4°. Conclusions Growth pattern has a significant influence on perception of lower facial asymmetry. Less severe asymmetry can be detected better in NGP. In severe degrees, increments of asymmetry can be perceived more in HGP by orthodontists and laypeople.

Güncel Gönderiler