Cerrahi Tıp Bilimleri Bölümü Koleksiyonu

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https://hdl.handle.net/20.500.13055/57

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Advances in parkinson's disease research: Exploring biomarkers and therapeutic strategies for halting disease progression
(Frontiers Media S. A., 2025) Bougea, Anastasia; Değirmenci, Yıldız
Parkinson's disease (PD) is a multifactorial neurodegenerative disorder, characterized by loss of dopaminergic neurons of substantia nigra (SN) in 1% of people aged above 65 years (Ben-Shlomo et al., 2024). Its complex clinical picture includes motor symptoms such as tremor, bradykinesia, and gait instability, as well as non-motor symptoms (depression, psychosis, cognitive decline) (Schilder et al., 2017;Titova and Chaudhuri, 2017). Current symptomatic therapies have limited long-term efficacy (Aldaajani and Khalil, 2024). A deep analysis of neural network after PD onset could deepen our understanding of the molecular crosstalk and biological processes underlying PD pathogenesis (Tomkins and Manzoni, 2021). However, there is a lack of reliable biomarkers for early diagnosis, presenting barriers to monitoring and developing disease-modifying therapies. There are several different types of biomarkers for PD , such as clinical, neurochemical and genetic (Bougea, 2020). Ten studies provided novel insights into the early detection and monitoring of PD.in the occipital region of the PD group can be usedtilized as a rapid and objective test indicator to screen for depressive symptoms in PD.Zhang et al. identified circadian rhythm genesAK3, RTN3, and LEPR as biomarkers in the progression of PD by regulating NK cells, however, the exact mechanism is not clear.Wang et al. confirmed that authenticated GPR78, CADM3, and CACNA1E were as the biomarkers that mostly mainly participated in pathways, such as the 'cell cycle' and 'hydrogen peroxide catabolic process', and They also found; five types of differential immune cells that differed between PD and control groups were identified. Together, these studies highlight the importance of combination of biomarkers and risk variables into predictive models , improving early diagnosis and monitoring of PD. Sme of them may serve as diagnostics (lncRNAs, P1 amplitude) or predictive (NVU, cathepsin B, APA2, circadian rhythm genesAK3) may shed novel light on the pathogenesis of PD.Both pharmaceutical and non-pharmacological (cognitive training, physical activity, and dietary changes) treatments are used to treat PD symptoms (Degirmenci et al., 2023;Ernst et al., 2024). Seven promising approaches were also highlighted by this showed that acupuncture, cognitive behavioral therapy, exercise and repetitive transcranial magnetic stimulation significantly improved sleep, depression, anxiety, cognition, constipation, and quality of life of PD patients.Studies suggest personalized pharmaceutical and non-pharmacological therapies for PD, with nicotine, Golexanolone, taVNS, acupuncture, and FMT showing promising antiparkinsonian properties, by modulating brain activity. Further research is needed to validate their sustainability, safety, and effectiveness.Bibliometric analysis is a systematic approach to evaluating scientific literature and detecting patterns, and effects by using quantitative tools to filter data from relevant sources (Passas, 2024). This research topic includes two bibliometric studies that significantly expand their respective fields. This research topic combines important studies on the risk factors, treatments, biomarkers and bibliometric analysis. The results of these studies provide a useful guide for clinicians in their practice and to suggest targets for researchers in developing new diagnostics and therapeutic strategies. We conclude that the results of these studies are a useful tool that help clinicians in their practice and motivate researchers to look for new developments.
In-depth analysis of the demographic landscape and clinical outcomes of assisted reproductive technologies in Türkiye: A comprehensive survey for the years 2020 and 2021
(Galenos Publishing House, 2025) Benlioğlu, Can; Aydın, Yunus; Bostancı, Mehmet Sühha; Bozdağ, Gürkan; Bulgurcuoğlu, Sibel; Demir, Ahmet; Dilbaz, Serdar; Dirican, Enver Kerem; Turan, Volkan; Balaban, Başak
Objective: To investigate patient characteristics and outcomes of assisted reproductive technology (ART) cycles conducted in Türkiye during the coronavirus disease-2019 (COVID-19) pandemic (2020-2021). Material and methods: ART centers in Türkiye were invited to participate in this survey. The questionnaire focused on patient demographics and performance outcomes and was sent to center directors via anonymous Qualtrics™ links. Results: The survey was sent to 167 centers and data were collected from 15 centers in 2020 and 24 centers in 2021. The clinical pregnancy rate from intrauterine insemination (IUI) procedures remained similar, with 15.1% in 2020 (1,245 IUI cycles) and 14.5% in 2021 (2,023 IUI cycles), while successful delivery rates were 12.5% and 11.5%, respectively. For ART treatments, the clinical pregnancy rate from fresh embryo transfers increased from 45.1% in 2020 (3,119 transfers) to 50.4% in 2021 (8832 transfers), with similar live birth rates, 34.2% vs. 34.4%. Frozen embryo transfers resulted in clinical pregnancy rates of 47.8% in 2020 (2,498 transfers) and 51.9% in 2021 (12,015 transfers), with live birth rates rising from 39.8% to 42.7%. Preimplantation genetic testing cycles resulted in clinical pregnancy rates of 64.2% in 2020 (271 transfers) and 60.8% in 2021 (2,102 transfers), with live birth rates of 53.5% and 48.2%, respectively. Regarding techniques for fertility preservation in females, 11 prepubertal and 61 postpubertal ovarian tissue cryopreservation procedures were reported, alongside 1,346 cycles performed within the same period. In males, 144 post-pubertal testicular tissue, 871 epididymal and 2,480 ejaculated sperm cryopreservations were reported. During the two years, six ovarian tissue transplantations followed by ART were performed, with 96 women using cryopreserved oocytes. In addition, 40 testicular tissue, 298 epididymal, and 238 ejaculated sperm samples were used for ART purposes. Conclusion: This survey provides a comprehensive overview of ART practices in Türkiye for 2020 and 2021, establishing a long-term, nationallevel analysis while highlighting the challenges posed by the COVID-19 pandemic. The longitudinal analysis established a foundation for future annual reports and offers critical insights into emerging trends over these two years.
Management of neuroleptic malignant syndrome induced by paliperidone: A case report of multidisciplinary treatment approaches, including apomorphine and electroconvulsive therapy
(Türk Nöroloji Derneği, 2025) Gültekin, Murat; Benli, Şeyma; Demirel Özsoy, Saliha; Değirmenci, Yıldız
A 34-year-old female patient with a history of bipolar affective disorder, who had been receiving paliperidone 100 mg monthly and biperiden 3 mg daily for the past two years, was admitted to the emergency department with a three-day history of fever, altered consciousness, dysphagia, mutism, rigidity, inability to walk, inability to speak, and vacant, meaningless stares. It was noted that her last paliperidone injection was administered 12 days before the hospitalization. Vital signs revealed a fever of 38.1°C, mild tachycardia, and normal blood pressure. Laboratory tests indicated leukocytosis and an elevated serum creatine kinase (CK) level of 1098 U/L (normal range: 39-308 U/L), suggesting muscle breakdown. Neurological examination revealed excessive sweating, confusion, rigidity, and dysphagia. A written informed consent was obtained from the patient.
From surgery to sports career: The long-term fate of athletes with discoid meniscus
(Lippincott Williams and Wilkins Ltd., 2025) Erden, Tunay; Ağır, Muzaffer; Ali, Jotyar; Toker, Berkin; Taşer, Ömer
Objective: This study aimed to evaluate the long-term effectiveness of different surgical techniques for discoid meniscus in athletes. Design: This retrospective cohort study included 44 athletes (51 knees) who underwent arthroscopic surgery for symptomatic discoid meniscus between 1996 and 2019. Setting: The study was conducted at a tertiary-level sports medicine center. Patients: Athletes aged 15 to 35 years with symptomatic discoid meniscus confirmed by magnetic resonance imaging and requiring surgical treatment were included. Exclusion criteria were cartilage injuries (Outerbridge grades 3-4), concomitant ligament injuries requiring surgery, osteochondritis dissecans, and prior knee surgery. Interventions: Patients underwent arthroscopic partial, subtotal, or total meniscectomy, with or without meniscus repair. Main outcome measures: Functional outcomes were assessed using Visual Analog Scale (VAS), International Knee Documentation Committee (IKDC), and Lysholm scores. Osteoarthritis progression was evaluated using the Kellgren-Lawrence classification. Return to sports time and total career duration were also recorded and compared between the surgical groups. Results: The mean follow-up was 13.5 ± 6.2 years (range: 5-27 years). At the final follow-up, 72% of the meniscus-preserving group (partial meniscectomy and repair) had KL grade 0 osteoarthritis, whereas 38% of the subtotal/total meniscectomy group developed KL grades 3 to 4 osteoarthritis (P < 0.001). All groups showed significant postoperative functional improvements (P < 0.001), but career duration and return to play time were significantly longer in the meniscus-preserving group (P = 0.004, P < 0.001, respectively). Conclusions: Subtotal/total meniscectomy significantly accelerates osteoarthritis progression. Meniscus-preserving techniques provide better long-term outcomes.
Fluid biomarkers in atypical Parkinsonism: Current state and future perspectives
(Springer Nature Link, 2025) Bougea, Anastasia; Colosimo, Carlo; Falup‑Pecurariu, Cristian; Palermo, Giovanni; Değirmenci, Yıldız
Diagnosing Atypical Parkinsonian Syndromes (APS) may be challenging due to overlapping clinical features of Parkinson’s disease (PD), and the lack of pathognomonic diagnostic tests. Fluid biomarkers can be useful tools that make it easier to identify and track diferent APS. Objectives: this narrative review aim to update the current state of fuid biomarker research in APS and their potential implications in clinical practice. A comprehensive literature search was conducted in PubMed and Scopus using the following terms: “Aβ42 amyloid beta with 42 amino acids’’, “ alpha-synuclein’’, “Atypical Parkinso nian Syndromes’’, “corticobasaldegeneration’’, “C reactive protein’’, “cerebrospinal fuid’’, “dementia with Lewy bodies’’, “multiple system atrophy’’, “neuroflament light, oligomericαsyn, phosphorylated α –syn’’, “tau phosphorylated at threonine 181’’, “progressive supranuclear palsy’’, “Seeding Amplifcation Assay’’, “t-tau; total tau”. The lack of high-afnity α-syn antibodies and ligands may contribute to α-syn’s low efcacy as a diagnostic biomarker of APS. Cerebrospinal fuid (CSF) biomarkers refecting Alzheimer pathology, axonal damage (neuroflament light chain) add valuable diagnostic and prog nostic information in the neurochemical characterization of APS. Infammatoryand microRNAs markers need to be further validated before their clinical use. Seeding Amplifcation Assays (SAA), despite their high sensitivity and specifcity, are at this point used only as a research tool, and they are not quantitative or refective of disease severity. Biomarker research for early identifcation and prognosis of APS patients requires multicenter collaboration, validation, and AI-based diagnostics, despite immature biological classifcation systems.
Epitelyal over kanserinde hipertermik intraperitoneal kemoterapi
(Turkiye Klinikleri Yayınevi, 2025) Şahin, Hanifi; Şahin, Turan; Uyar, Oğuz
Over kanseri periton yüzeyine hem primer hem de nüks olgularda tutmaktadır. Bundan dolayı özellikle periton yüzeyini hedef alan terapötik yaklaşımlardan biri olan Hipertermik İntraperitoneal Kemoterapi (HIPCE) literatürde tartışılan önemli bir tedavi modalitesidir. Bugün için over kanserinin standart tedavisinde etkin bir sitoredüksiyon veplatin bazlı kemoterapi standart yerini korumaktadır. HIPEC ile ilgili tartışma devam etmektedir. Eldeki veriler HIPEC'in Neoadjuvan Kemoterapi (NACT) sonrası İnterval Debulking Cerrahisi (IDS) sağkalımı artırdığı yönündedir. Primer ve Nüks cerrahisinde sağkalımı arttırdığına dair çalışmalar olsa da standart bir yaklaşım değildir.
Developments in pharmacotherapy for the preservation of ovarian function during cancer treatment
(Taylor & Francis, 2025) Turan, Volkan; Oktay, Kutluk
Introduction: Cancer is one of the major causes of human death, and anti-cancer therapy often results in premature ovarian failure and infertility, depending on factors such as age, initial ovarian reserve, and chemotherapy type and dose. Fertility preservation procedures, such as oocyte, embryo, and ovarian cortex cryopreservation, can help women achieve pregnancy after cancer treatment. However, the development of pharmacological therapies to protect ovarian function during chemotherapy would represent a significant advancement. Areas covered: We searched the published articles in PubMed up to December 2024, containing key words '"chemotherapy",' 'cancer,' '"ovarian protection",' '"pharmacological therapy",' '"ovarian reserve"' and '"fertility".' Chemotherapeutic agents act via various mechanisms in the human ovary, including direct DNA damage leading to oocyte apoptosis, as well as damage to ovarian stroma and microvascular architecture. In recent years, numerous protective agents have emerged, showing promise in protecting ovaries from chemotherapy-induced damage. However, most studies have relied on animal models, and only a limited number have directly tested these agents in human ovarian tissue. At present, no pharmacological treatment has been conclusively proven effective for preserving fertility. Expert opinion: A comprehensive understanding of the mechanisms underlying chemotherapy-induced ovarian damage is critical for the development of efficient and targeted pharmacological therapies.
Pharmacovigilance analysis of immune checkpoint inhibitor-related reproductive adverse effects based on the FDA adverse event reporting system
(Springer Nature, 2025) Köylü, Bahadır; Esen, Buğra Han; Bektaş, Şevval Nur; Özbek, Laşin; Turan, Volkan; Urman, Bülent; Öktem, Özgür; Selçukbiricik, Fatih
This study aims to investigate the adverse effects of immune checkpoint inhibitors (ICIs) on the female and male reproductive systems. In the FDA Adverse Event Reporting System (FAERS) database, adverse reactions under the "Reproductive system and breast disorders" category in the System Organ Classes were included, covering a period from January 1, 2015, to June 30, 2023. We identified 133,512 patients treated with ICIs. Immune checkpoint inhibitor-related reproductive adverse effects (irRAEs) were reported in 568 (0.43%) patients. Spermatogenesis abnormality (ROR025 = 7.91) had the highest signal strength associated with ICI use in males. Genital tract fistula was the only significant irRAE (ROR025 = 2.72) in females. PD-1 inhibitors pose greater risk than CTLA-4 inhibitors (OR = 1.65 [1.05-2.79], p = 0.045). Gynecologic cancers in females (OR = 3.77 [2.82-4.99], p < 0.0001) and urogenital cancers in males (OR = 1.56 [1.17-2.06], p = 0.0018) carried the highest risk compared to other cancers. Additional targeted drugs (OR = 2.32 [1.76-3.02], p < 0.0001), particularly lenvatinib (OR = 3.50 [2.48-4.94], p < 0.0001) and cabozantinib (OR = 3.71 [1.96-7.03], p < 0.0001) significantly increased the risk for females. Additional use of chemotherapy drugs was associated with a significant reduction in the risk for males (OR = 0.65 [0.42-0.96], p = 0.042) except for doxorubicin (OR = 2.58 [1.22-5.47], p = 0.013) and cyclophosphamide (OR = 2.36 [1.05-5.29], p = 0.038). This study demonstrates that ICIs could potentially lead to a wide range of adverse effects in the reproductive system in both males and females.
Determination of anti-mullerian hormone and inhibin b reference ranges according to pubertal stages in children and adolescent girls
(Karger, 2024) Kaynar, Özge; Turan, Hande; Tarçın, Gürkan; Karakaş, Hasan; Evliyaoğlu, Olcay; Turan, Volkan; Bayramoğlu, Elvan
Determination of Anti-Mullerian Hormone and Inhibin B Reference Ranges According to Pubertal Stages in Children and Adolescent Girls
Vasküler travmada kompartman sendromu
(Akademisyen Yayınevi A.Ş., 2024) Doğan, Emre; Yiğit, Görkem
Kalp ve damar cerrahları olarak, kompartman sendromunu (KS) en sık ekstremiteler de tecrübe etmekteyiz. Kompartman sendromunu, fasya ile sarılı olan kas gruplarının bulunduğu bir alanda basıncın artması ile gelişen perfüzyon bozukluğu olarak tanımla yabiliriz (1,2).KS tanısı koymak ve ardından tedavilerine başlamak hayatidir. Erken tanı ve uygun müdahale ile kompartman sendromunun komplikasyonlarından (rabdomyoliz, hiperkalemi, akut böbrek hasarı…) kaçınılabilir.
Maternal health experiences on respectful and adequate care of immigrant women: A prospective multicenter study
(Wiley, 2024) Topçu, Elif Göknur; Terzioğlu, Merve; Okumuş, Zihniye Gonca; Şavklı, Ayşe Özge; Demirkıran, Cansu İrem
Objective: Migration of pregnant women can be challenging. Access to adequate and respectful care may not be possible. We aimed to assess the maternity care that im migrant women receive and their satisfaction with the care they experience. Methods: This multicenter prospective study was conducted in a tertiary public hos pital and a private hospital in Istanbul between April 2023 and July 2023. A face-to face questionnaire was completed in the postpartum department by obstetricians and translators. Results: In total, 267 patients participated in this study. A majority of these patients delivered at the public hospital (75%). Approximately 21% of all deliveries in both hos pitals were with foreign mothers. A majority of the patients (82%) in the public hospi tal said they easily reached midwives, nurses, and an obstetrician, while this number rose to 100% in the private hospital. Patients in the private hospital had a higher average number of obstetrician visits compared to those in the public hospital, which was statistically significant (P< 0.05). Patients in the public hospital were significantly less informed about various maternity topics than those in the private hospital group (P< 0.001 for all topics). Most patients said their ideas and thoughts were taken seri ously by the health care providers (80% and 97% in the public and private hospitals, respectively). Almost all patients recommended giving birth in the same hospital (94% vs. 96%, public and private hospitals, respectively), while around 99% recommended giving birth in Turkey. Conclusion: Immigrant women are overall satisfied with the care they receive in both public and private hospitals. They have easier access to obstetricians in private hospi tals, as well as being more informed on maternal health issues. Clinical efforts should focus on patient education in antenatal care.
Labiaplasty revision surgery with using clitoral hood flap: A case-cohort study
(Springer, 2024) Şahin, Eda Adeviye; Ağlamış, Özgür; Şahin, Hanifi; Ozan Şahin, Elif; Yılmaz Ergani, Seval
Background: The demand for labia minora reduction surgery has increased due to aesthetic preferences and discomfort caused by labial hypertrophy. This study aims to share experiences with labial reconstruction using clitoral hood flaps in patients who underwent aggressive trim labiaplasty. Methods: Twenty-eight patients who had previously undergone only labiaplasty surgery were included in this study. Surgical techniques focused on preserving blood supply and achieving symmetry. Postoperative care included hospitalization, wound care training, and regular follow-up visits. Complications were monitored and managed as needed. Results: All 28 patients, comprising 23 bilateral and 5 unilateral labiaplasty cases, underwent revision surgery using 49 clitoral hood flaps. Complications occurred in 6 cases, including suture dehiscence, flap necrosis, and infection, all of which were effectively managed. All flaps maintained their viability, and high patient satisfaction was reported. Conclusion: Clitoral hood flap reconstruction following aggressive trim labiaplasty is a viable technique with minimal complications and high patient satisfaction. Further multicenter, long-term studies are necessary to validate these findings and improve surgical outcomes. Level of evidence iii: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Yaşlılarda safra kesesi hastalıklarına yaklaşım
(Akademisyen Kitabevi, 2024) As, Abdullah; Kanat, Burhan Hakan; Öndeş, Bahadır
Yaşlılığın ne olduğu ve hangi yaştan itibaren başladığı daima tartışılan bir konu olmuştur. Son yüzyıl içinde, tıp ve teknolojideki gelişmekte paralel olarak insan yaşamının uzadığı bilinen bir gerçektir. Bu durumla birlikte, dünya üzerindeki insan nüfusunun giderek yaslandığı ve yaşlı hastalara cerrahi müdahale gerekliliğinin giderek artmakta olduğu gözlenmektedir. Dünya Sağlık Örgütü verilerine göre 2019 yılı itibari ile 60 yaşını geçen insan popülasyonu 1 milyara yükselmiştir. 2030 yılına kadar bu rakamın 1.4 milyara, 2050 yılı itibariyle ise 2.1 milyara çıkacağı ön görülmektedir.
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.
Comparison of the effects of four laser wavelengths on Medication-Related Osteonecrosis of the Jaw (MRONJ) in a murine model: An in vivo photobiomodulation study
(Ivyspring International Publisher, 2024) Ayhan, Mustafa; Gedik, Betül; Kalelioğlu, Ekrem Emir; Kundakçıoğlu, Abdulsamet; Küçükgergin, Canan; Turgut, Cevat Tuğrul; Kocaelli, Hümeyra; Alatlı, Fatma Canan; İşsever, Halim; Ademoğlu, Evin; Yaltırık, Mehmet
Background: This study aims to investigate the effectiveness of lasers at various wavelengths in treating medication-related osteonecrosis of the jaw (MRONJ) using biochemical, clinical scoring, micro CT analysis, and histopathological methods. The study follows the ARRIVE guidelines to ensure robust and transparent research. Methods: In our study, there were 6 groups, including one SHAM group, one CONTROL group, and four experimental groups, with 8 rats in each individual group. Each rat received antiresorptive drug intraperitoneally for 4 weeks and then had the left second molar in the mandible extracted. All animals were sacrificed at the end of the 12th week. In the experimental groups, lasers at wavelengths of 405nm, 445nm, 660nm, and 808nm were applied to the animals. Parameters such as serum vitamin D levels, bone density and bone volume at the extraction site, new bone formation, dead bone count, inflammatory cell count, and epithelial regeneration were examined. Additionally, clinical scoring was conducted after sacrifice. The laser parameters included power density, area, time, fluence, and mode (continuous wave), and the light was administered using a fiber with a Gaussian profile. Statistical analyses were performed with the NCSS (Number Cruncher Statistical System) 2007 Statistical Software (Utah, USA) package program. The results were evaluated at the p<0.05 significance level. Results: According to the results obtained from our study, new bone formation in all experimental groups was significantly higher than in the SHAM and CONTROL groups. Furthermore, the 660nm and 808nm wavelengths increased serum vitamin D levels significantly. The most successful outcomes were observed in clinical scoring, dead bone count, epithelial cell regeneration, and bone density in the 660nm and 808nm wavelength groups. Conclusions: The combined use of lasers at 660nm and 808nm wavelengths may yield successful results in treating MRONJ.
Komplike olmayan üriner sistem enfeksiyonlarında lokal antibiyotik direncinin çok merkezli taranması: 37 merkezden 1850 hasta
(Ankara Microbiology Society, 2024) Cinislioğlu, Ahmet Emre; Cinislioğlu, Nazan; Öztürk, Metin İshak; Akkaş, Fatih; Aksakallı, Tugay; Atilla, Mustafa Kemal; Atiş, Gökhan; Aydın, Hasan Rıza; Balcı, Uğur; Bayrak, Ömer; Bedir, Selahattin; Biçer, Hüseyin; Çevik, Gökhan; Çift, Ali; Çiftçi, Halil; Coşkun, Burhan; Demirdöğen, Şaban Oğuz; Demirkol, Mehmet Kutlu; Dinçer, Murat; Doğan, Ahmet Emin; Dursun, Murat; Erdemir, Fikret; Erkan, Anıl; Eryıldırım, Bilal; Görür, Sadık; Hızlı, Fatih; Kadıhasanoğlu, Mustafa; Kalkan, Senad; Karabulut, İbrahim; Keskin, Mehmet Zeynel; Kızılay, Fuat; Köse, Osman; Küçük, Eyüp Veli; Odabaş, Öner; Oksay, Taylan; Özbey, Isa; Şefik, Ertuğrul; Sönmez, Mehmet Giray; Tek, Mesut; Tuğlu, Devrim; Tuncay, Ömer Levent; Usta, Mustafa Faruk; Yılmaz, Sercan; Kadıoğlu, Ateş
Bu çalışma, Türkiye’nin yedi farklı coğrafi bölgesinde komplike olmayan üriner sistem enfeksiyonu tanısı olan hastalardan elde edilen ayaktan üriner izolatlara göre en sık izlenen patojenleri tespit etmek ve bu patojenlere karşı kullanılan antibiyotiklerin direnç oranlarının coğrafi bölgelere göre anlamlı farklılık gösterip göstermediğini belirlemek amacıyla yapılmıştır. Mart 2021 ile Ağustos 2022 arasında, Türkiye genelindeki 37 farklı merkezde yapılan tetkikler sonucunda komplike olmayan üriner sistem enfeksiyonu tanısı koyulan ve pozitif idrar kültürleri olan 18 ile 65 yaş arası hastalar çalışmaya dahil edilmiştir. Araştırmaya katılan merkezler, idrar kültürlerinin verilerinin standardizasyonunu sağlamak için mikrobiyoloji laboratuvarlarında Avrupa Antimikrobiyal Duyarlılık Test Komitesi tarafından disk difüzyon yöntemini kullanan merkezlerden seçilmiştir. Bu çalışmaya, dahil edilme kriterlerine uyan toplam 1850 hasta dahil edilmiştir. Escherichia coli izolatlarının antibiyotik direnç oranlarının dağılımının analizi, ampisilin, fosfomisin ve nitrofurantoin dirençlerinde coğrafi bölgelere göre istatistiksel açıdan anlamlı farklılıkların olduğunu saptamıştır (sırasıyla p< 0.05, p< 0.05, p< 0.05). Güneydoğu Anadolu Bölgesi fosfomisin ve trimetoprimsülfametoksazol direncinin en yüksek olduğu bölge olarak tespit edilmiştir (sırasıyla; %27.4 ve %35.3). Bunun yanı sıra nitrofurantoin direncinin en yüksek olduğu bölge %35.7 oranıyla Doğu Anadolu Bölgesi ve siprofloksasin direncinin en yüksek olduğu bölge %51 oranıyla İç Anadolu Bölgesi olarak belirlenmiştir. Çalışma, komplike olmayan üriner sistem enfeksiyonlarının tedavisinde kullanılan antibiyotiklere direncin coğrafi bölgelere göre farklılık gösterdiğini ortaya koymuştur. Bu kapsamlı, ulusal prospektif araştırmanın, komplike olmayan üriner sistem enfeksiyonu için ampirik tedavi planlayan klinisyenlere değerli öngörüler sağlayacağı düşünülmektedir.
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.
Trends and regional differences for fertility 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.
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.
Deep brain stimulation with double targeting of the VIM and PSA for the treatment of rare tremor syndromes
(Karger, 2024) Yılmaz, Atilla; Eray, Halit Anıl; Çakır, Murtaza; Ceylan, Mustafa; Blomstedt, Patric
Introduction: In tremor syndromes, pharmacological therapy is the primary treatment, but deep brain stimulation (DBS) is used when it is insufficient. We explore the use of DBS, focusing on the globus pallidus internus for dystonia and the ventral intermediate nucleus (VIM) for tremor conditions. We introduce the posterior subthalamic area (PSA) as a potential target, suggesting its efficacy in tremor reduction, particularly in rare tremor syndromes. We aim to evaluate the efficacy and safety of double targeting the VIM and PSA in rare tremor conditions, highlighting the limited existing data on this. Methods: Between 2019 and 2023, 22 patients with rare tremor syndromes were treated with bilateral DBS of the VIM and PSA. This case series consisted of 7 isolated head tremor, 1 hepatic encephalopathic tremor due to Abernethy syndrome, 2 voice tremor, 4 dystonic tremor, and 8 Holmes tremor (2 multiple sclerosis, 2 cerebellar insult, and 4 posttraumatic) patients. Patients' preoperative and 12-month postoperative tremor scores were compared, and the optimum VIM and PSA stimulation areas were investigated. Results: There was a significant reduction in the mean TRS score from 3.70 (±0.57) to 0.45 (±0.68) after 12 months of surgery. Specific outcomes for different indications were observed: for head tremor, 6 of 7 patients showed a reduction in TRS scores to 0 points; the vocal tremor patients demonstrated improvement; this change was not statistically significant, which is likely to be due to the low number of patients in this subgroup; the dystonic tremor patients showed either complete tremor abolition or a reduction in TRS scores; the Holmes tremor patients showed an 80% reduction in TRS scores; and the hepatic encephalopathy tremor and Abernethy syndrome patients showed a 75% improvement in TRS scores. The stimulation parameters converged on the VIM and dorsal PSA. Complications included the need for electrode repositioning, infections requiring electrode removal and re-implantation, dysarthria, and stimulation-induced ataxia, which was resolved by adjusting the stimulation parameters. Discussion: The literature on DBS for rare tremors is limited. Double targeting of the VIM and PSA appears to produce promising improvements on the outcomes reported in the existing literature on VIM-only DBS. The proximity of the VIM and PSA allows for flexible electrode placement, contributing to the potential success of the dual-target approach. We also discuss the theoretical advantages of targeting the PSA based on the distribution of tremor circuits, emphasizing the need for further research and electrophysiological studies.

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