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    Association between ? arrestin 2 and filamin A gene variations with medical treatment response in acromegaly patients
    (EDIZIONI MINERVA MEDICA, 2021) Akdemir, Ayşe S.; Metin Armağan, Derya; Polat Korkmaz, Özge; Özkaya, Hande M.; Kadıoğlu, Pınar; Gazioğlu, Nurperi
    Background: Acromegaly is a disease that occurs as a result of excessive growth hormone caused by pituitary adenomas. Some acromegaly patients show resistance to somatostatin analog (SSA) treatment. Filamin-A (FLNA) and ?-arrestins are thought to play a role in the response to SSAs. We aimed to investigate the relationship between FLNA-rs782079491 and ?-arrestin-2-rs34230287 single-nucleotide polymorphisms and disease risk, as well as treatment response in patients with acromegaly in the Turkish population. Methods: The genotypes of 110 acromegaly patients and 99 controls were determined by realtime PCR. The genotype distributions were compared with clinical data on the disease. Results: There was no association between the ?-arrestin-2 gene polymorphism and the response to SSA treatment in acromegaly patients. For responder patients to SSAs, the ?-arrestin-2-rs34230287 CT+TT genotype was associated with higher microadenoma as compared with the CC genotype (p = 0.017). The FLNA polymorphism was not observed in the study group. Conclusions: We showed that there was no association between the polymorphic genotypes of FLNA and ?-arrestin-2 genes with acromegaly disease and SSAs response in the Turkish population. However, there was a relationship between ?-arrestin-2 and some of the clinical characteristics. Furthermore, the CC genotype and the C allele are risk factors associated with tumor growth rate in acromegaly patients.
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    Gender differences in work-life balance of European neurosurgeons
    (Elsevier Ltd., 2022) Lambrianou, Xanthoula; Tzerefos,Christos; Janssen, Insa K; Mihaylova, Stiliana; Aydın,Ayşegül Esen; Al-Ahmad, Selma; Broekman, Marike Ld; Gazioğlu, Nurperi; Duran, Silvia Hernandez; Ivan, Daniela Luminita; Karampouga, Maria; Magnadottir, Hulda B; Pajaj ,Ermira; Rodríguez-Hernández, Ana; Rosseau, Gail; Salokorpi, Niina; Tsianaka, Eleni; Vayssiere, Pia; Murphy, Mary; Tasiou, Anastasia
    Gender differences in work-life balance of European neurosurgeons
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    Machine learning as a clinical decision support tool for patients with acromegaly
    (SPRINGER, 2022) Sulu, Cem; Bektaş, Ayyüce Begüm; Şahin, Serdar; Durcan, Emre; Kara, Zehra; Demir, Ahmet Numan; Özkaya, Hande Mefkure; Tanrıöver, Necmettin; Çomunoğlu, Nil; Kızılkılıç, Osman; Gazioğlu, Nurperi; Gönen, Mehmet; Kadıoğlu, Pınar
    Objective To develop machine learning (ML) models that predict postoperative remission, remission at last visit, and resistance to somatostatin receptor ligands (SRL) in patients with acromegaly and to determine the clinical features associated with the prognosis. Methods We studied outcomes using the area under the receiver operating characteristics (AUROC) values, which were reported as the performance metric. To determine the importance of each feature and easy interpretation, Shapley Additive explanations (SHAP) values, which help explain the outputs of ML models, are used. Results One-hundred fifty-two patients with acromegaly were included in the final analysis. The mean AUROC values resulting from 100 independent replications were 0.728 for postoperative 3 months remission status classification, 0.879 for remission at last visit classification, and 0.753 for SRL resistance status classification. Extreme gradient boosting model demonstrated that preoperative growth hormone (GH) level, age at operation, and preoperative tumor size were the most important predictors for early remission; resistance to SRL and preoperative tumor size represented the most important predictors of remission at last visit, and postoperative 3-month insulin-like growth factor 1 (IGF1) and GH levels (random and nadir) together with the sparsely granulated somatotroph adenoma subtype served as the most important predictors of SRL resistance. Conclusions ML models may serve as valuable tools in the prediction of remission and SRL resistance.
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    Should we take precautions to avoid respiratory compromise while delaying CPAP resumption following transsfenoidal surgery? An alternative approach in a patient with severe obstructive sleep apnea: case report
    (Springer, 2022) Yenigün, Yılmaz; Özonur, Anıl; Tuğrul, Kamil Mehmet; Özbek, Uğur; Gazioğlu, Nurperi
    Background We describe a patient with severe obstructive sleep apnea scheduled for transsfenoidal surgery. Early postoperative use of continuous positive airway pressure (CPAP) was considered unsafe because increased risk of intracranial complications. Methods Aiming to bypass the upper airway obstruction and thus avoid CPAP, a 6-mm nasopharyngeal airway was introduced by the surgical team under endoscopic vision. In the postoperative period and during follow-up, patient and his family did not complain about apnea/hypopnea episodes and nasopharyngeal airway was tolerated comfortably. Conclusion We recommend this technique as an alternative in obstructive sleep apnea patients undergoing transsfenoidal surgery.