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Laparoscopic Totally Extraperitoneal Inguinal Hernia Repair under Combined Spinal Epidural Anesthesia Versus General Anesthesia
(Lippincott Williams and Wilkins, 2024) Dönmez, Turgut; Tülübaş, Evrim Kucur; Bostancı, İpek
Background: Inguinal hernia repair is one of the most frequently used elective surgical operations in the world. General anesthesia (GA) has risks and routine postoperative complications, such as nausea, vomiting, throat irritation, and postoperative pain. Regional anesthesia (RA) has many advantages over GA, such as faster recovery, less postoperative pain, nausea, and vomiting, and less hemodynamic compromise. We aimed to investigate the efficacy and safety of combined spinal and epidural anesthesia (CSEA) in preventing shoulder pain in patients undergoing totally extraperitoneal herniorrhaphy (TEP). Materials and Methods: The files of patients who had undergone the TEP method under GA and CSEA due to inguinal hernia between April 2020 and November 2021 at the Bakirköy Dr. Sadi Konuk Training and Research Hospital were reviewed retrospectively. Results: A total of 81 patients were included in the study. The number of patients operated on GA (group 1) was 40, and the number of patients operated under CSEA (group 2) was 41. There was no significant difference in the demographic characteristics of the patients. The surgical time was 42.9 and 42.5 minutes in groups 1 and 2, respectively (P=0.970). The mean operative time was recorded as 60.1 and 80.2 minutes in groups 1 and 2, respectively, and it was statistically significantly shorter in group 1 (P<0.001). A peritoneal tear was seen in 18 patients (43.90%) in the GA group and 16 patients (40%) in the CSEA group, but no significant difference was found between the groups (P=0.823). Mild shoulder pain that did not require intervention was observed in 1 patient (2.5%) in the CSEA group. In group 2, the VAS scores at all times and the need for postoperative analgesia were statistically significantly lower (P<0.001). In terms of anesthesia complications, headache was not observed in group 1, while it was seen in 6 (15%) patients in group 2 (P=0.012) Conclusions: In laparoscopic TEP surgeries, CSEA may be an alternative anesthesia method to GA anesthesia due to the low VAS score, less need for analgesia, and fewer postoperative pulmonary complications. © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Effects of internal iliac artery ligation on stress and urge incontinence: a retrospective evaluation
(Springer, 2024) Akay, Emrullah; Gül, Alime Dilayda Uzun; Mutlu, Enes Burak; Nalbant, Ayşe Ceren; Irmak, Kübra; Ersan, Fırat
Introduction: Does bilateral internal iliac artery ligation (BIIAL), a fundamental intervention in the treatment of postpartum hemorrhage, increase the risk of urinary incontinence (UI)? This study aims to shed light on the effects of BIIAL on bladder perfusion and urinary system integrity, thereby elucidating urinary function disorders following pelvic surgery. Methods: Demographic and medical data were collected from a total of 192 female patients, with and without the application of BIIAL. Urinary incontinence conditions were assessed using the Questionnaire for Urinary Incontinence Diagnosis (QUID) test. The data collection process was conducted according to ethical standards, and the results were analyzed to determine the types of incontinence. Results: In the group that underwent BIIAL, the number of pregnancies and births was statistically higher compared to the control group. A significant effect of BIIAL was seen in cases of urge urinary incontinence (UUI), while no meaningful impact was detected on stress urinary incontinence (SUI). After the BIIAL procedure, an increase in the rate of urinary leakage was seen in certain cases. Conclusion: Bilateral internal iliac artery ligation has proven to be a safe and effective intervention in the management of postpartum hemorrhage. The findings suggest a potential impact of BIIAL on UUI but not on SUI. Comprehensive and long-term prospective studies are needed to further investigate the effects of BIIAL on pelvic blood flow and bladder functions.
Left Atrial Coupling Index Predicts Heart Failure in Patients with End Stage Renal Disease
(Multidisciplinary Digital Publishing Institute (MDPI), 2024) Avcı Demir, Fulya; Bingöl, Gülsüm; Uçar, Mustafa; Özden, Özge; Özmen, Emre; Tüner, Haşim; Nasifov, Muharrem; Ünlü, Serkan
Background and Objectives: We aimed to ascertain the predictive power of the left atrial coupling index (LACI) in patients with end stage renal disease (ESRD) for heart failure with preserved ejection fraction (HFpEF). Materials and Methods: This is a retrospective study including 100 subjects between 18 and 65 years of age with ESRD and not on dialysis treatment. Patients were divided into groups with and without HFpEF. The LACI was defined as the ratio of the left atrial volume index (LAVI) to the a′ wave in tissue Doppler imaging (TDI). Statistical analyses were performed, including univariate and multivariate regression analyses. Results: The mean age of the participants was 47 ± 13.3 years. Individuals with HFpEF exhibited a higher LACI. Univariate and multivariate regression analyses demonstrated that the predictive capacity of the LACI for HFpEF was considerably higher than that of the LAVI and other echocardiographic parameters. Conclusions: Higher LACI levels were consistently related to the presence of HFpEF in ESRD patients. The LACI can be easily obtained in daily practice using conventional Doppler echocardiographic measurements during left atrial functional assessments. © 2024 by the authors.
Comparing wound healing and infection risk between early and late dressing removal after abdominal hysterectomy
(Springer nature, 2024) Akay, Emrullah; Irmak, Kübra; İncebıyık, Ravza; Sağlam, Fatma; Mutlu, Enes Burak
Introduction: This study evaluates the effects of dressing timing after abdominal hysterectomy on wound healing and infection risk. It highlights the potential for early dressing removal to accelerate healing and underscores the need for clear guidelines in wound care that align with the ERAS (Enhanced Recovery After Surgery) protocol. Methods: Using a prospective, randomized, double -blind design, this research was carried out at Ba & scedil;ak & scedil;ehir & Ccedil;am and Sakura City Hospital, Istanbul, Turkey. The objective was to investigate the impact of early dressing removal on wound healing and infection rates after elective abdominal hysterectomy. Results: Demographic parameters such as age, height, weight, and body mass index (BMI) were found to have no significant impact on wound healing. Patients whose dressings were removed early had shorter hospital stays. No significant differences were observed between the two groups in terms of wound complications and hospital readmission rates. Conclusions: Early dressing removal after abdominal hysterectomy was observed to positively affect wound healing and facilitate earlier hospital discharge. However, no significant differences were found in hospital readmission rates between the two groups. These findings suggest that the dressing timing can be more flexible within the ERAS protocol and does not have a decisive impact on postoperative complications.
Flexible posterior vertebral tethering for the management of Scheuermann's kyphosis: correction by using growth modulation-clinical and radiographic outcomes of the first 10 patients with at least 3 years of follow-up
(Springer, 2024) Aydoğan, Mehmet; Pehlivanoğlu, Tuna; Erdağ, Yiğit; Aktürk, Umut Doğu; Akar, Abdulhalim
PurposeThe present prospective cohort study was intended to present the minimum 3 years' results of flexible posterior vertebral tethering (PVT) applied to 10 skeletally immature patients with SK to question, if it could be an alternative to fusion.MethodsTen skeletally immature patients with radiographically confirmed SK, who had flexible (minimum 35%) kyphotic curves (T2-T12), were included. A decision to proceed with PVT was based on curve progression within the brace, and/or persistent pain, and/or unacceptable cosmetic concerns of the patient/caregivers, and/or non-compliance within the brace.ResultsPatients had an average age of 13.1 (range 11-15) and an average follow-up duration of 47.6 months (range 36-60). Posterior vertebral tethering (PVT) was undertaken to all patients by utilizing Wiltse approach and placing monoaxial pedicle screws intermittently. At the final follow-up: mean pre-operative thoracic kyphosis and lumbar lordosis improved from 73.6 degrees-45.7 degrees to 34.7 degrees-32.1 degrees. Mean sagittal vertical axis, vertebral wedge angle and total SRS-22 scores improved significantly. A fulcrum lateral X-ray obtained at the latest follow-up, showed that the tethered levels remained mobile.ConclusionThis study, for the first time in the literature, concluded, that as a result of growth modulation applied to skeletally immature patients with SK, flexible PVT was detected to yield gradual correction of the thoracic kyphosis by reverting the pathological vertebral wedging process, while keeping the mobility of the tethered segments in addition to successful clinical-functional results. The successful results of the present study answered the role of the PVT as a viable alternative to fusion in skeletally immature patients with SK.Level of evidenceIV.
Percutaneous delivery of oncogel for targeted liver tumor ablation and controlled release of therapeutics
(John wiley and sons inc, 2024) Albadawi, Hassan; Zhang, Zefu; Keum, Hyeongseop; Çevik, Enes; Nagalo, Bolni M.; Gündüz, Şeyda; Kita, Hirohito; Oklu, Rahmi
Advanced-stage liver cancers are associated with poor prognosis and have limited treatment options, often leading the patient to hospice care. Percutaneous intratumoral injection of anticancer agents has emerged as a potential alternative to systemic therapy to overcome tumor barriers, increase bioavailability, potentiate immunotherapy, and avoid systemic toxicity, which advanced-stage cancer patients cannot tolerate. Here, an injectable OncoGel (OG) comprising of a nanocomposite hydrogel loaded with an ionic liquid (IL) is developed for achieving a predictable and uniform tumor ablation and long-term slow release of anticancer agents into the ablation zone. Rigorous mechanical, physiochemical, drug release, cytotoxicity experiments, and ex vivo human tissue testing identify an injectable version of the OG with bactericidal properties against highly resistant bacteria. Intratumoral injection of OG loaded with Nivolumab (Nivo) and doxorubicin (Dox) into highly malignant tumor models in mice, rats, and rabbits demonstrates enhanced survival and tumor regression associated with robust tissue ablation and drug distribution throughout the tumor. Mass cytometry and proteomic studies in a mouse model of colorectal cancer that often metastasizes to the liver indicate an enhanced anticancer immune response following the intratumoral injection of OG. OG may augment immunotherapy and potentially improve outcomes in liver cancer patients.
The Association between Aminoglycoside Exposure and Ototoxicity in Children with Cystic Fibrosis
(S. Karger AG, 2025) Yılmaz Yeğit, Cansu; Ergenekon, Pınar; Yanaz, Mürüvvet; Öztürk Akar, Nezafet; Toktaş Yavuz, Fatma; Molla Kafi, Hale; Çollak, Abdülhamit; Bal, Nilüfer; Gedik Toker, Özge; Meral, Özge; Ataş, Ahmet; Çetin Kara, Halide; Karasu, Nesibe
Introduction: Pulmonary exacerbations increase the requirement of aminoglycoside (AG) antibiotics in people with cystic fibrosis (pwCF). Several studies have shown that AGs have a cumulative effect on ototoxicity. We aimed to investigate the relationship between AG exposure and ototoxicity by using 3 different methods in patients with CF. Materials/Methods: The multicenter study included 121 pwCF aged between 5 and 18 years with a history of parenteral AG exposure. Standard pure-tone audiometry, extended high-frequency pure-tone audiometry (EHF-PTA), and distortion-product otoacoustic emissions (DPOAE) tests were performed. Mitochondrial mutation analysis for m1555G>A was performed in 61 patients. Results: Median age was 12.85 years and 52.1% (n = 63) were male. 18.2% (n = 22) of the patients had received parenteral AGs more than 5 courses/lifetime. Ototoxicity was detected in at least one of the tests in 56.2% (n = 68) of the patients. Only 10.7% (n = 13) of the patients had reported a symptom indicating ototoxicity. 30.3% (n = 30) of the patients had ototoxicity in the low exposure group, while it was 45.5% (n = 10) in the high exposure group according to EHF-PTA (p > 0.05). Median number of parenteral amikacin courses was significantly higher in the ototoxic group (2 [1.25-5.75] vs. 2 [1-3]; p = 0.045). No m1555A>G mutation was detected in 61 patients who screened for mitochondrial mutation analysis. Conclusion: As AG ototoxicity occurs primarily at high frequencies, EHF-PTA is important in early detecting ototoxicity. EHF-PTA and DPOAE detected ototoxicity in some patients with normal PTA results. All pwCF with a history of AG exposure should be evaluated for hearing loss since symptoms may only be noticed in the late period. © 2024 S. Karger AG, Basel.
Omental calcified fibrous tumor with symptoms after COVID-19 infection
(Oxford University Press, 2022) Topçu, Feyza Sönmez; İpek, Turgut; Kapan, Metin; Yılmaz, Serpil; Ensaroǧlu, Fatih
Calcified fibrous tumor (CFT) is a rare benign tumor of mesenchymal origin. Between 1988 and 2019, a total of 272 CFT cases were reported. CFTs can be seen in all anatomical regions with soft tissue. Histologically, mononuclear inflammatory infiltrates and the presence of psammomatous calcification in dense hyalinized collagen are characteristic features of the tumor. Currently, if the tumor is located in only one focus, surgical removal is recommended. Although CFT is a benign tumor, it may cause complications. Diagnosis is often difficult due to the confusion of tumor findings with many diseases. We present a patient with CFT, whose omental lesions were detected on abdominal computed tomography, and the diagnosis was confirmed by histopathological examination. © 2022 Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved.
Gender Disparity in Authorship in High-Impact Obstetrics and Gynecology Journals over Twenty Years
(Routledge, 2025) Yüksel Ozgor, Bahar; Ergül, Aslıhan; Berkay, Ezgi Gizem
In the present study, we evaluate the proportion of women authorship in the field of obstetrics and gynecology research by assessing five prominent journals spanning 2001–2021, analyzing article types, study types, sub-specificities, and regions. Our outcomes demonstrate a significant increase in women’s authorship over time, highlighting progress in promoting gender equality. However, the rate of first and most senior women authors remains relatively unchanged. Notably, we determine a rise in the proportion of first authors who are women in experimental studies but not in studies that require surgical practice. This study sheds light on the challenges faced by women in scientific pursuits. Our study suggests that systemic barriers, prejudices, and inequalities likely continue to hinder gender equality in our discipline. By emphasising the continuance of this problem, we intend to encourage collective awareness and action. Together, we can transcend gender disparities and create a space where every voice, regardless of gender, can flourish. Through our study, we hope to inspire future generations and ignite change within the field of obstetrics and gynecology. By valuing and amplifying diverse perspectives, we can create a future where gender equality is the norm, enabling scientific discovery to reach new heights. © 2025 Informa UK Limited, trading as Taylor & Francis Group.
Are YouTube Videos Useful in Robot-assisted Segmentectomy Education?
(Journal Citation Reports, 2025) Coşgun, Tuğba; Doğruyol, Talha; Tezel, Çağatay
Background Segmentectomy operation became a preferable operation for small lesions due to the importance of saving lung parenchyma. Using robotic technology has too many advantages for segmentectomy operations. Web sites such as YouTube have become educational tools for surgical trainees. The aim of our study is to analyze YouTube videos for accurate and up-to-date information about robotic segmentectomy operations. Methods The videos on www.youtube.com , which were reached on July 11, 2024, by using the keywords "robot segmentectomy" and "robotic segmentectomy lung," were evaluated in this research. The videos were evaluated by using the Journal of the American Medical Association (JAMA) scoring system, Critical View of safety (CVS), and LAParoscopic surgery Video Educational GuidelineS (LAP-VEGaS). Results Eighty-one videos were included. Almost half of the videos ( n = 42) were affiliated with university hospitals. Preoperative imaging was seen in 49% of all videos; however, the rates were 32% and 20.9% for patients' demographics and preoperative assessment information, respectively. Only 29.6% of the videos presented the placement of trocars during the presentation. Conclusion It has become possible to record high-quality videos easily with developing technology. However, our results showed that many of the videos do not include the parameters especially related to education. Our findings suggest that those videos are inadequate for trainees.
ROLE OF THE DUCTUS THORACICUS IN PULMONARY FAT EMBOLISM AFTER SUBARACHNOID HAEMORRHAGE: A PRELIMINARY EXPERIMENTAL STUDY
(Istanbul University Press, 2025) Kına, Hakan; Elveren, Muhammet
Objective: Subarachnoid haemorrhage is a multisystemic disease due to its effects on the autonomic nervous system. Pulmonary tissues may be affected due to its effects on the intestinal system, lipid metabolism, and ductus thoracicus in subarachnoid haemorrhage. This study demonstrate the pathophysiology of pulmonary fat embolism after sympathetic activation of the ductus thoracicus with lipid absorption disorders after subarachnoid haemorrhage. Material and Methods: In the study, 24 male rabbits were used, of which five were selected as the control group (GI) and five as the SHAM group (GII). The SHAM group was injected with a 0.7 mL isotonic solution into the cisterna magna. The study group (GIII) was injected with 0.7 mL autologous blood into the cisterna magna. The lymphatic vessels in the middle sections of the duodenum, the thoracic duct portions opening into the jugular vein, and the terminal branches of the pulmonary arteries were examined and counted. Results: The thoracic duct vasospasm index (VSI) values and numbers of branches occluded by fat particles in the pulmonary arteries were: 1.65±0.22/3.21±0.54 in GI, 1.97±0.34/7.3±2.4 in GII, and 2.54±0.56/14.53±14.53 in GIII. In the six subjects with severe thoracic duct spasm in GIII, the number of pulmonary arteries occluded with chylomicrons was higher (p>0.00001). P values among groups were: p > 0.05 in GI/GII; p<0.005 in GII/GIII and p<0.0001 in GI/GIII. Conclusion: This is the first experimental study conducted on animals investigating the lipid metabolism disorder associated with subarachnoid haemorrhage affecting the cervical ganglia, thoracic duct spasm, and pulmonary fat embolism. © 2025 Istanbul University Press. All rights reserved.
The effect of the distance between mesh and the urethra on sexual function in patients who underwent transobturator tape
(Galenos publishing house, 2024) Şahin, Fatih; Doğan, Ozan
Objective: To evaluate the effect of mesh-urethra distance on sexual function in continent patients who underwent transobturator tape (TOT) surgery due to isolated stress urinary incontinence (SUI). Material and Methods: Continent patients who had undergone TOT surgery for SUI were eligible. Objective treatment for SUI was defined as the absence of urine leakage during a stress test. Translabial perineal ultrasound was performed six months after surgery. The successful surgical group was split into two subgroups based on the distance from the posterior of the urethra at the bladder neck to the nearest proximal edge of the tape: <5 mm and >5 mm. In addition to these, band percentile, the descent of bladder neck and urethra length measured by perineal ultrasound, pubo-urethral distance, urethral thickness, detrusor thickness, cystocele descent, rectal descent, and uterine descent were evaluated. Preoperative and postoperative results of the standardized and internationally valid incontinence questionnaires Incontinence Questionnaire Urinary Incontinence Short Form and Female Sexual Function Index (FSFI) were compared between groups. Results: Eighty-two patients were included. The postoperative FSFI scores for the >5 mm group were significantly lower than those of the <5 mm group, including the postoperative FSFI average, all subscales except lubrication, and average change scores due to the operation (p<0.001). There was no statistically significant relationship between the percentile occupied and postoperative FSFI score (p=0.553), and the FSFI preoperative-postoperative difference was not significant (p=0.905). Conclusion: Sexual functions are more affected in patients with a mesh-urethra distance >5 mm as measured by perineal ultrasound.
The effect of uric acid and albumin ratio in undergoing lower extremity endovascular interventions for peripheral arterial disease related contrast induced nephropathy
(Elsevier inc., 2024) Demirci, Gökhan; Şahin, Ahmet Anıl; Altunova, Mehmet; Aktemur, Tuğba; Atmaca, Sezgin; Yalçın, Ahmet Arif
Background: Among patients undergoing percutaneous vascular intervention, contrast- induced nephropathy (CIN) is associated with increased morbidity and mortality. Serum uric acid/albumin ratio (UAR) has emerged as a new marker associated with poor cardiovascular outcomes. We aimed to evaluate the relationship between UAR and CIN occurrence in patients treated for peripheral artery disease. Methods: Patients underwent percutaneous intervention due to peripheral artery disease were enrolled. The primary endpoint was development of contrast related nephropathy. Patients were divided into 2 groups according to the CIN occurrence. Results: A total of 663 patients were enrolled and mean age was 62 +/- 10 years. After the intervention, 45 patients had CIN and 618 patients did not have CIN. Logistic regression analysis was performed to define the parameters of CIN. Male gender, diabetes, UAR, contrast volume, presence of coronary artery disease, and C-reactive protein levels were found significant in univariate analysis. However, only UAR was found significant in multivariate analysis (odds ratio 95% confidence interval: 3.426 (1.059-11.079), (P 1 / 4 0.040)).Therefore, it is the only independent predictor for occurrence of CIN. Conclusions: UAR is a reliable scoring system, which predicts CIN in such patient group. This score is not only cost-effective also simple, which can be easily applied into the clinical practice.
Diagnostic Role of Hysteroscopy In Women With Abnormal Uterine Bleeding: A Single-Center Retrospective Study
(Yüzüncü Yıl Üniversitesi Tıp Fakültesi, 2025) Günkaya, Samet Osman; Tekelioğlu, Meltem; Karataş, Suat; Şahin, Fatih; Keskin, İlkhan; Bestel, Melih; Tuğ, Niyazi
Hysteroscopy is a minimally invasive technique that has advantages over blind curettage, such as direct visualization of the intrauterine cavity, biopsy of the suspicious area, and simultaneous treatment of benign intracavitary lesions. The stud y aims to evaluate the diagnostic role of hysteroscopy in endometrial and focal intracavitary lesions. This retrospective study was conducted in the department of obstetrics and gynecology of a tertiary center between January 2018 and July 2022. Diagnostic hysteroscopy was performed on women with abnormal uterine bleeding, and lesions seen during hysteroscopy were noted and excised using a resectoscope. Uterine sampling with blind curettage was applied to all patients. The resected lesions and uterus samples were evaluated histopathologically. Diagnostic accuracy of hysteroscopy was higher than 90% in each group classified according to morphology of endometrium as normal, atrophic and hyperplastic. Sensitivity, specificity and diagnostic accuracy were higher than 90% for focal intracavitary pathologies. Sensitivity for endometrial hyperplasia and cancer were 80% and 50%, respectively. Hysteroscopy is exceedingly viable for distinguishing intracavitary pathologies such as polyps, myomas and foreign bodies in ladies with abnormal uterine bleeding. However, for the diagnosis of endometrial hyperplasia and cancer, a hysteroscopy-guided biopsy with uterine curettage is needed to be combined with hysteroscopy. © 2025, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
The relationship between frontal QRS-T angle and vitamin d deficiency
(MDPI, 2024) Demir, Fulya Avcı; Bingöl, Gülsüm; Ersoy, İbrahim; Arslan, Akif; Ersoy, Pınar; Demir, Meltem; Ünlü, Serkan
Background and Objectives: A deficiency in serum 25-hydroxyvitamin D levels is associated with a number of cardiovascular situations, such as high blood pressure, heart failure, atherosclerotic heart disease, and peripheral artery disease. The frontal QRS-T angle has recently been proposed as a marker of ventricular repolarization. A wider frontal QRS-T angle has been positively correlated with adverse cardiac events. The objective of our study was to examine the association between serum 25-hydroxyvitamin D level and the frontal QRS-T angle. Materials and Methods: A total of 173 consecutive patients aged 18-60 years undergoing routine cardiology check-up evaluation, and not receiving concurrent vitamin D treatment were included in the study. Patients were classified in three groups, depending on their vitamin D levels, and categorized as follows: Group 1-deficient (<20 ng/mL), Group 2-insufficient (20-29 ng/mL), or Group 3-optimal (>= 30 ng/mL). The frontal QRS-T angle was determined using the automated reports generated by the electrocardiography machine. Results: The average age of participants was 45.8 (+/- 12.2) years, and 55.5% of participants were female (p < 0.001). Individuals with low vitamin D concentrations exhibited a wider frontal QRS-T angle. It was determined that vitamin D level is an independent predictive factor for the frontal QRS-T angle. Conclusions: As the levels of 25-hydroxyvitamin D decrease, repolarization time assessed by frontal QRS-T angle is widened. Our findings indicate that lower concentrations of vitamin D may increase the susceptibility to ventricular arrhythmia.
A single center study of the efficacy and safety of Pro-Glide used for closure in thoracic endovascular aortic repair in patients with previous groin intervention
(SAGE Publications Ltd, 2025) Gülmez, Recep; Altunova, Mehmet; Şahin, Ahmet Anıl; Çelik, Ömer
Background: This study aimed to evaluate the efficacy and safety of Pro-Glide, a suture-mediated vascular closure device, regarding technical success and complications in patients who had undergone aortic intervention and had previous groin intervention (PGI). Methods: One hundred and thirty-five patients who underwent percutaneous thoracic endovascular aortic repair via the femoral artery and were closed with the Pro-Glide device were analyzed retrospectively. PGI was defined as a history of open surgical access to the femoral artery or wide sheath (>18 F) placement due to endovascular or valvular intervention. The patients were divided into two groups 38 cases with PGI and 97 cases without PGI. Results: The overall success rate of closure of the femoral artery with Pro-Glide was not statistically significant between the two groups (93.8% vs 92.1%, p =.711). Sheath sizes were compared between the groups and PGI (+) group had significantly higher sheath sizes compared to PGI (−) group (24.3 ± 1.1 F vs 23.8 ± 1.0 F, p =.011). Three patients in the PGI (+) group and six patients in the PGI (−) group experienced technical failure of the percutaneous femoral approach. Femoral complications were seen after the procedures in four patients in the PGI (+) group and four in the PGI (−) group. The PGI (+) group had a higher complication rate when compared to the PGI (−) group; however, this was not statistically significant (p =.181). Conclusion: The present study was conducted on a significantly larger sample compared to previous studies and the findings suggest that the Pro-Glide vascular closure device is a safe option for patients with a history of PGI and may not be considered as a contraindication. © The Author(s) 2024.
Wedge Osteectomy of Bony Cap in Rhinoplasty: Minor Nasal Bone Hump Reduction
(Wolters Kluwer Medknow Publications, 2024) Çöloğlu, Harun; Eyüboğlu, Atilla Adnan
Background: Hump reduction with traditional ostectomy is an invasive procedure performed in aesthetic rhinoplasty. Natural and flawless nasal dorsum can be obtained with wedge ostectomy (WO) technique. Objective: The objective of this study is to describe the nasal dorsum WO technique and examine its effectiveness in correcting nasal dorsum with absent and minor humps in patients undergoing aesthetic rhinoplasty. Materials and Methods: Senior author performed 488 rhinoplasty and septorhinoplasty operations from April 2009 to April 2021. After exclusion of major hump patients, the remaining 312 patients had a secondary evaluation for suitability for wedge ostectomy. After secondary examination, 87 patients, including 19 with absent humps (0 mm) and 68 with small humps (1-3 mm) were operated. Results: Nasal bone hump reduction with WO has proven satisfactory results in majority of patients, minimal revision in done in five patients but no complications were occurred related to this method. Conclusions: Nasal dorsum WO provides lesser invasive approach to bony hump reduction in selected patients, ensuring bone cortex continuity in nasal dorsum. It decreases possible dorsal nasal irregularities associated with conventional coronal plane ostectomies. At the same time, it provides a natural and anatomically accurate nasal dorsum. © 2024 Annals of African Medicine.
A post-international gastrointestinal cancers conference (IGICC) position statements '
(Dove medical press, 2024) Yalçın, Suayib; Laçin, Şahin; Kaseb, Ahmed Omar; Peynircioğlu, Bora; Cantaşdemir, Murat; Çil, Barbaros Erhan; Hürmüz, Pervin; Dorul, Ahmet Bülent; Bozkurt, Murat Fani; Abalı, Hüseyin; Akhan, Okan; Şimşek, Halis; Şahin, Berksoy; Aykan, Nuri Faruk; Yücel, İdris; Tellioğlu, Gürkan; Selçukbiricik, Fatih; Philip, Philip
Hepatocellular carcinoma (HCC), the most prevalent liver tumor, is usually linked with chronic liver diseases, particularly cirrhosis. As per the 2020 statistics, this cancer ranks 6th in the list of most common cancers worldwide and is the third primary source of cancer-related deaths. Asia holds the record for the highest occurrence of HCC. HCC is found three times more frequently in men than in women. The primary risk factors for HCC include chronic viral infections, excessive alcohol intake, steatotic liver disease conditions, as well as genetic and family predispositions. Roughly 40-50% of patients are identified in the late stages of the disease. Recently, there have been significant advancements in the treatment methods for advanced HCC. The selection of treatment for HCC hinges on the stage of the disease and the patient's medical status. Factors such as pre-existing liver conditions, etiology, portal hypertension, and portal vein thrombosis need critical evaluation, monitoring, and appropriate treatment. Depending on the patient and the characteristics of the disease, liver resection, ablation, or transplantation may be deemed potentially curative. For inoperable lesions, arterially directed therapy might be an option, or systemic treatment might be deemed more suitable. In specific cases, the recommendation might extend to external beam radiation therapy. For all individuals, a comprehensive, multidisciplinary approach should be adopted when considering HCC treatment options. The main treatment strategies for advanced HCC patients are typically combination treatments such as immunotherapy and anti-VEGFR inhibitor, or a combination of immunotherapy and immunotherapy where appropriate, as a first-line treatment. Furthermore, some TKIs and immune checkpoint inhibitors may be used as single agents in cases where patients are not fit for the combination therapies. As second -line treatments, some treatment agents have been reported and can be considered.
The combined role of metacognition and mindfulness in social anxiety symptoms: a path model
(Serbian psychological society, 2024) Obuca, Faruk; Aydın, Orkun; Çakıroğlu, Süleyman
Although social anxiety disorder (SAD) is widespread and associated with significant distress, its etiology is not yet fully explored. We aimed to examine how metacognitions and mindfulness interact with SAD symptoms. 531 college students were enrolled in this study. Participants completed the Liebowitz Social Anxiety Scale (LSAS), the Metacognition Questionnaire -30 (MCQ-30), and the Five -Facet Mindfulness Questionnaire (FFMQ). A path analysis was run to explore the associations between test variables. A positive correlation was found between metacognition and SAD symptoms, while mindfulness negatively correlated with SAD symptoms and metacognition. In the established path model, metacognition had an indirect effect on SAD symptoms, which is partially mediated by mindfulness. Our findings imply that metacognitions and mindfulness may influence SAD symptoms among young adults. Mindfulness seems to have a prominent role in regulating metacognition's effects on SAD symptoms. Therefore, interventions that accurately target these factors may alleviate the symptoms of this debilitating psychological disturbance.
Does adding TENS to pelvic floor rehabilitation effect on urodynamics and clinical results in children with spina bifida?
(John wiley and sons inc, 2025) Özdemir Ayla, Özge; Özel, Şeyhmus Kerem; Acar, Gönül; Alataş, İbrahim
Introduction Children with spina bifida (SB) experience a reduced quality of life due to neurogenic bladder dysfunction and the risk of renal failure later in life. Pelvic floor rehabilitation (PFR) and transcutaneous electrical nerve stimulation (TENS) have gained prominence in recent years due to their positive effects in treating different types of bladder issues in both adults and children. Our study aims to investigate the effects of using these two methods together in children with SB and to delineate their potential value for clinical practice. Materials and Methods Children with neurogenic bladder dysfunction due to SB who admitted to our spina bifida center were enrolled. Those patients, between 5 and 15 years of age, with only neurogenic detrusor overactivity (NDO) were randomly divided into two groups using an online computer application. While only the PFR was applied to Group PFR (n = 14), TENS was used in addition to this therapy in Group PFR + T (n = 14). The PFR sessions included abdominal massage, strength exercises, diaphragmatic breathing exercises, and contracting pelvic floor muscles. TENS was used in a standard fashion as previously described in patients with SB. Before and after treatment, patients' clinical data, dysfunctional voiding symptom score (DVSS), lower urinary tract symptoms, and quality of life scores due to urinary incontinence were evaluated. Urodynamic outcomes such as detrusor pressure, bladder capacity, contractility, and residual urine amount were also evaluated. Results Twenty eight children out of 750 SB patients were enrolled in our center. Children with only NDO due to SB were included in the study (Group PFR, mean age 8.3 +/- + 2.7 years, 10 boys, four girls; Group PFR + T, 7.86 +/- 2.03 years, eight boys, six girls). Treatment duration was 6 weeks (18 sessions). There was a decrease in voiding and lower urinary tract symptoms in both groups regardless of the use of TENS (p < 0.05). Maximum detrusor pressure significantly decreased only in the TENS group after treatment (from 82.143 +/- 58.069 cmH2O to 58.077 +/- 39.872 cmH2O) (p < 0.05). The difference in clinical parameters, quality of life scores and other urodynamic parameters were not found to be significant between groups. Discussion PFR and TENS may be effective in SB with NDO to reduce voiding symptoms, and protect bladder from increased pressures. PFR seems to be a useful conservative approach in patients with NDO, adjunt to standard treatment. Further studies are needed in delineation of a personalized holistic treatment approach in these patients. Conclusion Addition of TENS to standard PFR in NDO may be effective in reducing maximum detrusor pressures, however, it does not seem to specifically contribute for improving incontinence and incontinence-related quality of life.

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