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  • Article
    Citation - Scopus: 1
    Nationwide prospective audit for the evaluation of appendicitis risk prediction models in adults: Right iliac fossa treatment (RIFT) - Turkey
    (Oxford University Press, 2024-09-03) Ozgen, Utku; Aktas, Ahmet; Yildirim, Mehmet; Sungurtekin, Ugur; Ozturk, Selen; Sahin, Mustafa; Aykota, Muhammed Rasid; Akin, Emrah; Zarbaliyev, Elbrus; Sevmis, Murat; Kayacan, Gulsum Sueda; Gulcu, Baris; Sevinc, Mert Mahsuni; Sakca, Merve; Demirbag, Ali Eba; Attaallah, Wafi; Bayrak, Mehmet; Sekerci, Ulas Utku; Aydogan, Burak; Cennet, Omer; Gultekin, Fatma Ayca; Basceken, Salim Ilksen; Isik, Arda; Ozben, Volkan; Utkan, Nihat Zafer; Damburaci, Nurullah; Atci, Recep; Ozturk, Ersin; Kupeli, Aydln Hakan; Demirkiran, Ahmet Ender; Eraslan, Huseyin; Kaya, Ismail Oskay; Yalcinkaya, A.; Haksal, Mustafa Celalettin; Iflazoglu, Nidal; Ohri, Nurian; Kucuk, Hasan Fehmi; Altuntas, Yunus Emre; Yirgin, Hakan; Altiner, Saygin; Aybar, Engin; Ozmen, Mehmet Mahir; Ozdenkaya, Yasar; Ozkan, Zeynep; Yesiltas, Metin; Karahan, Omer; Hacim, Nadir Adnan; Emral, Ahmet Cihangir; Yeni, Mustafa; Haberal, Elifcan; Borcek, Alp Ozgun; Zengin, Abdullah Kagan; Durma, Ahmet Guray; Dinc, Bulent; Pekuz, Caglar Kazim; Balcin, Ozkan; Isik, Ozgen; Yildiz, Aybala; Ozdemir, Yavuz; Eray, Ismail Cem; Ozcan, Adem; Soylu, Sinan; Badak, Bartu; Ergin, Emin; Kutluk, Fadime; Devay, Ali Onder; Erkan, I.; Liman, Rumeysa Kevser; Oktay, Ahmet; Arslan, Rasim Ersin; Yildirim, Yasemin; Bakar, Burak; Aliyeva, Zumrud; Serin, Musa; Posteki, Gokhan; Aktas, Melik Kagan; Cimen, Sebnem; Ergun, Sefa; Aba, Murat; Uzunkoy, Ali; Yildirim, Ali Cihat; Goktepe, Berk; Osmanov, Igbal; Kozan, Erdem Baran; Guldogan, Cem Emir; Ozen, Dogan; Berkan, Ahmet; Turk, Yigit; Kilinc, Gizem; Ilhan, Enver; Kirimtay, Busenur; Demir, H.; Dincer, Onur Ilkay; Yazici, Faruk; Turap, Huseyin; Bilgic, Ethem; Ece, Ilhan; Sevinc, Baris; Alabaz, Omer; Kara, Eray; Ozdemir, Murat; Sari, Ramazan; Kartal, Murat; Demirel, Ahmet Onur; Omak, Ahmet; Azili, Cem; Safak, Turugsan; Uludag, Server Sezgin; Acar, Nihan; Yilmaz, Mehmet; Demirli Atici, Semra; Ureyen, Orhan; Yildiz, Yasin Alper; Celayir, Mustafa Fevzi; Savda, Mervan; Bozkurt, Mehmet Abdussamet; Sozutek, Alper; Sivrikoz, Emre; Kurt, Atilla; Ekici, Mehmet Fatih; Demirer, Ali Ilbey; Kurt, Begum; Kanat, Burhan Hakan; Ozturk, Ece; Dedemoglu, Akin; Yildiz, A.; Taspinar, Ersoy; Kokdas, Suleyman; Buyukkasap, Ahmet Cagri; Duru, Sila; Karabacak, Harun; Kilincarslan, Ozgur; Dalkilic, Munevver Irem; Cakir, Remzi Can; Yilmaz, Sumeyye; Kaya, Tayfun; Atasever, Ahmet; Apaydin, Muhammed; Kamer, E.; Altinel, Yuksel; Konca, Can; Balci, B.; Guler, Sertac Ata; Leventoglu, Seza; Caglikulekci, Mehmet; Yigit, Direnc; Karaca, Berkay Enes; Egeli, Tufan; Arslan, Kemal; Ozen, Ata; Tutcu, Semra; Tufekci, Tutku; Taghiyeva, Abdulla; Gundogdu, Tamer; Ertürk, Candeniz; Aslan, Deniz; Temiz, Muhyittin; Yetkin, Sitki Gurkan; Aydin, Ismail; Durak, Ahmet Turan; Sahin, Hasan Berk; Copelci, Yasar; Ugur, Mustafa; Aktimur, Yunus Emre; Akin, Tezcan; Cakmak, Guner; Rencuzogullari, Ahmet; Akyol, Cihangir; Sanli, Ahmet Necati; Yener, Kemal; Avci, Tevfik; Gonullu, Emre; Uprak, Tevfik Kivilcim; Bayraktar, Onur; Sahin, Can; Dulger, Ugur Can; Olcum, Mehmet; Algin, Mustafa Cem; Kural, Said; Kulle, Cemil Burak; Nazli, Okay; Gunduz, Umut Riza; Bolukbasi, Basak; Bozdag, Emre; Aydin, Altan; Gundogdu, Emre; Calik, Bulent; Ulutas, Mehmet Esref; Cetinkunar, Suleyman; Kucuk, Gultekin Ozan; Arslan, Yusuf; Eroz, Erhan; Bisgin, Tayfun; Gencer, Ilayda; Balik, Emre; Akay, Tamer; Saracoglu, Can; Tok, Hasan; Ergul, Zafer; Calta, Alpaslan Fedayi; Dogan, Lutfi; Calisir, Akin; Ersoz, Siyar; Simsek, Oguzhan; Erdogrul, Guven; Turhan, Anil; Kirkan, Emre Furkan; Ermis, Ilker; Tirnova, Ismail; Balkan, Ali Zeynel Abidin; Altintoprak, Fatih; Gok, Ali Fuat Kaan; Colak, Bayram; Topcu, Omer; Irkorucu, Oktay; Aydin, Cengiz; Aksoy, Fuat; Koc, Mehmet Ali; Keskin, C.; Uludag, Emrah; Pusane, Ali; Yalcinkaya, A.; Ceylan, Alper; Ulgur, Hanife Seyda; Tezcaner, Tugan; Yuksekdag, Sema; Metin, Sukru Hakan; Velipasaoglu, Melih; Emsal, Emine Zulal; Yanar, Hakan Teoman; Meric, Serhat; Ciftci, Erman; Erol, Timucin; Sokmen, Selman; Dere, Ozcan; Solak, Ilhami; Ozcelik, Mehmet Faik; Yalkin, Omer; Dincer, Hilmi Anil; Kirnap, Mahir; Hasirci, Ismail; Muhammedoglu, Bahtiyar; Kaya, Rumeysa Betul; Karakas, Dursun Ozgur; Uzunyolcu, Gorkem; Tan, Necati; Dadasoglu, Mustafa Aykut; Acar, Sami; Sahin, Enes; Yilmaz, Eyup Murat; Bozkurt, Emre; Akdogan, Osman; Ilhan, Onur; Aydin, Onur; Altintas, Yasemin; Karaca, Emre; Uysal, Erkan; Ozata, Ibrahim Halil; Gunes, Gizem; Lapsekili, Emin; Mantoglu, Baris; Demir, Batuhan; Ulgen, Yigit; Vural, Selahattin; Tatar, Ozan Can; Dalkiran, Alperen; Ozkan, Omer Faruk; Kalayci, Tolga; Yormaz, Serdar; Bozkurt, Halil Alper; Kiraz, Irem Nur; Akbas, Ahmet; Yasar, Necdet Fatih; Cengiz, Fevzi; Tayar, Serkan; Erenler Bayraktar, Ilknur; Gulmez, Mehmet; Cetinkaya, Gokay; Yarbug Karayali, Feza; Okkabaz, Nuri; Mercan, Metin; Mutlu, Arda Ulas; Acar, Turan; Cetinkaya, Erdinc; Gullu, Hasim Furkan; Tanal, Mert; Yildiz, Mehmet Nuri; Ozdemir, Abdullah; Erkent, Murathan; Kesicioglu, Tugrul; Kaya, Murat; Gundes, Ebubekir; Zeren, Sezgin; Kayhan, Okan; Aytac, Erman; Sari, Erdem; Kara, Yasin; Calikoglu, Fikret; Ure, Iyimser; Garip, Gokhan; Sevik, Husnu; Moran, Munevver; Bozbiyik, Osman; Kilic, Erol; Vartanoglu Aktokmanyan, Talar; Uzunoglu, Mustafa Yener; Karacan, Erkan; Memisoglu, Ecem; Ozeller, Elif; Polat, Suleyman; Tan, Sedat; Aksel, Bulent
    Background: Appendicitis is the most prevalent surgical emergency. The negative appendicectomy rate and diagnostic uncertainty are important concerns. This study aimed to assess the effectiveness of current appendicitis risk prediction models in patients with acute right iliac fossa pain. Methods: A nationwide prospective observational study was conducted, including all consecutive adult patients who presented with right iliac fossa pain. Diagnostic, clinical and negative appendicectomy rate data were recorded. The Alvarado score, Appendicitis Inflammatory Response (AIR), Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) and Adult Appendicitis Score systems were calculated with collected data to classify patients into risk categories. Diagnostic value and categorization performance were evaluated, with use of risk category-based metrics including 'true positive rate' (percentage of appendicitis patients in the highest risk category), 'failure rate' (percentage of patients with appendicitis in the lowest risk category) and 'categorization resolution' (true positive rate/failure rate). Results: A total of 3358 patients from 84 centres were included. Female patients were less likely to undergo surgery than men (71.5% versus 82.5% respectively; relative risk 0.866, 95% c.i. 0.834 to 0.901, P < 0.001); with a three-fold higher negative appendicectomy rate (11.3% versus 4.1% respectively; relative risk 2.744, 95% c.i. 2.047 to 3.677, P < 0.001). Ultrasonography was utilized in 56.8% and computed tomography in 75.2% of all patients. The Adult Appendicitis Score had the best diagnostic performance for the whole population; however, only RIPASA was significant in men. All scoring systems were successful in females patients, but Adult Appendicitis Score had the highest area under the receiver operating characteristic curve value. The RIPASA and the Adult Appendicitis Score had the best categorization resolution values, complemented by their exceedingly low failure rates in both male and female patients. Alvarado and AIR had extremely high failure rates in men. Conclusion: The negative appendicectomy rate was low overall, but women had an almost three-fold higher negative appendicectomy rate despite lower likelihood to undergo surgery. The overuse of imaging tests, best exemplified by the 75.2% frequency of patients undergoing computed tomography, may lead to increased costs. Risk-scoring systems such as RIPASA and Adult Appendicitis Score appear to be superior to Alvarado and AIR. © 2024 The Author(s). Published by Oxford University Press on behalf of BJS Foundation Ltd.
  • Article
    Citation - WoS: 4
    Citation - Scopus: 2
    Evaluation of Catatonia with Different Assessment Scales in Psychiatry and Neurology
    (Turkish Association of Nervous and Mental Health, 2024) Erdogan, Ibrahim Mert; Aytulun, Asli; Avanoglu, Kezban Burcu; Turkoglu, Ozge; Erdogan, Nilguen O. K. T. A. R.; Gurel, S. Can; Karahan, Sevilay
    Amaç: Katatoni klinik ortamlarda gözden kaçabilen bir klinik sendromdur.Katatoni tanısı tablonun çoğunlukla geri dönüşlü olabilmesi ve müdahale edilmediğinde ciddi komplikasyonlarla sonuçlanması nedeniyle önemlidir. Bu çalışmada, bir üniversite hastanesi psikiyatri ve nöroloji servislerinde yatan hastaların katatoni açısından taranması, özelliklerinin incelenmesi ve ölçeklerin karşılaştırılması amaçlanmıştır. Yöntem: Ardışık 20 aylık bir süre boyunca psikiyatri, nöroloji yatan hasta klinikleri ve psikiyatri servisine yatış için bekleme listesindeki hastalara Bush-Francis Katatoni Değerlendirme ve KANNER ölçeklerinin Türkçe uyarlamalarıyla eş zamanlı olarak DSM-5 Katatoni Tanı Ölçütleri uygulandı. Psikiyatri grubundaki hastaların sosyodemografik ve klinik özellikleri karşılaştırıldı. Bulgular: Örneklemdeki 214 hastanın 28’i (%13,1) ölçek değerlendirmesinde katatoni taramasını geçti ve taramayı geçen hastaların 23’üne (%82,1) DSM-5’e göre katatoni tanısı konuldu. Daha önce sıklıkla katatoniyle ilişkilendirilen şizofreni ve duygudurum bozukluklarının yanında nörogelişimsel bozukluk, ensefalit, postpartum psikoz, obsesif kompulsif bozukluk, deliryum, serebrovasküler hastalık, fonksiyonel nörolojik belirti bozukluğu gibi tanıların da katatoniyle ilişkili olabildiği saptandı. Değerlendirmede kullanılan her iki ölçek de aynı hastaları katatoni olarak tanımladı. En yaygın komplikasyonun idrar yolu enfeksiyonu olduğu görülmekle birlikte hayatı tehdit eden daha ciddi komplikasyonlar da mevcuttu. Sonuç: Gözden kaçtığında ciddi sonuçlara neden olabilen katatoninin tanısında sadece DSM-5 kriterlerine bağlı kalmak, bazı hastalara katatoni tanısının konulamamasına neden olabilmektedir. Standardize katatoni ölçeklerinin dünya genelinde yaygın ve etkili bir şekilde kullanılmasıyla klinisyenlerin teşhis kapasitesi artabilir ve katatoniyle ilişkili morbidite ve mortalite iyileştirilebilir.
  • Article
    Citation - Scopus: 3
    The Relationship of Body Mass Index with Insulin Resistance, hs-CRP, and Lp(a) Levels in Female Gender
    (Galenos Publishing House, 2023-04-14) B., Uludağ; H., Solmaz; Y.İ., Alihanoğlu; İ.D., Kılıç; Y., Enli
    Background and Aim: Chronic obesity causes adipose tissue to produce mediators that promote atherogenesis and vascular inflammation, contributing to hyperlipidemia, diabetes, hypertension, and cardiovascular disease (CVD). This study aimed to examine the relationship between body mass index (BMI) with homeostatic model assessment for insulin resistance (HOMA-IR), high-sensitivity C-reactive protein (hs-CRP), and lipoprotein(a) [Lp(a)] levels in females. Materials and Methods: One hundred thirty-one females participated in the study: 46 morbidly obese, 38 obese, 25 overweight, and 22 normal BMI. To determine insulin resistance, all participants had their HOMA-IR values assessed. As an inflammatory marker, hs-CRP and as a lipid biomarker, Lp(a) were checked. Results: A significant difference in the HOMA-IR was found between the normal and the obese (P = 0.001) and morbidly obese (P = 0.0001) participants. There was also a significant difference in terms of HOMA-IR between the overweight and morbidly obese (P = 0.001) groups. In paired-group comparisons, hs-CRP was found to be significantly different between the normal group and obese (P = 0.001) and morbidly obese (P = 0.0001). Additionally, a significant difference in terms of hs-CRP between the overweight and morbidly obese participants (P = 0.003) was found. When Lp(a) values were compared, there was a significant difference between the normal group and those who were overweight (P = 0.0001), obese (P = 0.0001), and morbidly obese (P = 0.0001). A significant positive correlation of BMI was shown with HOMA-IR, hs-CRP, and Lp(a) levels. Conclusion: Elevated BMI in females is related to insulin resistance, elevated hs-CRP, and Lp(a), which confer a residual risk for CVD. ©Copyright 2023 by the Cardiovascular Academy Society / International Journal of the Cardiovascular Academy published by Galenos Publishing House.
  • Article
    Citation - WoS: 1
    Citation - Scopus: 1
    Clinical, Demographic, and Radiological Characteristics of Patients Demonstrating Antibodies Against Myelin Oligodendrocyte Glycoprotein
    (Galenos Publ House, 2024-06-03) Koc, Sumeyye; Sen, Sedat; Terzi, Yuksel; Kizilay, Ferah; Demir, Serkan; Aksoy, Durdane Bekar; Kurtulus, Fatma
    Background: Optic neuritis, myelitis, and neuromyelitis optica spectrum disorder (NMOSD) have been associated with antibodies against myelin oligodendrocyte glycoprotein-immunoglobulin G (anti-MOG-IgG). Furthermore, patients with radiological and demographic features atypical for multiple sclerosis (MS) with optic neuritis and myelitis also demonstrate antibodies against aquaporin-4 and anti-MOG-IgG. However, data on the diagnosis, treatment, follow-up, and prognosis in patients with anti-MOG-IgG are limited. Aims: To evaluate the clinical, radiological, and demographic characteristics of patients with anti-MOG-IgG. Study Design: Multicenter, retrospective, observational study. Methods: Patients with blood samples demonstrating anti-MOG-IgG that had been evaluated at the Neuroimmunology laboratory at Ondokuz Mayıs University’s Faculty of Medicine were included in the study. Results: Of the 104 patients with anti-MOG-IgG, 56.7% were women and 43.3% were men. Approximately 2.4% of the patients were diagnosed with MS, 15.8% with acute disseminated encephalomyelitis (ADEM), 39.4% with NMOSD, 31.3% with isolated optic neuritis, and 11.1% with isolated myelitis. Approximately 53.1% of patients with spinal involvement at clinical onset demonstrated a clinical course of NMOSD. Thereafter, 8.8% of these patients demonstrated a clinical course similar to MS and ADEM, and 28.1% demonstrated a clinical course of isolated myelitis. The response to acute attack treatment was lower and the disability was higher in patients aged > 40 years than patients aged < 40 years at clinical onset. Oligoclonal band was detected in 15.5% of the patients. Conclusion: For patients with NMOSD and without anti-NMO antibodies, the diagnosis is supported by the presence of anti-MOG-IgG. Furthermore, advanced age at clinical onset, Expanded Disability Status Scale (EDSS) score at clinical onset, spinal cord involvement, and number of attacks may be negative prognostic factors in patients with anti-MOG-IgG.
  • Article
    Adult acute megakaryoblastic leukemia with persistent diarrhea and extreme thrombocytosis: A very unusual case
    (Wolters Kluwer Medknow Publications, 2023-04-14) Aslan, Nevin Alayvaz; Gulten, Gulsun
    Acute megakaryoblastic leukemia (AML‑M7) is rarely seen in adult patients and patients usually present with cytopenias. Here we discuss diagnostic challenges and pathologic features in a patient with AML‑M7 who presented with thrombocytosis and diarrhea. A 63‑year‑old male patient presented with persistent diarrhea lasting for 2 months, fatigue, and thrombocytosis. The diagnostic workup included a stool analysis, endoscopy colonoscopy, and imaging studies; however, these studies did not reveal any possible etiology. The hematologic evaluation included peripheral blood smear, bone marrow aspiration and biopsy, flow cytometry, and cytogenetic analysis. Eventually, according to pathologic and flow cytometric findings, a diagnosis of AML‑M7 was made. Diagnosis of AML‑M7 may be challenging, especially in adult patients with atypical presentation. Patients with megakaryoblastic leukemia respond poorly to standard induction regimens and they should be advised to participate in a clinical trial. © 2024 Indian Journal of Pathology and Microbiology.
  • Article
    Citation - Scopus: 4
    Global practice patterns in the evaluation of non-obstructive azoospermia: results of a world-wide survey and expert recommendations
    (Korean Society for Sexual Medicine and Andrology, 2024) Duran, Mesut Berkan; Baser, Aykut; Atmoko, W.; Martinez, M.; Ziouziou, I.; Kothari, P.; Tadros, N.; Phuoc, Nguyen Ho Vinh; Kavoussi, Parviz; Harraz, Ahmed; Salvio, Gianmaria; Ceker, Gokhan; Falcone, Marco; Balercia, Giancarlo; Taniguchi, Hisanori; Fukuhara, Shinichiro; Patel, Niket; Thomas, Charalampos; Park, Hyun Jun; Cherian, Dinesh Thomas; Agarwal, Ashok; Gherabi, Nazim; Meliegy, Amr El; Busetto, Gian Maria; Gadda, Franco; Mak, Siu King; Gamidov, Safar; Saleh, Ramadan; Dimitriadis, Fotios; Haghdani, Saeid; Ba, Hung Nguyen; Seno, Doddy Hami; Yazbeck, Chadi; Sindhwani, Puneet; Truong, Manh Nguyen; Kanbur, Ajay; Ragab, Maged; Javed, Qaisar; Çayan, Selahittin; Rajmil, Osvaldo; Wyns, Christine; Le, Sang Thanh; Moussa, Mohamad; Puigvert, Ana; Jindal, Sunil; Shah, R.; Konstantinidis, Charalampos; Gilani, Mohammad Ali Sadighi; Cannarella, Rossella; Kuroda, Shinnosuke; Jain, Divyanu; Priyadarshi, Shivam; Nguyen, Thang; Kunz, Yannic; Serefoglu, Ege Can; Vazquez, Jesus Fernando Solorzano; Marino, Angelo; Kheradmand, Alireza; Danacıoğlu, Yavuz Onur; Kosgi, Raghavender; Oleksandr, Knigavko; Amar, Edouard; Russo, Giorgio Ivan; Bosco, Ndagijimana Jean; Akhavizadegan, Hamed; Siddiqi, Kashif; Mustafa, Akhmad; Wurzacher, Jana; Banka, Surendra Reddy; Rojas-Cruz, Cesar; Parikesit, Dyandra; Purnomo, Medianto; Malhotra, Vineet; Alali, Hamed; Hoai, Bac Nguyen; Deswanto, Isaac Ardianson; Jayaprakash, Sanjay Prakash; Abdelrahman, Islam Fathy Soliman; Soebadi, Mohammad Ayodhia; Huang, Zhongwei; Margiana, Ria; Selim, Osama Mohamed; Eugeni, Elena; Bendayan, Marion; Chak-Lam, Cho; Gudeloglu, Ahmet; Pescatori, Edoardo; Musa, Muhammad Ujudud; Gul, Murat; Zilaitiene, Birute; Ramsay, Jonathan; Narimani, Nima; Sethupathy, Tamilselvi; Hussein, Alayman; Efesoy, Ozan; Ramirez, Marlene Lizbeth Zamora; Rezano, Andri; Japari, Andrian; Tsujimura, Akira; Makarounis, Konstantinos; Adamyan, Aram; Elshahid, Ahmed Rashad; Quang, Nguyen; Al Hashimi, Manaf; Mazzilli, Rossella; Boitrelle, Florence; Minh, Dang Hoang; Orozco, Eduardo Gutiérrez; Gungor, Nur Dokuzeylul; Ambar, Rafael F.; Cuong, Hoang Bao Ngoc; Deger, Muslim Dogan; Singla, Karun; Kandil, Hussein; Hasan, Mohamed Saeed Mohamed; Adriansjah, Ricky; Ruzaev, Mikhail; Mostafa, Taymour; Kinzikeeva, Ella; Sokolakis, Ioannis; Altay, Baris; Putra, Rosadi; Kaya, Coşkun; Teo, Colin; Jungwirth, Andreas; Alfatlawy, Noor Kareem; Şahin, Bahadır; Sefrioui, Omar; Al-Marhoon, Mohamed S.; Kadıoğlu, Ateş; Jezek, Davor; Quang, Vinh Nguyen; Borges, Edson; Acosta, Herik; Arslan, Umut; Kanakis, George; Calogero, Aldo E.; Boeri, Luca; Hebrard, Guadalupe Hernández; Colombo, Fulvio; Elkhouly, Mohamed; Nada, Essam; Trang, Nguyen Thi Minh; Kalkanli, Arif; Ceyhan, Erman; Andreadakis, Sotiris; Almardawi, Abdulmalik; Calik, Gokhan; Lin, Haocheng; Ko, Edmund; Tuan, Anh Đang; Timpano, Massimiliano; Bocu, Kadir; Rashed, Ayman; Ramazan, Asci; Castiglioni, Fabrizio; Maruccia, Serena; Shamohammadi, Iman; Al Dayel, Adel; Pinggera, Germar-Michael; Pai, Hrishikesh; Motawi, Ahmad; Daoud, Salima; Brodjonegoro, Sakti Ronggowardhana; Toprak, Tuncay; Duarsa, Gede Wirya Kusuma; Arianto, Eko; Rachman, Rinaldo Indra; Nguyen, Tuan Thanh; Sofikitis, Nikolaos; Mutambirwa, Shingai; Vinod K.V.; Giacone, Filippo; Rambhatla, A.; Birowo, Ponco; El-Sakka, Ahmed; Salacone, Pietro; Franco, Giorgio; Moorthy, Dharani; Avoyan, Armen; Dolati, Parisa; Giulioni, Carlo; Al-Kawaz, Ula; Long, Tran Quang Tien; Paul, Gustavo Marquesine; Turunç, Tahsin; Barrett, Trenton; Zylbersztejn, Daniel Suslik; Saylam, Barış; Blecher, Gideon; Zini, Armand; Ho, Christopher Chee Kong; Kafetzis, Dimitrios; Gupte, Deepak; Yenice, Mustafa Gurkan; Micic, Sava; Molina, Juan Manuel Corral; Le, Tan V.; Chung, Eric; Ibrahim, Wael; Mogharabian, Nasser; Jamali, Mounir; Wong, Michael Y.C.; Elbardisi, Haitham; Salzano, Ciro; Arafa, Mohamed; Gul, Umit; Sarikaya, Selcuk; Bahar, Fahmi; Katz, Darren; Sajadi, Hesamoddin; Aydos, Kaan; Ghayda, Ramy Abou; Savira, Missy; Singh, Keerti; Bouzouita, Abderrazak; Tanic, Marko; Zohdy, Wael; Crafa, Andrea; Özkent, Mehmet Serkan; Alsaid, Sami; Binsaleh, Saleh; Moon, Du Geon; Bellavia, Marina; Hamoda, Taha; Kim, Shannon Hee Kyung; Franceschelli, Alessandro; Galstyan, Raisa; Karthikeyan, Vilvapathy Senguttuvan; Suyono, Seso Sulijaya; Hoffmann, Ivan; Zachariou, Athanasios; Taha, Emad; Abumelha, Saad; Peña, Marcelo Rodriguez; Keskin, Hakan; Kahraman, Oguzhan; Rizaldi, Fikri; Ozer, Cevahir; Lee, Joe; Sogutdelen, Emrullah; Tanwar, Raman; Nair, Raju; Colpi, Giovanni M.; Mierzwa, Tiago Cesar; Khalafalla, Kareim; Banthia, Ravi; Paghdar, Smit; Basurkano, Ari; Smith, Ryan; Preto, Mirko; Kulaksiz, Deniz; Gokalp, Fatih; Alhathal, Naif; Noegroho, Bambang S.; Liguori, Giovanni; Amir, Azwar; Ferreira, Raphael Henrique; Sheibak, Nadia; Nagao, Koichi; Vishwakarma, Ranjit B.; Farsi, Hasan M.A.; Gupta, Chirag
    Purpose: Non-obstructive azoospermia (NOA) represents the persistent absence of sperm in ejaculate without obstruction, stemming from diverse disease processes. This survey explores global practices in NOA diagnosis, comparing them with guidelines and offering expert recommendations. Materials and Methods: A 56-item questionnaire survey on NOA diagnosis and management was conducted globally from July to September 2022. This paper focuses on part 1, evaluating NOA diagnosis. Data from 367 participants across 49 countries were analyzed descriptively, with a Delphi process used for expert recommendations. Results: Of 336 eligible responses, most participants were experienced attending physicians (70.93%). To diagnose azoospermia definitively, 81.7% requested two semen samples. Commonly ordered hormone tests included serum follicle-stimulating hormone (FSH) (97.0%), total testosterone (92.9%), and luteinizing hormone (86.9%). Genetic testing was requested by 66.6%, with karyotype analysis (86.2%) and Y chromosome microdeletions (88.3%) prevalent. Diagnostic testicular biopsy, distinguishing obstructive azoospermia (OA) from NOA, was not performed by 45.1%, while 34.6% did it selectively. Differentiation relied on physical examination (76.1%), serum hormone profiles (69.6%), and semen tests (68.1%). Expectations of finding sperm surgically were higher in men with normal FSH, larger testes, and a history of sperm in ejaculate. Conclusions: This expert survey, encompassing 367 participants from 49 countries, unveils congruence with recommended guidelines in NOA diagnosis. However, noteworthy disparities in practices suggest a need for evidence-based, international consensus guidelines to standardize NOA evaluation, addressing existing gaps in professional recommendations. Copyright © 2024 Korean Society for Sexual Medicine and Andrology.
  • Article
    Citation - WoS: 8
    Citation - Scopus: 7
    Global Practice Patterns and Variations in the Medical and Surgical Management of Non-Obstructive Azoospermia: Results of a World-Wide Survey, Guidelines and Expert Recommendations
    (Korean Society for Sexual Medicine and Andrology, 2025) Rambhatla, Amarnath; Shah, Rupin; Ziouziou, Imad; Kothari, Priyank; Salvio, Gianmaria; Gul, Murat; Hamoda, Taha
    Purpose: Non-obstructive azoospermia (NOA) is a common, but complex problem, with multiple therapeutic options and a lack of clear guidelines. Hence, there is considerable controversy and marked variation in the management of NOA. This survey evaluates contemporary global practices related to medical and surgical management for patients with NOA. Materials and Methods: A 56-question online survey covering various aspects of the evaluation and management of NOA was sent to specialists around the globe. This paper analyzes the results of the second half of the survey dealing with the management of NOA. Results have been compared to current guidelines, and expert recommendations have been provided using a Delphi process. Results: Participants from 49 countries submitted 336 valid responses. Hormonal therapy for 3 to 6 months was suggested before surgical sperm retrieval (SSR) by 29.6% and 23.6% of participants for normogonadotropic hypogonadism and hypergonadotropic hypogonadism respectively. The SSR rate was reported as 50.0% by 26.0% to 50.0% of participants. Interestingly, 46.0% reported successful SSR in <10% of men with Klinefelter syndrome and 41.3% routinely recommended preimplantation genetic testing. Varicocele repair prior to SSR is recommended by 57.7%. Half of the respondents (57.4%) reported using ultrasound to identify the most vascularized areas in the testis for SSR. One-third proceed directly to microdissection testicular sperm extraction (mTESE) in every case of NOA while others use a staged approach. After a failed conventional TESE, 23.8% wait for 3 months, while 33.1% wait for 6 months before proceeding to mTESE. The cut-off of follicle-stimulating hormone for positive SSR was reported to be 12-19 IU/mL by 22.5% of participants and 20-40 IU/mL by 27.8%, while 31.8% reported no upper limit. Conclusions: This is the largest survey to date on the real-world medical and surgical management of NOA by reproductive experts. It demonstrates a diverse practice pattern and highlights the need for evidence-based international consensus guidelines. Copyright © 2024 Korean Society for Sexual Medicine and Andrology.
  • Article
    Citation - WoS: 4
    Citation - Scopus: 6
    The Effectiveness of Adjuvant PD-1 Inhibitors in Patients with Surgically Resected Stage III/IV Acral Melanoma
    (Lippincott Williams and Wilkins, 2024-03-11) Arak, Haci; Erkilic, Suna; Yaslikaya, Sendag; Mocan, Eda Eylemer; Aktas, Gokmen; Ozdemir, Melek; Semiz, Huseyin Salih
    Our aim was to assess the efficacy of adjuvant programmed cell death protein-1 (PD-1) inhibitors and compare the other adjuvant treatments in patients with surgically resected stage III or IV acral melanoma. This study is a multicenter, retrospective analysis. We included 114 patients with stage III or IV acral malignant melanoma who underwent surgery within the past 10 years. We analyzed the effect of adjuvant programmed cell death protein-1 inhibitors on disease-free survival (DFS). The mean follow-up was 40 months, during which 69 (59.5%) patients experienced recurrence. Among the participants, 64 (56.1%) received systemic adjuvant therapy. Specifically, 48.4% received anti-PD-1 therapy, 29.7% received interferon, 14.1% received tezozolomide, and 7.8% received B-Raf proto-oncogene/mitogen-activated protein kinase inhibitors. Patients who received adjuvant therapy had a median DFS of 24 (10.9-37.2) months, whereas those who did not receive adjuvant therapy had a median DFS of 15 (9.8-20.2) months. Multivariate analysis for DFS revealed that the receipt of adjuvant therapy and lymph node metastasis stage were independent significant parameters (P = 0.021, P = 0.018, respectively). No statistically significant difference was observed for DFS between programmed cell death protein-1 inhibitor treatment and other adjuvant treatments. Regarding overall survival (OS), patients who received adjuvant treatment had a median OS of 71 (30.4-111.7) months, whereas those who did not receive adjuvant treatment had a median OS of 38 (16.7-59.3; P = 0.023) months. In addition, there were no significant differences in OS observed between various adjuvant treatment agents (P = 0.122). In our study, we have shown that adjuvant therapy had a positive effect on both DFS and OS in patients with stages III-IV acral melanoma who underwent curative intent surgery. Notably, we found no significant differences between anti-PD-1 therapy and other adjuvant therapies. © 2024 Lippincott Williams and Wilkins. All rights reserved.
  • Article
    Association of Age and Response to Methylphenidate HCL Treatment in Adult ADHD: A Proton Magnetic Resonance Spectroscopy Study
    (Dove Medical Press Ltd, 2024-02) Unal, Gonca Ayse; Kenar, Ayse Nur Inci
    Purpose: This study investigated the age-dependent effects of methylphenidate (MPH) on brain metabolites including choline (Cho), N-acetyl aspartate (NAA) and creatine (Cr) levels in the dorsolateral prefrontal cortex (DLPFC), striatum, cerebellum, and anterior cingulate cortex (ACC) regions of the brain in adult patients with attention deficit hyperactivity disorder (ADHD). Patients and Methods: The study was included 60 patients with ADHD between the ages of 18 and 60 years. The patients were grouped with respect to their ages as follows: 18-24 years, 25-30 years, and 31 and over years. Levels of NAA, Cr and Cho in DLPFC, ACC, cerebellum and striatum were measured with magnetic resonance spectroscopy (MRS). Subjects were then given 10 mg of oral MPH and the same metabolite levels were measured 30 minutes apart. Results: Twelve (20%) of the cases were female and 48 (80%) were male. The age distribution of the cases is as follows: 15 subjects between the ages of 18-24, 26 subjects between the ages of 25-30 and 19 subjects over the age of 30. NAA levels were higher after MPH in the DLPFC of the 18-24 age group (p = 0.016) and in the cerebellum of the 25-30 age group (p = 0.041). No increase in Cho and Cr levels was observed after treatment compared to before (p > 0.05). Conclusion: It is thought that treatment of MPH can be effective on metabolites in different brain regions and this effect can vary upon age adult ADHD patients. After MPH treatment, both the 18-24 age group (in the DLPFC) and the 25-30 age group (in the cerebellum) was detected significantly higher NAA levels compared to pre-treatment levels. This increase in NAA levels suggested that pharmacotherapy, especially at early ages, may be effective on neuronal damage.
  • Article
    Citation - WoS: 2
    Citation - Scopus: 2
    Factors Associated With Increasing Costs in Severe Chronic Obstructive Pulmonary Disease Exacerbation: Turkish Thoracic Society Chronic Obstructive Pulmonary Disease Assembly
    (AVES, 2024-01-10) Baha, Ayse; Kokturk, Nurdan; Baysan, Caner; Ozturk, Burcu; Cengiz, Sumeyye Kodalak; Varol, Yelda; Mertoglu, Aydan
    OBJECTIVE: Chronic obstructive pulmonary disease (COPD) that is the third leading cause of death in the world is one of the main economic burden. The cost is primarily due to COPD exacerbations and hospitalizations. We aimed to determine the factors associated with increasing costs in severe COPD exacerbation. MATERIAL AND METHODS: It was a multicenter and prospective observational recording study. 294 patients who severe COPD exacerbation were included in the study. An amount of more than 429.58 euros was accepted as increasing costs (IC). Factors associated with IC were determined by regression analysis. RESULTS: Mean age was 69.90 ± 9.79/years (minimum: 40 maximum: 95), mean costs were 594.9 ± 70.9 euros. About 83.7% of the patients were male, 24.1% (71) were active smokers, and 81% (238) had at least 1 comorbidity. Factors associated with IC in the regression analysis were delay of discharge (due to prolonged consultation), antibiotic use longer than 7 days, need to enteral/parenteral feeding, application of pulmonary rehabilitation (physiotherapy) at hospitalization, and refusal to be discharged. CONCLUSION: The increasing costs in severe COPD exacerbation depends not only treatment but also the patient’s social status and hospital-related factors. We think that the cost of severe COPD exacerbation can be reduced by interventions on interchangeable factors such as patient's social status and hospital-related factors.