Tıp Fakültesi Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11499/46004
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Article Citation - WoS: 1Citation - Scopus: 1The Effects of Early Rehabilitation on Physical and Psychosocial Functions After Breast Cancer Surgery(Springer, 2025-09-23) Kas Ozdemir, Atiye; Telli Atalay, Orcin; Yilmaz, Sevda; Senol, HandePurpose The aim of this study was to examine the short-term effects of early rehabilitation on physical and psychosocial functions in individuals undergoing breast cancer surgery. Methods Sixty-three female patients with breast cancer who were scheduled for surgery were randomly divided into three groups using the closed envelope method. Participants in Group 1 (G1) received preoperative patient education, exercised under the supervision of a physiotherapist during postoperative hospitalization, received a patient information brochure, and were followed up for 3 months after surgery with telephone calls at 2-week intervals. Participants in Group 2 (G2) received preoperative patient information and a patient information brochure. Participants in Group 3 (G3) received only preoperative patient information. Upper extremity circumference measurements, tissue dielectric constant measurements, shoulder Function, quality of life, and fatigue level assessments were repeated preoperatively, at postoperative discharge, and 3 months after surgery. Results The limb volumes of all the groups increased over time (p < 0.05; except the volume of the unaffected limb in G2). The volume difference between the extremities increased over time only in G2 (p < 0.05). The subdermal fluid ratios of all the groups increased after surgery but decreased after 3 months. The modified Constant-Murley score, which reflects shoulder Function, decreased in all groups after surgery and was similar to the baseline value after 3 months, except G3, in which the score was significantly lower than the baseline value (p < 0.05). Conclusions The results of this study revealed that the physical and psychosocial functions of individuals deteriorate after breast cancer surgery, but early physiotherapist follow-up is effective in maintaining these functions and preventing breast cancer-related lymphedema.Article An Exclusive Endoscopic Transcanal Treatment of Congenital Cholesteatoma: A Multi-Institutional Study(Springer, 2025-10-01) Gulsen, Secaattin; Ozdek, Ali; Orhan, Kadir Serkan; Yorgancilar, Ediz; Surmelioglu, Ozgur; Ardic, Fazil NecdetPurpose To present surgical and audiological outcomes of the pure endoscopic transcanal approach in the treatment of congenital cholesteatoma (CC). Methods The present retrospective multicentre study included 34 patients who underwent exclusive transcanal endoscopic ear surgery (ETEES) for CC treatment by senior surgeons with expertise in endoscopic ear surgery. The extent of the CC was classified according to the Potsic stage. A comprehensive investigation was conducted, encompassing a multitude of parameters, including patients' demographics, CC characteristics, ossicular chain status, ossiculoplasty techniques, operative time, complications, residual or recurrent cholesteatoma, and audiological outcomes. Results Of the 34 CC patients enrolled in the study, 19 (55.9%) were male and 15 (44.1%) were female; their mean age was 15.2 +/- 6.1 years, and their average follow-up period was 36.4 +/- 10.2 months. There were 11 cases (32.4%) of Potsic stage I CC, 7 (20.6%) stage II, 10 (29.4%) stage III, and 6 (17.6%) stage IV. The average operating time was 86.2 +/- 16.9 min (ranging 40-180 min). Overall, 9 (26.5%) patients underwent a second-look and revision surgery via ETEES approach, due to conductive hearing loss and recurrence, in 4 (11.8%) cases with Potsic stage III and in 2 (5.8%) cases with Potsic stage IV iatrogenic and residual CC were observed. The preoperative air-bone gap (ABG) values demonstrated a notable postoperative improvement, declining from a mean of 31.4 +/- 8.1 dB preoperatively to 13.5 +/- 3.6 dB (p < 0.001). Conclusion ETEES, with the advantage of being able to visualize concealed areas of the middle ear with minimal bone work, is a feasible, safe, and effective surgical technique in the treatment of CC, even when CC extends into the mastoid, offering comparable audiological outcomes with lower recurrence ratios relative to conventional surgical techniques present in the current literature.Article Citation - WoS: 3Citation - Scopus: 3Emergency Radiology: Roadmap for Radiology Departments(Springer, 2025-06-20) Aydin, Sonay; Ece, Bunyamin; Cakmak, Vefa; Kocak, Burak; Onur, Mehmet RuhiEmergency radiology has evolved into a significant subspecialty over the past 2 decades, facing unique challenges including escalating imaging volumes, increasing study complexity, and heightened expectations from clinicians and patients. This review provides a comprehensive overview of the key requirements for an effective emergency radiology unit. Emergency radiologists play a crucial role in real-time decision-making by providing continuous 24/7 support, requiring expertise across various organ systems and close collaboration with emergency physicians and specialists. Beyond image interpretation, emergency radiologists are responsible for organizing staff schedules, planning equipment, determining imaging protocols, and establishing standardized reporting systems. Operational considerations in emergency radiology departments include efficient scheduling models such as circadian-based scheduling, strategic equipment organization with primary imaging modalities positioned near emergency departments, and effective imaging management through structured ordering systems and standardized protocols. Preparedness for mass casualty incidents requires a well-organized workflow process map detailing steps from patient transfer to image acquisition and interpretation, with clear task allocation and imaging pathways. Collaboration between emergency radiologists and physicians is essential, with accurate communication facilitated through various channels and structured reporting templates. Artificial intelligence has emerged as a transformative tool in emergency radiology, offering potential benefits in both interpretative domains (detecting intracranial hemorrhage, pulmonary embolism, acute ischemic stroke) and non-interpretative applications (triage systems, protocol assistance, quality control). Despite implementation challenges including clinician skepticism, financial considerations, and ethical issues, AI can enhance diagnostic accuracy and workflow optimization. Teleradiology provides solutions for staff shortages, particularly during off-hours, with hybrid models allowing radiologists to work both on-site and remotely. This review aims to guide stakeholders in establishing and maintaining efficient emergency radiology services to improve patient outcomes.Article Citation - WoS: 4Citation - Scopus: 4Influence of Visual Objects and Music on Anxiety Levels and Imaging Process in Patients Undergoing Coronary Ct Angiography(Springer, 2025-04-24) Tekinhatun, Muhammed; Alver, Kadir Han; Akbudak, Ibrahim; Turmak, Mehmet; Cavdar, Eyyup; Deniz, Muhammed AkifObjective High anxiety during coronary computed tomography angiography (CCTA) can compromise imaging quality, increase radiation exposure, and elevate medication use. Therefore, optimizing waiting room environments to reduce patient anxiety is important for clinical outcomes. This study examines the effects of music and visual stimuli in the waiting rooms on patients' anxiety levels, heart rate, radiation dose, and beta-blocker use prior to CCTA. Methods This study, designed as a prospective and randomized trial, was conducted between April 15 and August 15, 2024, with 216 patients randomized into two groups: a standard waiting room (SWR) and a designed waiting room (DWR) featuring music and visual objects. Anxiety and depression levels were measured using the Hospital Anxiety and Depression Scale (HADS) and the State-Trait Anxiety Inventory (STAI). Additional parameters, such as heart rate, radiation dose, and beta-blocker requirement, were also recorded. Results In the DWR group, anxiety scores and heart rates were significantly lower compared to the SWR group (p < 0.001). Additionally, a notable reduction in radiation dose and beta-blocker use was observed in the DWR group (p < 0.05). In the general patient population, higher anxiety scores were associated with poorer imaging quality. Imaging quality was significantly better in the DWR group (p < 0.001). Conclusion It has been demonstrated that waiting room designs enriched with music and visual stimuli reduce anxiety during CCTA scanning, enhancing patient comfort, improving imaging quality, and enabling imaging with lower radiation doses. The design of such waiting rooms can improve patient experience while optimizing outcomes.Conference Object Covid-19 in Pediatric Nephrology Centers in Turkey(Springer, 2021) Bakkaloglu, Sevcan A.; Atikel, Yesim Ozdemir; LeventoGlu, Emre; Nalcacioglu, Hulya; Dursun, IsmaIl; PoyrazoGlu, Hakan; Dursun, Hasan; Yildirim, Zeynep Yuruk; Yildiz, Nurdan; Aksoy, Gulsah Kaya; Akman, Sema; Tasdemir, Mehmet; Bilge, Ilmay; Celakil, Mehtap; Kilic, Beltinge Demircioglu; Selcuk, Senay Zirhli; Canpolat, Nur; Cakici, Evrim Kargin; Ozlu, Sare Gulfem; Yuksel, SelcukArticle Citation - WoS: 2Citation - Scopus: 2Incidence and Predictors of Woven Endobridge (Web) Shape Modification Following Treatment of Intracranial Aneurysms in a Large Multicenter Study(Springer, 2025-02-25) Adeeb, Nimer; Salim, Hamza Adel; Musmar, Basel; Aslan, Assala; Swaid, Christian; Cuellar, Miguel; Dibas, Mahmoud; Dmytriw, Adam A.The Woven EndoBridge (WEB) device is FDA-approved for the treatment of bifurcation aneurysms. Despite its wide popularity, it has been under scrutiny for its association with potential aneurysm recanalization and retreatment due to device shape modification. This study aims to analyze the shape modification rate of WEB devices and identify factors associated with this phenomenon, as well as its correlation with aneurysm retreatment. We conducted a retrospective review of the WorldWide WEB Consortium database, including adult patients treated for intracranial aneurysms with the WEB device. We assessed aneurysm occlusion using the WEB Occlusion Scale and defined WEB shape modification as a percentage reduction in the distance between two WEB markers. Logistic regression and Cox proportional hazards models were utilized to evaluate predictors of shape modification and retreatment. Kaplan-Meier curves were used to estimate the time-dependent probability of no or minor shape modification. A total of 405 patients were analyzed, with minor and major shape modification occurring in 31.4% and 10.1% of cases, respectively. Major shape modification was associated with lower rates of adequate occlusion (70.7%) compared to no or minor shape modification (86.6%) and a higher rate of retreatment (26.8% vs. 8.1%). Predictors of major shape modification included the presence of daughter sac, bifurcation aneurysms, absence of immediate flow stagnation, and a WEB width minus aneurysm width ratio <= 0.5. The probability of no or minor shape modification declined within the first 25 months and stabilized thereafter. WEB device shape modification is a significant predictor of aneurysm occlusion efficacy and retreatment. Recognizing the factors influencing shape modification can guide treatment decisions and follow-up protocols to improve patient outcomes.Article Citation - WoS: 1Citation - Scopus: 1Gamma Knife Radiosurgery for Cavernous Malformations: a Comprehensive Study on Symptom Relief, Hemorrhage Rates, and Histopathological Changes(Springer, 2025-01-30) Civlan, Serkan; Berker, Berk Burak; Kiraz, Ilker; Yalcin, Nagihan; Sagtas, Ergin; Egemen, Emrah; Albuz, BarisThis study aims to demonstrate the effect of gamma knife radiosurgery (GKRS) on symptoms, hemorrhage rates, and histopathological changes in patients with cavernous malformations (CMs), regardless of whether the symptomatic lesions are hemorrhagic. This single-center retrospective study evaluated symptomatic patients with single CMs treated with GKRS between 2016 and 2023. The patients' demographic data, presenting symptoms, GKRS radiation dose, complications developed during follow-up (hemorrhage, radiotoxicity), the rate of symptom improvement, and histopathological changes of surgically removed CMs were recorded. Our study included 134 symptomatic patients, of whom 55 were male (41%) and 79 were female (59%). Among the patients, 80 (59.7%) had CMs in the lobar region, 23 (17.1%) in the cerebellum, 16 (12%) in the brainstem, and 15 (11.2%) in the basal nuclei/thalamus. The mean target volume was 0.64 +/- 1.23 cm3, and the mean tumor margin dose was 14.89 +/- 1.90 Gy. Symptoms were completely recovered in 95 patients (70.9%), while 18 (13.4%) experienced partial recovery. The annual hemorrhage rate (AHR) reduced from 6.26 to 1.01 following GKRS. Adverse radiation effects (ARE) were encountered in ten patients (7.46%) of cases, with only three patients (2.2%) being permanent. The mean follow-up period was 35.57 +/- 23.54 months (2-83 months). Two patients without hemorrhage underwent surgical removal of CM due to symptomatic deterioration after GKRS. Histopathological examination demonstrated numerous vascular structures with luminal narrowing due to hyalinization and fibrinoid necrosis caused after GKRS. Our findings suggest that GKRS may help reduce hemorrhage rates and potentially relieve symptoms in patients with symptomatic CMs, although further long-term studies are necessary to confirm these observations and to fully assess potential risks. Since there is no radiological method to evaluate the impact of GKRS on CMs, our study examines the histopathological changes that occurred following the GKRS. The histopathological changes prove that GKRS alters the morphology of the CMs and thus can relieve symptoms and reduce hemorrhage rates associated with CMs.Article Citation - WoS: 1Citation - Scopus: 1Impact of Laparoscopic Sleeve Gastrectomy on Pulmonary Arterial Stiffness and Right Ventricular Function in Obese Patients(Springer, 2024-12-09) Buber, Ipek; Aykota, Muhammed Rasid; Sevgican, Cihan Ilyas; Kaya, Derya; Akarsu, Harun; Tekin, Isik; Kilic, Ismail DoguIntroduction Pulmonary hypertension (PH) is a serious condition associated with high morbidity and mortality, with obesity identified as a significant risk factor. Pulmonary arterial stiffness (PAS) is an early marker of PH, often preceding clinical symptoms. While laparoscopic sleeve gastrectomy (LSG) has been shown to improve various cardiac parameters in obese patients, its impact on PAS and right ventricular (RV) function in the absence of PH remains unclear. This study investigates the effects of LSG on PAS and RV function in obese patients without pre-existing PH. Methods A cohort of 54 patients with obesity who underwent LSG between January and June 2023 at the University hospital was prospectively studied. Patients were evaluated preoperatively and six months postoperatively using comprehensive echocardiographic assessments. Key parameters measured included tricuspid annular systolic velocity (TAS), tricuspid regurgitation velocity (TRV), pulmonary flow acceleration time (PFAT), pulmonary artery velocity, and PAS. Statistical analyses were conducted using paired t-tests and the Wilcoxon signed-rank test. Results Significant improvements were observed in several echocardiographic and hemodynamic parameters post-LSG. PAS showed a notable reduction from 2.44 +/- 0.68 preoperatively to 1.74 +/- 0.32 postoperatively (p < 0.001). Additionally, significant decreases were observed in TRV (2.00 +/- 0.30 m/sec to 1.79 +/- 0.40 m/sec, p = 0.025) and systolic pulmonary artery pressure (SPAP) (21.28 +/- 4.69 mmHg to 18.36 +/- 5.28 mmHg, p = 0.025). Improvements in RV function were indicated by an increase in tricuspid annular plane systolic excursion (TAPSE) from 17.68 +/- 4.17 mm preoperatively to 21.18 +/- 3.53 mm postoperatively (p < 0.001). Conclusions LSG significantly reduces PAS and improves RV function in obese patients, even in the absence of PH. These findings suggest that LSG may offer protective effects on pulmonary vascular health, highlighting its potential as a therapeutic intervention for reducing PH risk in obese patients. Further research is warranted to explore the long-term cardiovascular benefits of LSG in diverse populations.Conference Object A Rare Case of Primitive Neuroectodermal Tumor on <sup>18</Sup>f-fdg Pet/Ct(Springer, 2024) Gultekin, A.; Aydogmus, U.; Sarioglan, G.[No Abstract Available]Conference Object Radiopharmaceutical Properties of Hydroxyapatite Smaller Than 50 Nm Produced From Eggshell and Labeled With Tc-99m and Its Biodistribution in Rabbits(Springer, 2024) Gultekin, A.; Ugur, A.; Sulak, M.; Demirezen, S.; Yuksel, D.[No Abstract Available]