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Öğe Impact of Metastatic Lymph Node Ratio on Survival and Prognosis in Rectal Carcinoma: A Retrospective Cohort Study(SPRINGERNATURE, 2024) Kartal, Bahadır; Tutan, Mehmet BerksunObjective This study aimed to evaluate the impact of the metastatic lymph node ratio (mtLNR) on survival outcomes and prognosis in patients with rectal carcinoma, in comparison with other clinicopathological factors. Methods A retrospective cohort analysis was conducted on 97 patients with rectal adenocarcinoma who underwent surgical treatment at Erol Ol & ccedil;ok Training and Research Hospital between January 2017 and December 2022. The inclusion criteria consisted of patients over 18 years of age and the absence of hematological disorders or concurrent inflammatory conditions. The patients' demographic data, tumor characteristics, surgical details, lymph node (LN) status, mtLNR, and survival outcomes were analyzed. The optimal cutoff value of mtLNR for predicting mortality was determined using receiver operating characteristic (ROC) curve analysis. Kaplan-Meier survival analysis was employed to estimate overall survival (OS) and disease-free survival (DFS), and differences between groups were evaluated using the log-rank test. The Cox proportional hazards model was used to calculate hazard ratios (HRs) for all-cause mortality. Statistical significance was set at p<0.05. Results The mean age of the patients was 70.31 +/- 11.57 years, with 65.98% being male. Low anterior resection (LAR) was performed in 83.51% of the patients, and laparoscopic surgery was conducted in 26.8%. The median OS for the entire cohort was 24 months (range: 3-60). Patients were divided into two groups based on mtLNR, with the cutoff value set at 0.2183. A high mtLNR was significantly associated with poorer DFS and OS (p=0.021 and p=0.003, respectively). Moreover, patients with an mtLNR>0.2183 exhibited significantly higher rates of recurrence, lymphovascular invasion (LVI), and perineural invasion (PNI) compared to those with a lower mtLNR (all p<0.001). The optimal cutoff value of mtLNR predicted mortality with a specificity of 81.4% and a sensitivity of 48.1% (area under the curve (AUC) 0.662, p=0.012). Kaplan-Meier analysis showed a significant difference in survival between the two groups; the risk of all-cause mortality was 3.71 times higher in patients with mtLNR>0.2183 (p=0.002). Conclusion The mtLNR is a strong determinant of survival and prognosis in patients with rectal carcinoma. High mtLNR values are associated with worse survival outcomes and more aggressive tumor characteristics. The findings suggest that mtLNR should be considered in clinical decision-making processes. These results indicate that mtLNR could be a valuable prognostic tool in clinical decision-making.Öğe Investigating AXIN1 gene polymorphisms in Turkish children with cryptorchidism: A pilot study(ELSEVIER SCI LTD, 2024) Doğan, Gül; Yılmaz, Akın; İpek, Hülya; Metin, Mehmet; Peltek Kendirci, Havva Nur; Afşarlar, Çağatay EvrimIntroduction Cryptorchidism is one of the most common congenital anomalies in male children, occurring in 2e5% of full-term male infants. Both genetic and environmental factors are observed to play a role in its etiology. A study conducted in Japan identified the AXIN1 gene as being associated with cryptorchidism. Objective We aimed to conduct a pilot study on AXIN1 gene polymorphism in Turkish children with cryptorchidism, and whether AXIN1 gene polymorphism is a risk factor for cryptorchidism. Study design Between January 2023 and December 2023, we have planned a prospective controlled study including 84 boys operated for cryptorchidism as study group, and 96 boys operated for circumcision as control group. The remaining blood samples of preoperative laboratory tests in ethylenediamine tetraacetic acid (EDTA) tubes were kept at 20 Co freezer for genomic studies. Patient demographics, physical examination and operative findings were recorded, study patients were grouped according to testis localization. After collecting all samples, genomic DNA isolation procedure was done, and analysis of the 3 polymorphisms (rs12921862, rs1805105 and rs370681) of AXIN1 gene was performed using conventional Polymerase Chain Reaction Restriction Fragment Length Polymorphism (PCR-RFLP) method. Genotype and allele frequencies of each group was analyzed and compared. Results The most common location of cryptorchid testis was proximal inguinal (53%), followed by distal inguinal (25.3%), bilateral (13.3%), and intra-abdominal (8.4%). Regarding the 3 polymorphisms of AXIN1 gene, there was no significant difference between study and control groups, in terms of genotype and allele frequencies (P > 0.05). Eight haplotype blocks were estimated for 3 polymorphisms of AXIN1. However, no significant difference was observed between study and control groups regarding haplotype distributions (P > 0.05). In addition, the comparison of the localization of testis with AXIN1 gene polymorphism did not show any significant difference among cryptorchid testis groups (P > 0.05). Discussion The AXIN1 gene is located on chromosome 16p and its polymorphisms have been associated with various diseases. In a Chinese study, the rs370681 polymorphism was found to be associated with cryptorchidism. However, our results showed no association between the AXIN1 gene haplotypes for the studied polymorphisms and cryptorchidism. Conclusion In this study we have investigated the AXIN1 gene polymorphism in Turkish children with cryptorchidism as a pilot study. Although we could not identify any difference as compared to control group, further research is necessary to uncover the underlying molecular mechanisms contributing to the development of cryptorchidism.Öğe Predictive Value of Serial Rapid Shallow Breathing Index Measurements for Extubation Success in Intensive Care Unit Patients(MDPI, 2024) Turhan, Semin; Tutan, Duygu; Şahiner, Yeliz; Kısa, Alperen; Önen Özdemir, Sibel; Tutan, Mehmet Berksun; Kayır, Selçuk; Doğan, GüvençAbstract: Background and Objectives: Extubation success in ICU patients is crucial for reducing ventilator-associated complications, morbidity, and mortality. The Rapid Shallow Breathing Index (RSBI) is a widely used predictor for weaning from mechanical ventilation. This study aims to determine the predictive value of serial RSBI measurements on extubation success in ICU patients on mechanical ventilation. Materials and Methods: This prospective observational study was conducted on 86 ICU patients at Hitit University between February 2024 and July 2024. Patients were divided into successful and unsuccessful extubation groups. RSBI values were compared between these groups. Results: This study included 86 patients (32 females, 54 males) with a mean age of 54.51 ± 12.1 years. Extubation was successful in 53 patients and unsuccessful in 33. There was no significant difference in age and intubation duration between the groups (p = 0.246, p = 0.210). Significant differences were found in RSBI-1a and RSBI-2 values (p = 0.013, p = 0.011). The median RSBI-2a was 80 in the successful group and 92 in the unsuccessful group (p = 0.001). The ?RSBI was higher in the unsuccessful group (p = 0.022). ROC analysis identified optimal cut-off values: RSBI-2a ? 72 (AUC 0.715) and ?RSBI ? ?3 (AUC 0.648). RSBI-2a ? 72 increased the likelihood of successful extubation by 10.8 times, while ?RSBI ? ?3 increased it by 3.4 times. Using both criteria together increased the likelihood by 28.48 times. Conclusions: Serial RSBI measurement can be an effective tool for predicting extubation success in patients on IMV. These findings suggest that serially measured RSBI may serve as a potential indicator for extubation readiness.Öğe Unusual ocular manifestations of ethomoidal mucocele: a case report(CONSEL BRASIL OFTALMOLOGIA, 2024) Cevher, Selim; Elkıran, Serdar AliA 42-year-old female patient had vision loss and chronic epiphora in her left eye. Her best-corrected visual acuity was 10/10 in the right eye and 0.3/10 in the left eye. The anterior segment examination results were normal. In fundus examination, choroidal folds were detected. Optical coherence tomography showed elevation on the macula and choroidal folds. Ultrasonography revealed a T-sign. Magnetic resonance imaging revealed an ethmoidal mucocele that compresses the orbital tissues. Surgical treatment was performed in the otorhinolaryngology department. Postoperatively, choroidal folds recovered, and the best-corrected visual acuity improved, but subretinal fluid accumulated. During the follow-up period without any treatment, subretinal fluid totally disappeared.Öğe Comparison of radiological and functional results in osteoporotic distal femur fractures operated with single plating, lateral incision, and double plating, anterior paramedial incision: A retrospective study(LIPPINCOTT WILLIAMS & WILKINS, 2024) Çalbıyık, Murat; Zehir, Sinan; Demirezen, Murat OkanTreatment of osteoporotic distal femur fractures is often complicated by a high rate of nonunion and varus collapse. For such fractures, lateral plating with lateral incision and double plating with anterior paramedial incision have shown promising results in the recent literature. The hypothesis of this study was that bilateral plating of comminuted distal femur fractures in osteoporotic patients would result in higher union rates and lower revision rates compared to an isolated lateral locking plate. The study included 56 patients (23 males, 33 females) with supracondylar femur fracture. According to the OA/OTA classification, 9 were type A3, 8 were A2, 13 were C1, 16 were C2, and 10 were C3. The mean follow-up period was 12 months, with 29 patients treated using lateral mini-incision, lateral locking plate, and 27 patients treated with anterior paramedial incision, dual plating. The clinical and radiological results were evaluated. The mean duration of radiological union in the studied population was 15 +/- 2.1 months (range, 11-21 months) in the single plate group (Group A), and 13.5 +/- 2.6 months (range, 9-19 months) in the double plate group (Group B). Mean ROM was 112.3 degrees and flexion contracture 4 degrees in Group A, and ROM 108.3 degrees and flexion contracture 6.7 degrees in Group B. (P = .15). The average Western Ontario and McMaster Universities Arthritis Index (WOMAC) score was 85.6 points in Group A and 83.5 points in Group B (P = .2278). The postoperative anteversion measurement in the operated extremity ranged from -15 to 19 in Group A, and from 5 to 18 in Group B. When the anteversion degrees were compared between the injured and uninjured extremities in the postoperative period, a significant difference was observed within Group A (P = .0018), but no significant difference was observed in Group B (P = .2492). Dual plate fixation using the anterior paramedial approach is an effective operative method for osteoporotic distal femur fractures. This has many advantages such as precise exposure, easy manipulation, anatomic reduction, and stable fixation. However, for surgical indications and medial bone defects > 1 cm, grafting should be performed.Öğe Long-term outcomes of percutaneous release technique or open for trigger finger in diabetic patients(MediHealth Academy Yayıncılık, 2023) Dündar, Abdulrahim; İpek, Deniz; Kaya, ŞehmuzAims: Trigger finger is seen more often in diabetic patients and can lead to more serious postoperative complications compared to non-diabetic patients. The aim of this study was to compare the outcomes of open and percutaneous release techniques in diabetic patients. Methods: This retrospective study included 62 patients who met the study criteria. Of these patients, 32 underwent open release surgery and 30 underwent percutaneous release with an 18-gauge needle. The patients were evaluated retrospectively in respect of the data on first presentation preoperatively and at postoperative follow-up examinations at 3 weeks, 6 months and 1 year. A retrospective examination was made of the demographic data, Visual Analog Scale (VAS) scores preoperatively, at 6 and 12 months postoperatively, recurrence rates at the end of 6 months and 1 year, the Quinnell grading scale at the end of 1 year, wound site infection, tendon damage and neurovascular complications. VAS scores and the Quinnell grading scale were used for clinical evaluation. Results: The data of a total of 62 patients were statistically analyzed in the study, with 32 (51.6%) in the Open group and 30 (48.4%) in the Percutaneous group. The mean age of the patients was 58.97±7.51 (min-max: 45-72) years. The distributions of trigger finger and Quinnell grading system scores were statistically similar between the groups (P=0.974, P=0.279, respectively). The recurrent triggering rate at the 6th and 12th month was significantly higher in the Percutaneous group (P=0.049, P=0.049, respectively). The average return to work duration in the Percutaneous group (1.70±0.75) was significantly shorter than that in the Open group (3.88±1.21) (P<0.001). Pre-op, Post-op 6th and 12th month VAS scores did not significantly differ between the groups (P=0.466, P=0.356, P=0.175, respectively). Conclusion: Although satisfactory results were obtained with both percutaneous and open release techniques in the patients with diabetes in this study, the percutaneous release technique was seen to be a method which can be easily performed in an outpatient setting and had fewer complications.Öğe Clinical and Radiological Results of Patients Treated with Talon Distalfix Femoral Intramedullary Nail for Femoral Shaft Fractures(Hitit University, 2023) Dündar, Abdulrahim; İpek, Deniz; Zehir, Sinan; Kaya, ŞehmuzObjective: Talon distalfix intramedullary nails have been developed as a solution to the technical difficulties experienced during the placement of locking screws. We aimed to evaluate the radiological and clinical results of retractable talon distal fix for the treatment of femoral shaft fractures. Material and Method: Between January 2017 and January 2022, 28 patients with femoral shaft AO type 32-A and B fractures were treated with Talon distalfix nails. AO Type 32-A and B fractures were included in the study. Demographic characteristics, follow-up times, ASA of Anesthesiologists classification and fracture type were recorded. The duration of the operation, intraoperative blood loss, fluoroscopy time (in min), and time to bone union were recorded. General and technical complications (nonunion, malunion, malrotation, and shortening) were evaluated. Clinical functional outcomes were evaluated using the Knee Injury and the Osteoarthritis Outcome Score Physical Function Shortform (KOOS-PS), Hip Injury and Osteoarthritis Outcome Score Physical Function Shortform (HOOS-PS) and Thoresen criteria. Results: A total of 28 patients (11 female and 17 male) were included in the study. The mean age was 46.8 years and the mean follow-up was 23.7 months. The mean time to bone union was 22.6 weeks. No nonunion was observed in any of the patients. The mean hospital stay was 3.4 days and the mean Body Mass Index was 24.2. The mean operation time was 40.3±3.4 minutes and the mean scope time was 26.9 seconds. The mean KOOS-PS score and HOOS-PS were 83.4 and 85.6, respectively. Conclusion: Talon distalfix nails can be safely used in AO type A-B fractures of the midshaft femur. Talon distalfix nail application provides advantages including shorter operation times, less radiation exposure, fewer surgical incisions, and less blood loss. In addition, it should be emphasized that the union time is prolonged compared with that of conventional nailsÖğe Acetabular fractures from Judet and Letournel to the present: Research trends and global outcomes with bibliometric analysis during 1980 to 2022(LIPPINCOTT WILLIAMS & WILKINS, 2023) Dündar, Abdulrahim; İpek, Deniz; Kaya, ŞehmuzFractures of the acetabulum are one of the most challenging injuries treated by orthopedic surgeons. However, a bibliometric analysis has not been performed in the literature on acetabular fractures, which seriously affect the quality of life of patients. The aim of this study was to summarize the bibliometric and intellectual structure, and determine and map the most recent trends on the topic of acetabular fractures by analyzing the social and structural relationships between the different research components of articles published on the acetabular fractures. 1599 articles on acetabular fractures published between 1980 and 2022 were extracted from the Web of Science (WoS) database and analyzed. Bibliometric visualization maps were used to reveal trending topics, citation analyses, and international collaborations. Spearman correlation analysis was performed for correlation investigations. The trend in the expected number of articles to be published over the next few years was displayed using the exponential smoothing estimator. The top 3 contributing countries to the literature were United States of America (USA) (551, 34.4%), China (170, 10.6%), and Germany (160, 10%). The most active author was Berton R. Moed (n = 29) and the most active institution was the University of California System (n = 41). A high-level statistically significant correlation was found between the number of articles on the topic of acetabular fractures published by nations and the gross domestic product (GDP) and GDP per capita values of those countries (R = 0.719, P < .001; R = 0.701, P < .001, respectively). The trending topics researched in recent years were 3D printing, 3-dimensional printing, outcomes, Open Reduction and Internal Fixation (ORIF), mortality, Kocher-Langenbeck, Pararectus approach, tranexamic acid, transfusion, epidemiology, fracture mapping, modified Stoppa approach, post-traumatic osteoarthritis, pelvis fracture, pelvic trauma, fracture reduction, and pelvic ring injury. The leading countries in research on the subject of acetabular fractures were seen to be western countries with large economies (especially the USA, European countries, and Canada) and China, India and Turkey.Öğe A bibliometric perspective with research trends and global productivity on the modernization of andrology from the founder of modern clinical andrology Edward Martin to the present(Verduci Editore, 2023) Ekici, Musa; Demir, Emre; Aydın, CemilOBJECTIVE: The number of studies in the field of andrology is increasing day by day, but a bibliometric study covering the entire literature on andrology has not yet been conducted. This bibliometric study aims to shed light on the question of where we came from and where we are going in andrology from past to present. It also aimed to summarize the intellectual structure of andrology to reveal global productivity and identify and map the latest trends of scientific articles published in the field of andrology. MATERIALS AND METHODS: 16,659 articles published between 1980 and 2022 were extracted from the Web of Science and analyzed using various statistical methods. Bibliometric network visualization maps revealed trending topics, global productivity, the most influential studies, and international collaborations. Spearman’s correlation analysis was used for determining correlations. RESULTS: The top three productive countries were United States of America (3,452; 20.7%), China (2,300; 13.8%), and Germany (1,069; 6.4%). The top two most productive authors were Agarwal A. (n=130) and Nieschlag E. (n=130). The most productive institution was the Egyptian Knowledge Bank (n=422). From past to present, the most studied subjects were testis, male infertility, spermatozoa, testosterone, infertility, erectile dysfunction, spermatogenesis, sperm, prostate cancer (PCA)/neoplasms, oxidative stress, fertility/fertilization, semen, rat(s), apoptosis, azoospermia, sperm motility, human and varicocele. CONCLUSIONS: The trend topics that have been researched more in recent years include erectile dysfunction, oxidative stress, prostate cancer, sperm quality, sperm parameters, infertility, premature ejaculation, diabetes mellitus, obesity, prognosis, sperm DNA fragmentation/damage, antioxidant, asthenozoospermia, varicocelectomy, COVID-19, inflammation, prostatectomy, metabolic syndrome, hypogonadism, benign prostatic hyperplasia, lower urinary tract symptoms, meta-analysis, sexual dysfunction, peyronie’s disease, and proliferation. We identified the research leadership of China, Japan, Turkey and India, in addition to Western countries, such as the USA and European countries.Öğe The Effect of Biogel Using Biomagnetic Energy in the Treatment of Acute Pain in the Upper Extremity and Spine: A Randomized Controlled Trial(2023) Kayır, Tuba; Demir, Emre; Alıç, Taner; Kayır, SelçukObjective: Pain is a public health problem, which is caused by various etiological factors and leads to diminished quality of life and decreased workforce. The aim of this study was to determine whether Biogel has an effect in the treatment of pain. Methods: Patients due to acute pain in the upper extremity and/or trunk were divided into two groups as treatment and placebo by randomization method. For the patients in the treatment group,the non-interventional Biogel was applied for 10 minutes. For the control group, a non-interventional placebo was applied for 10 mins. A record was made of patient demographic data,the region of the pain, and mean arterial pressure (MAP) values before and after the application. All the patients in both groups were administered a Visual Analogue Scale (VAS) to evaluate pain severity,and the Nottingham Health Profile (NHP) before and after the applications. The data obtained were compared. Results: In the biogel group, a statistically significant decrease was determined in the NHP-P values after treatment compared to before treatment (P<0.001). In the placebo group,no statistically significant difference was determined in the NHP-P values before and after treatment (P=0.104). In the Biogel group,a statistically significant decrease was determined in the VAS values after treatment compared to before treatment (P<0.001). In the placebo group,no statistically significant difference was determined in the VAS values before and after treatment (P=0.157). Conclusion: These types of complementary medicine applications focussed on pain treatment can reduce the disease burden and can probably reduce costs.Öğe Biomechanical comparison of different suture materials with different techniques in tendon repair: An ex-vivo study(ELSEVIER, 2023) Muslu, Ümran; Alıç, Taner; Demir, Emre; Gölpınar, Murat; Bilici, İbrahim; Demirezen, Murat OkanObjectives Sheep Achilles tendons are used as an effective preclinical model of flexor tendon repair in plastic surgery, due to their biomechanical properties, which are similar to humans. The aim of this study was to examine the efficacy and biomechanical outcomes of suture materials and tendon repair techniques in flexor tendon repair. Material and methods 72 sheep tendons were obtained for a total of 12 different scenarios. Tendons were repaired using 4 different suture types and 3 different suture techniques. After repair, the tendons were fixed at both ends and subjected to biomechanical tests. Ultimate Failure Load (UFL) and 2-mm Gap Load (GL) per scenario were compared statistically within and between groups. Results UFL and GL of all sutures were significantly different between the modified Kessler, Bunnell and Krackow techniques (P??0.05). Conclusion When UFL and GL were considered together, our findings indicate that optimal strength scenarios were for the modified Kessler technique using Monosorb or V-loc sutures.Öğe Evolution of Inguinal Hernia Publications: A Bibliometric Analysis from 1980 to 2021(INT SCIENTIFIC INFORMATION, INC, 2023) Şahiner, İbrahim Tayfun; Altunal, ÇetinAbstract BACKGROUND Despite the increasing number of studies published worldwide focusing on inguinal hernia, a major condition in the surgical field that affects the quality of life of many patients, a bibliometric study on inguinal hernia is yet to be conducted. The present study aimed to analyze the scientific articles published on inguinal hernia using statistical methods. MATERIAL AND METHODS Articles published between 1980 and 2021 on inguinal hernia were downloaded from the Web of Science database and analyzed using statistical methods. RESULTS A total of 11 761 publications were found. The top 5 contributors to the literature were the United States (n=2109, 27%), Germany (563, 6.7%), United Kingdom (595, 5.7%), Turkey (415, 5.3%), and Japan (388, 4.9%). The top 3 most influential journals by average number of citations per article were Annals of Surgery (citations: 67.4), British Journal of Surgery (citations: 49.9), and Surgical Clinics of North America (citations: 43.2). CONCLUSIONS In the current comprehensive bibliometric study on inguinal hernia, which has demonstrated an upward trend in the number of articles published recently, we present a summary of 7810 articles published from 1980 to 2021. According to the results of the analysis conducted to identify trending topics, the keywords studied in recent years are believed to include pediatric, outcomes, minimally invasive surgery, robotic, incisional hernia, umbilical hernia, chronic pain, obesity, bariatric surgery, NSQIP, seroma, surgical site infection, abdominal wall reconstruction, ventral hernia repair, and hiatal hernia repair.Öğe The association between plasma concentration of pigment epithelium-derived factor and diabetic retinopathy(WALTER DE GRUYTER GMBH, 2023) Şahin, Tayfun; Karabulut, AlpaslanObjectives Diabetic retinopathy (DRP) is one of the most common microvascular complications of diabetes. The pigment epithelium-derived factor (PEDF) is a protein that is one of the most potent angiogenesis inhibitors. The effect of blood PEDF concentration on DRP formation remains unclear. The present study aimed to determine whether the plasma concentration of PEDF is effective on the appearance of DRP. Methods The present study consisted of 62 patients with diabetes mellitus and 20 healthy participants. The patient group included 28 patients with non-proliferative DRP, 13 with proliferative DRP, and 21 diabetic patients without DRP. The PEDF levels in patient serum samples were detected through the ELISA method. The body mass index of the participants was calculated. Results Serum PEDF levels of diabetic patients (1.533 ± 0.233??g/mL) were found to be lower (2.163 ± 0.343??g/mL) than healthy participants (p=0.002). The PEDF levels were similar in the DRP and non-DRP groups (p=0.337). The plasma PEDF level decreased along with the progression of DRP (p=0.001). Conclusions The PEDF concentration in the blood decreases along with the increase of DRP grade. Decreased blood concentration of PEDF may be important to predict microvascular complications. Agents containing PEDF may be used intraocularly/systemically for therapeutic purposes to prevent vascular complications of diabetes in the near future.Öğe Intragastric injection botulinum toxin A for obesity management with or without liraglutide(Verduci Editore s.r.l, 2023) Altunal, Çetin; Şahiner, İbrahim Tayfun; Yavuzer, Serap; Cengiz, Mahir; Sadıkoğlu, TümayAbstract. – OBJECTIVE: Obesity is a global public health problem with rapidly increasing prevalence in many countries, including Turkey, and different treatment modalities have been used. This study aimed to compare the effect of intragastric botulinum toxin A (BTA) injection and BTA injection combined with low-dose liraglutide in patients with obesity. PATIENTS AND METHODS: Records of 701 patients (female/male, 660:41; mean age, 45.6 ± 6.2 years) who received an intragastric injection of BTA for weight loss between November 2019 and May 2020 were reviewed retrospectively. The patients were divided into the BTA group, which included patients who received BTA injection alone, and BTA + liraglutide, which included those who used liraglutide after BTA injection. The demographic characteristics and comorbid diseases of the patients and follow-up results 6 months after the procedure were evaluated. RESULTS: In the comparison of the 3-month and 6-month weights of the patients, weight measurements were significantly lower in the BTA + liraglutide group than in the BTA group (p < 0.001 and p < 0.001, respectively). Adverse effects were observed in 212 (30.2%) of the study participants, of which 25% were observed in the BTA group and 31.8% in the BTA + liraglutide group, with no significant difference. CONCLUSIONS: The intragastric injection of BTA combined with liraglutide is a safe method that provides more effective weight loss than BTA alone, which is minimally invasive without any serious adverse effects.Öğe Is tendinitis in volar plating related to the dorsally protruding screw length and its compartment?(TURKISH JOINT DISEASES FOUNDATION, 2023) Alıç, Taner; Fidan, Nurdan; Hassa, Ercan; Zehir, SinanObjectives: The aim of this study was to evaluate the relationship between the length of the protruded screws from the dorsal cortex and extensor tendon damage in all compartments. Patients and methods: Between May 2020 and April 2021, a total of 29 patients (13 males, 16 females; mean age: 52.3±13.0 years; range, 30 to 78 years) who were operated and followed in our clinic for AO A2 and A3 distal radius fractures were included in this prospective study. Surface ultrasound (US) imaging was made to the dorsal sides of both wrists of the operated patients at different timepoints postoperatively. The length of screws with radius dorsal cortex penetration and the presence of tendinitis were recorded. Results: In 15 of 23 patients, the presence of 29 protruding screws was accompanied by tendinitis and, in eight patients, no tendinitis was observed, despite the partial protrusion of screws. A statistically significant correlation was found between the screw protrusion and presence of tendinitis (p1.6 mm and the presence tendinitis (p1.6 mm. Screw penetration can be easily identified with intraoperative US to prevent tendinitis and potential tendon ruptures.Öğe Relationship Between Psychological Symptoms and Self-Esteem Levels Before and After Stomach Botox Treatment(INT SCIENTIFIC INFORMATION, INC, 2023) Altunal, Çetin; Şahiner, İbrahim TayfunBackground: Obesity is an exponentially increasing public health problem all over the world. When obesity is treated, many healing states begin to occur in obese individuals. Stomach Botox is also frequently used among non-surgical treatment methods. This prospective study examined the relationship between psychological symptoms and self-esteem levels before and after stomach Botox treatment. Material/Methods: We administered a survey to gather baseline information, and used the form, Brief Symptoms Inventory and Rosenberg Self-Esteem scales. In total, 406 patients, including 369 females (90.9%) and 37 males (9.1%), par-ticipated in the research during February to August 2020. Results: Anxiety, negative personality, somatization, and hostility levels before Botox treatment were higher than after Botox treatment. Depression levels were higher after Botox treatment. Anxiety, somatization, and hostility in-creases were statistically significant (P<0.05). Depression and negative personality differences were insignifi-cant (P>0.05). Before Botox treatment, all psychological symptom and self-esteem level correlations were insig-nificant (P>0.05). After Botox treatment, correlations between anxiety, negative personality and hostility levels with self-esteem level were statistically and negatively significant (P<0.05). Anxiety after Botox treatment had a significant effect on self-esteem level on multivariate level (P<0.05). Conclusions: Obesity treatment methods positively affect physical health and mental health. While there are many con-fusing scientific studies on stomach Botox treatment, none of these studies seem to have had strict diet and movement monitoring. Stomach Botox treatment not only positively affects the physical appearance and men-tal health of individuals, but also their self-perception during the obesity treatment process.Öğe Global productivity and research trends of colorectal carcinoma: A scientometric analysis of studies published between 1980 and 2021(LIPPINCOTT WILLIAMS & WILKINS, 2023) Şahiner, İbrahim Tayfun; Altunal, ÇetinAbstract Although colorectal cancer (CRC) is a serious cause of death and has a significant impact on patients’ quality of life and incidence rate of CRC has increased among the younger populations, bibliometric research of CRC has not been conducted yet. To perform a comprehensive analysis of scientific publications on CRC using various statistical and bibliometric techniques. Publications on CRC published between 1980 and 2021 were downloaded from the Web of Science database and analyzed using statistical methods. The trending topics, collaborations among countries, and citation relationships were analyzed using bibliometric network visualization mapping. The number of articles to be probably published in the next 5 years was estimated using the exponential smoothing estimator. The Spearman’s correlation rank correlation coefficient was used to analyze the correlations among the variables. A total of 122,717 publications were found in the fields of oncology, gastroenterology, hepatology, and surgery. Of the published articles, 64,774 publications were research articles. The top five countries that contributed the most to the literature were the USA (16,604; 25.6%), China (10,567; 16.3%), Japan (7932; 12.2%), the UK (5009; 7.1%), and Italy (4287; 6.6%). The most prolific author, institution, and journal in the field of CRC were Zhang Y (n = 331), University of Texas System (n = 1646), and Diseases of the Colon and Rectum (n = 2090), respectively. The most influential journal based on the average number of citations received per article was CA-A Cancer Journal for Clinicians (citations per article; 286). There was a significant positive correlation between the number of articles produced by the countries on CRC and gross domestic product and human development index (r = 0.726, P < .001; r = 0.658, P < .001, respectively). Additionally, a significant moderate correlation of CRC was found with gross domestic product per capita (r = 0.711, P < .001). Keywords like overall survival, neoadjuvant chemoradiotherapy, locally advanced rectal cancer, robotic surgery, anastomotic leakage, chemoradiotherapy, metastatic colorectal cancer, KRAS, metaanalysis, colorectal surgery, and laparoscopic surgery were studied. Abbreviations: CI = confidence interval, CRC = colorectal cancer, EMT = epithelial-mesenchymal transition, GDP = Gross Domestic Product, HDI = human development index, NC = number of citation, RNA = Ribo Nucleic AcidÖğe Analgesic efficacy of ultrasound-guided bilateral transversus abdominis plane block in children: retrospective analysis of 97 cases(TUBITAK SCIENTIFIC & TECHNICAL RESEARCH COUNCIL TURKEY, 2023) Pampal, Hasan Kutluk; Erel, Selin; Turhan, Semin; Uğraş Dikmen, Asiye; Işık, BerrinBackground/aim: Transversus abdominis plane (TAP) block is a method for postoperative pain management. Studies on children are gradually increasing. The aim of this retrospective study was to evaluate effectiveness of TAP block on pain control, its side effects, and parental satisfaction levels in children. Material and methods: Study included patients operated between January 2019 and December 2020 in Gazi University Faculty of Medicine. Total of 97 patients (35 girls, 62 boys) between 5 and 18 years who had an ultrasound guided TAP block for lower abdominal or inguinal surgery were examined retrospectively. TAP block application time, hemodynamic variables, postoperative pain scores, postoperative analgesic requirement, sex, surgical history and satisfaction levels were evaluated. Results: The average application time of TAP block was 9.48 ± 3.4 and the time between TAP block and surgical incision was 12.06 ± 6.1 min. Pain scores in postanesthesia care unit (PACU) and at the postoperative first hour decreased as the time between TAP block and surgical incision increased (p < 0.05). Girls have higher pain scores at PACU than boys (p < 0.05). Previous surgical history increased postoperative 1st hour pain scores (OR: 13.8; 95% CI 1.7–113.3; p = 0.01). There was a significant negative correlation between pain scores at PACU, postoperative 1st, 2nd, 4th, 6th, 12th and satisfaction levels (r = –0.45, r = –0.56, r = –0.60, r = –0.54, r = –0.52, r = –0,43, respectively, p < 0.05). Conclusion: Ultrasound-guided TAP blocks can be performed safely in children in lower abdominal surgeries. However, the efficacy of TAP block on late term postoperative pain scores is limited. Time interval between the TAP block and the incision, sex, and pain memory, as well as other factors that may improve the quality of TAP block should be considered.Öğe Does lymph node ratio (metastasis/total lymph node count) affect survival and prognosis in gastric cancer?(SAUDI MED J, 2022) Topcu, Ramazan; Şahiner, İbrahim Tayfun; Kendirci, Murat; Erkent, Murathan; Sezikli, İsmail; Tutan, Mehmet B.Objectives: To investigate the influence of the metastatic lymph node/total lymph node ratio (N- ratio) on survival and prognosis in surgically treated gastric carcinomas. Methods: A retrospective review of 73 patients who underwent curative resection at the Department of General Surgery, Hitit University Faculty of Medicine, Turkey. Receiver operating characteristic analysis was used to calculate the cut-off value for the N-ratio of the patients. The N-ratio cut-off value was determined to be 0.32. Patients were divided into 2 groups: below 0.32 (Group 1) and 0.32 and above 0.32 (Group 2). Results: Group 2 patients had a total lymph node mean of 25.10 +/- 13.64 while Group 1 patients had a total lymph node mean of 18.77 +/- 9.36 (p=0.04). In Group 2, the mean of metastatic lymph node was 15.97 +/- 10.30 (p<0.001). The mortality rate of Group 1 was 18% while Group 2 was 51.7%, and were statistically significant (p=0.0039). The estimated survival duration of Group 2 was 24.22 months, and Group 1 was 48.01 months (p=0.001). The mean estimated survival time for the entire group was 40.92 months. We differentiated patients from the development of mortality cut-off value in ROC analysis with 65.2% sensitivity and 72% specificity. This ratio was found to be 0.32, which was statistically significant (p=0.003). Ratios greater than 0.32 raised the risk of mortality by 4.8 times, which was statistically significant (p=0.003). Conclusion: The N-ratio could be a new metric to evaluate prognosis following curative gastrectomy and improve the existing tumor lymph node metastasis staging system.Öğe Efficacy of Annona muricata (graviola) in experimental spinal cord injury: biochemical and histopathological analysis(TURKISH ASSOC TRAUMA EMERGENCY SURGERY, 2022) Keskin, Emrah; Elmas, Özlem; Keser Şahin, Havva Hande; Güven, BerrakBACKGROUND: Annona muricata (AM) (graviola) is a plant that grows in tropical regions and is thought to be good for many diseases by local people. Unfortunately, there is no acceptable medical treatment for spinal cord injury (SCI) yet. In our study, we investigated the neuropeotective effects of AM leaf extract on SCI in an experimental rat model. METHODS: A total of 40 Wistar albino rats were randomly divided into five equal groups (n=8). Group 1 was the control group in which only laminectomy was performed. Trauma was induced in four groups after laminectomy. Group 2 (untreated trauma group) was given no medication. In Group 3, a single intraperitoneal dose of methylprednisolone (30 mg/kg) was administered after trauma. The rats in Groups 4 received a low dose (100 mg/kg) of AM leaf extracts by oral gavage one week before trauma while the rats in Group 5 received a high-dose (300 mg/kg) of these extracts by oral gavage one week before trauma. All rats, including the control group, were sacrificed 24 h after the trauma was created. RESULTS: Tissue samples taken to evaluate the neuroprotective effect were examined biochemically and histopathologically. Inflammatory findings in the trauma group were significantly better in both groups treated with AM. There was no difference between the groups in terms of clinical motor examination and inclined plane test results. CONCLUSION: Our histopathological and biochemical results showed that AM is an agent with neuroprotective effects in traumatic SCI.
