Objective: Several studies have shown that the De Ritis (aspartate aminotransferase/alanine aminotransferase) ratio is a prognostic biochemical biomarker in many cancers, including urological cancers. Biochemical recurrence is a well-known indicator
of the biological aggressiveness of the tumor. In our study, we aimed to evaluate the predictability of the De Ritis ratio for biochemical recurrence in patients who underwent radical prostatectomy due to localized prostate cancer.
Methods: This study included 198 patients who underwent radical prostatectomy for localized prostate cancer between
2008 and 2015 in our clinic. Preoperative data of the patients included age, prostate-specific antigen level, post-biopsy Gleason
score, De Ritis ratio, neutrophil/lymphocyte ratio, and platelet count. Among the postoperative data, the Gleason score, extracapsular invasion, positive surgical margin, seminal vesicle invasion, perineural invasion, lymph node invasion, and pathological
tumor stage data were evaluated retrospectively. The relationship of these parameters was examined in patients who developed biochemical recurrence during the follow-up period.
Results: The mean follow-up period of the patients was 56.7 ± 23.6 months and biochemical recurrence occurred in 10.1% of
all patients. In the receiver-operating characteristic analysis, the cut-off value for biochemical recurrence was 1.184, and the
patients with a ratio below this value were grouped as the low De Ritis group and the patients with higher rates were grouped
as the high De Ritis group. According to multivariate logistic regression analysis, high De Ritis ratio, Gleason score >8 of radical
prostatectomy specimen, positive surgical margin, and the presence of seminal vesicle invasion were detected as independent
risk factors for biochemical recurrence after radical prostatectomy.
Conclusion: De Ritis ratio is an independent risk factor for predicting biochemical recurrence in patients who underwent radical
prostatectomy due to localized prostate cancer.
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Objective: To evaluate upper extremity movement, pain intensity, and respiratory functions in preoperative and postoperative
periods in patients undergoing thoracotomy sparing the serratus anterior muscle (TSSAM).
Methods: Forty-three patients (25 male and 18 female) were included in this prospective observational cohort type study. In
the preoperative period and on postoperative days 1, 2, 3, and 5, ipsilateral shoulder range of motion was evaluated by a goniometer, pain intensity was evaluated by a visual analog scale (VAS), and respiratory functions were evaluated by spirometry.
Results: When compared with preoperative values, shoulder flexion and abduction angle, forced expiratory volume in 1 second
(FEV1), and functional vital capacity (FVC) decreased on postoperative day 1, while VAS significantly increased (P < .05). Shoulder
flexion and abduction angle, FEV1, and FVC significantly increased and VAS significantly decreased on postoperative days 2, 3,
and 5 compared to postoperative day 1 (P < .05). However, they could not reach preoperative values on postoperative day 5
(P < .05). On postoperative day 1, while there was a correlation between pain and flexion (r=−0.438; P=.003) and abduction
(r=−0.503; P=.001) angles, no correlation was found between pain and FEV1 (r=−0.189; P=.225) and FVC (r=0.009; P=.953).
There was no correlation between pain and flexion, abduction, FEV1, and FVC on postoperative days 2,3, and 5 (P > .05).
Conclusions: Patients undergoing the TSSAM had less upper extremity range of motion and respiratory functions and more
pain intensity in the early postoperative period than in the preoperative period. It was observed that pain and flexion and
abduction angles were negatively correlated on postoperative day 1. In the postoperative period, they should be taken into
account in the design/development of rehabilitation programs.
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Objective: Umbilical vein catheterization and central venous catheters are frequently used. We aimed to present our experiences in 15 of 16 patients with embolized catheters who were successfully retrieved by percutaneous intervention.
Methods: During 10 years, 16 patients with embolized umbilical vein catheters, port catheters, central venous catheters, catheter fragments, and guide wires were examined. Demographic characteristics of the patients, catheter indications, embolized
catheter types, localizations and lengths of a catheter, durations of flora, entry points during retrieval of embolized catheters,
snare’s features used, grasping location of the embolized catheter, and additional procedures were examined retrospectively.
Results: Of the 16 patients, 7 were girls; their ages were between 11 days and 39 years; 14 of the patients were children. Their weights
were between 1.3 kg and 65 kg. The umbilical vein catheter in 5 patients, the port catheter in 7 patients, a double-lumen central
venous catheter in 1 patient, the distal part of the fragmented sheath in 1 patient, and the guide wire in 2 patients were embolized.
Conclusions: The procedures of umbilical vein catheterization, peripheral central vein catheterization, and port catheterization
are safe in experienced hands. Rarely, those catheters may break and embolize. As soon as it is diagnosed, embolized catheters
should be removed to prevent complications. Since the retrieval of embolized catheters by percutaneous transcatheter route is
safe and successful, it should be used as the first choice.
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Suna KOÇ ,
Mehmet DOKUR , Türkan ÖZER,
Taner Şerif KÜÇÜKCERİT ,
Burcu KARAOĞUZ , Yunus Emre CELEP,
Emre AKTEPE ,
Hakan KAPTANOĞULLARI ,
Mehmet KARADAĞ ,
Hacer DİZMEN ,
Betül TULUM ,
Elif KUAS ,
Aslıhan İLERİ ,
Sema Nur DOKUR
Objective: Sepsis is a major cause of mortality and morbidity in the intensive care units. The goal of this study is to investigate
whether changes in the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio are a prognostic marker for patients
with sepsis (according to sepsis stages, and patient’s and disease’s characteristics) who have been followed up in the intensive
care unit and who have received HA330 resin-directed hemadsorption column for sepsis.
Methods: The study included a group of 100 (male [healed: 19, exitus: 42], female [cured: 29, exitus: 10]) sepsis patients who
were followed up in the intensive care unit between December 2019 and December 2021 and who received HA-330 sepsis
adsorption column.
Results: Although a strong positive correlation was found between the neutrophil-to-lymphocyte ratio and the baseline platelet-to-lymphocyte ratio values (r=0.725 and P = .001), a weak positive correlation was found between the baseline neutrophil-to-lymphocyte ratio and the comorbidity values (r = 0.253 and P=.001). In addition, the period found for hemoperfusion
in those who healed was statistically significantly higher in exitus patients (P=.001). It was noted that the improvement in
repeated neutrophil-to-lymphocyte ratio measurements in the healing and death observations was identical (P > .05). The
repeated neutrophil-to-lymphocyte ratio measurement values were found to be statistically significantly different for those
with healing (P=.014). In addition, repeated neutrophil-to-lymphocyte ratio measurement values were found to be statistically
significantly different from those with exitus (P=.001). It was observed that the change of repeated platelet-to-lymphocyte ratio
measurements in the observations with healing and death was statistically significant (P < .05).
Conclusion: It is thought that it may be a cheap and useful biomarker in the prognosis of patients who are followed up in the
intensive care unit and are treated with HA-330 sepsis adsorption column since the rate of neutrophils and lymphocytes in
patients with hematological healing and death differs greatly.
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Objective: Marrubium L. genus (Lamiaceae), which has 40 taxa in the world, is represented by 25 taxa in Turkey. Marrubium
rotundifolium Boiss. is an endemic species and is distributed in Aegean. This study was aimed to determine the antioxidant, antimicrobial, and cytotoxic effects of hexane, ethyl acetate, and methanol extracts of the endemic Marrubium rotundifolium Boiss.
Methods: Ultrasonic-assisted extraction was applied to aerial parts of the plant. The Folin-Ciocalteu and aluminum chloride/
potassium acetate methods determine the extract’s total phenolic and flavonoid contents. The 2,2’-azinobis-(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS+) radical decolorinaztion assay was used to determine the extracts’ Trolox equivalent antioxidant
capacity. The deoxyribose assay was carried out for determining the extracts’ OH− radical scavenging activity, and 2,2-diphenyl1-picrylhydrazyl was used for radical scavenging assay. 3-[4,5-Dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide method
was used to determine the in vitro cytotoxicity of plant extracts on 3 cancer (Caco-2, SH-SY5Y, and PC-3) and 2 non-cancer cell
lines (NIH-3T3 and HK-2). The antimicrobial activity was examined through the microdilution method.
Results: Phenolic contents of 2.62 ± 0.16 gallic acid equivalents μg/mL were observed in the methanol extract, while the highest
flavonoid content was determined in n-hexane extract (168.63 ± 2.76 QE μg/mL). In the OH˙−, ABTS˙+, and 2,2-diphenyl-1-picrylhydrazyl radical scavenging activity studies, M. rotundifolium methanol extract showed higher IC50 values at lower doses (0.277
± 0.024, 3.21 ± 0.081, 0.033 ± 0.001 mg/mL, respectively). Concerning the cytotoxic activity, only methanol extract showed
inhibition on PC-3 cells (IC50: 0.173 ± 0.018 µg/mL). Minimum inhibitory concentrations of the extracts against Gram-positive
bacteria were lower than Gram-negative bacteria and yeast strains.
Conclusion: This study is the first detailed study that examines antioxidant and cytotoxic properties of endemic M. rotundifolium.
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Objective: We aimed to investigate the impact of novel coronavirus pandemic on the number and diversity of electrophysiology
procedures in a tertiary referral electrophysiology unit in Turkey.
Methods: All consecutive electrophysiology procedures were retrospectively analyzed performed in our electrophysiology
department between January 2017 and March 2021. The number of procedures and the distribution of cases per month were
calculated preceding and during the pandemic. The diversity of the procedures was also evaluated. We compared the number
of electrophysiology procedures between pre-coronavirus disease and post-coronavirus disease period.
Results: Overall, the electrophysiology procedures were decreased by 11.1% compared to previous years (P=.017). The most
significant difference was observed in April (−89.8%), May (−66.1%), November (−21.7%), December (−29.4%) 2020, and the
first month of 2021 (−38.8%). These intervals coincided with the peak coronavirus disease incidence in our country. Atrial
fibrillation and supraventricular tachycardia ablation rates significantly dropped by 22.2% (P=.038 and P=.039; respectively)
throughout the coronavirus disease outbreak; however, only mild non-significant change occurred in the number of ventricular
tachycardia ablations.
Conclusion: The coronavirus pandemic has significantly affected the number of electrophysiological studies in our center. It is
apparent that this pandemic will be affecting our practice for a while. We need to develop contemporary measures to improve
healthcare for non- coronavirus disease patients.
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Objective: Laparoscopic ovarian drilling normalizes ovulation by reducing cortical thickening, lowering androgen production,
and regulating luteinizing hormone pulse frequency. On the other hand, the effect of laparoscopic ovarian drilling on the endometrium is unknown. This study was planned to investigate the changes in the functional markers of choline, creatine, lactate, and lipid metabolites of the endometrium before and after laparoscopic ovarian drilling in women with polycystic ovary
syndrome.
Methods: Twenty women diagnosed with clomiphene-resistant polycystic ovary syndrome who did not ovulate successfully
despite the administration of clomiphene citrate or aromatase inhibitor were included in the study. Patients were offered
Assisted Reproductive Technology (ART) or laparoscopic ovarian drilling options. Patients who accepted laparoscopic ovarian
drilling formed the study group. Endometrial MR spectroscopy was applied to the participants in the mid-luteal phase before
laparoscopic ovarian drilling. Choline, creatine, lactate, and lipid metabolites of all patients were measured and denominated
parts per million. The second MR spectroscopy was performed 2 months after the first MR spectroscopy, and the changes in
endometrial metabolites after laparoscopic ovarian drilling were recorded. Twenty patients who did not have clinical and laboratory findings of polycystic ovary syndrome and were matched for age and body mass index were accepted as the control
group. The patients in this group were selected from fertile women with at least 2 children. MR spectroscopy was performed in
the mid-luteal phase in fertile women. The obtained results were compared within and between groups and the possible effects
of laparoscopic ovarian drilling on metabolite synthesis were tried to be determined.
Results: During MR spectroscopy examination main endometrial metabolites choline, creatine, lactate, and lipid were detected
in the polycystic ovary syndrome group. The most prominent metabolite peak before and after laparoscopic ovarian drilling
was recorded as choline and creatine. There was a significant increase in choline and creatine peaks after laparoscopic ovarian
drilling compared to the values before laparoscopic ovarian drilling. There was no significant increase in lactate and lipid signals
before and after laparoscopic ovarian drilling. The choline and creatine metabolite levels of the women with polycystic ovary
syndrome before laparoscopic ovarian drilling were significantly lower than those of the fertile women. The choline and creatine
metabolite levels of the women with polycystic ovary syndrome after m laparoscopic ovarian drilling were similar to those of
the fertile women. There was no significant difference between lactate and lipid signals before and after laparoscopic ovarian
drilling.
Conclusion: Laparoscopic ovarian drilling improves polycystic ovary syndrome-related subfertility by increasing endometrial
choline and creatine metabolite levels to those of fertile women.
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Objective: The aim of this study is to determine the prevalence of osteopenia and osteoporosis in newly diagnosed primary
hyperparathyroidism patients and to evaluate the relationship between the presence of osteoporosis and the primary hyperparathyroidism routine laboratory parameters including N-terminal-pro-brain natriuretic peptide.
Methods: This prospective study included 94 patients (mean age: 59.7 ± 11.7 years, female/male: 78/16) who have been diagnosed with primary hyperparathyroidism. For all patients participating in this study, laboratory tests were performed (routine
tests and tests for diagnosing hyperparathyroidism), and dual-energy x-ray absorptiometry inspections were also performed.
The participants of the study were divided into 3 groups according to T score in dual-energy X-ray absorptiometry as normal
(group I or T score >−1), patients with osteopenia (group II or T score between −1 and −2.5), and the patients with osteoporosis
(group III or T score ≤ −2.5).
Results: Notable level increase of blood urea nitrogen and N-terminal-pro-brain natriuretic peptide from group I to group
III is seen in the results. In logistic regression analysis, it was found that levels of N-terminal-pro-brain natriuretic peptide
and urine calcium independently determined the patients for osteoporosis (P < .05). According to the analysis, it was
found that increasing levels of urine calcium (per 10 mg/day) and N-terminal-pro-brain natriuretic peptide (per 10 pg/mL)
increase the risk of osteoporosis by 8.6% and 9.1% for patients, respectively. When we took N-terminal-pro-brain natriuretic
peptide and urine calcium cut-off values as 200 pg/mL and 300 mg/day, respectively, it determines patients for osteoporosis with 82.6% sensitivity and 73.2% specificity, and 73.9% sensitivity and 63.4% specificity, respectively. N-terminalpro-brain natriuretic peptide and urinary calcium levels were independently associated with T score in dual-energy X-ray
absorptiometry.
Conclusion: The primary outcome of this study is N-terminal-pro-brain natriuretic peptide levels are significantly increased
in newly diagnosed primary hyperparathyroidism patients and are independently associated with osteoporosis presence. In
addition, apart from N-terminal-pro-brain natriuretic peptide level, urine calcium level is also independently associated with
osteoporosis presence, in our study.
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Objective: Celiac disease is an autoimmune enteropathy that primarily affects the small intestine. Celiac disease occurs with
the ingestion of foods containing gluten and is characterized by malabsorption in individuals with a genetic predisposition.
This study aimed to review the clinical, laboratory, radiological, and pathological findings of pediatric celiac patients who were
followed in our clinic and to compare the data with previous reports in the literature.
Methods: A total of 509 patients who were diagnosed with celiac disease in the Pediatric Gastroenterology Clinic between
2010 and 2013 were included in this study. Medical records of the patients were reviewed retrospectively to collect their demographic characteristics, anthropometric and bone mineral density measurements, laboratory results, radiological imaging,
endoscopic examinations, and pathology reports of the biopsy materials.
Results: Of the 509 patients enrolled in the study, 290 (57%) were females and 219 (43%) males. Among these patients, 441
(86.6%) presented with typical symptoms and 68 (13.4%) presented with atypical symptoms. A total of 479 (94.1%) patients
were compliant with the gluten-free diet, whereas 30 (5.9%) patients were not. The chief complaint was growth retardation
in the patient groups aged 61 to 144 months (44.6%) and >145 months (59%) and diarrhea (26.1%) in the patient group aged
0-60 months. In all patients, the most common physical examination findings at the time of presentation were normal (57.4%),
and the most common comorbidities were iron deficiency anemia (35%) and osteoporosis (33%). While Marsh-Oberhuber stage
3c (52.5%) was most common in patients aged 0-60 months, Marsh-Oberhuber stage 3b was most common in patients aged
61-144 months and patients aged >145 months (51.9% and 63.8%, respectively).
Conclusions: Although growth and developmental retardation and chronic diarrhea are cautionary for celiac disease, patients
may also present with extra-gastrointestinal (atypical) findings. The mainstay of celiac disease treatment is strict compliance
with a gluten-free diet. Reviewing a relatively large number of cases, this study sheds some light on the current status of pediatric celiac disease patients in the southeastern part of Turkey.
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