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Permanent URI for this collectionhttps://hdl.handle.net/20.500.14288/3

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3D bioprinted glioma models
(Iop Publishing Ltd, 2022) N/A; N/A; N/A; N/A; N/A; N/A; N/A; Department of Mechanical Engineering; Yığcı, Defne; Sarabi, Misagh Rezapour; Üstün, Merve; Atçeken, Nazente; Sokullu, Emel; Önder, Tuğba Bağcı; Taşoğlu, Savaş; Undergraduate Student; PhD Student; PhD Student; Researcher; Faculty Member; Faculty Member; Faculty Member; Department of Mechanical Engineering; Koç University Research Center for Translational Medicine (KUTTAM) / Koç Üniversitesi Translasyonel Tıp Araştırma Merkezi (KUTTAM); School of Medicine; Graduate School of Sciences and Engineering; Graduate School of Sciences and Engineering; N/A; School of Medicine; School of Medicine; College of Engineering; N/A; N/A; N/A; N/A; 163024; 184359; 291971
Glioma is one of the most malignant types of cancer and most gliomas remain incurable. One of the hallmarks of glioma is its invasiveness. Furthermore, glioma cells tend to readily detach from the primary tumor and travel through the brain tissue, making complete tumor resection impossible in many cases. To expand the knowledge regarding the invasive behavior of glioma, evaluate drug resistance, and recapitulate the tumor microenvironment, various modeling strategies were proposed in the last decade, including three-dimensional (3D) biomimetic scaffold-free cultures, organ-on-chip microfluidics chips, and 3D bioprinting platforms, which allow for the investigation on patient-specific treatments. The emerging method of 3D bioprinting technology has introduced a time- and cost-efficient approach to create in vitro models that possess the structural and functional characteristics of human organs and tissues by spatially positioning cells and bioink. Here, we review emerging 3D bioprinted models developed for recapitulating the brain environment and glioma tumors, with the purpose of probing glioma cell invasion and gliomagenesis and discuss the potential use of 4D printing and machine learning applications in glioma modelling.
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A brief atlas of insulin
(Bentham Science, 2022) N/A; Department of Molecular Biology and Genetics; Ayan, Esra; Demirci, Hasan; PhD Student; Faculty Member; Department of Molecular Biology and Genetics; Koç Üniversitesi İş Bankası Yapay Zeka Uygulama ve Araştırma Merkezi (KUIS AI)/ Koç University İş Bank Artificial Intelligence Center (KUIS AI); Graduate School of Sciences and Engineering; College of Sciences; N/A; 307350
Insulin is an essential factor for mammalian organisms: a regulator of glucose metabolism and other key signaling pathways. Insulin is also a multifunctional hormone whose absence can cause many diseases. Recombinant insulin is widely used in the treatment of diabetes. Understanding insulin, biosimilars, and biobetters from a holistic perspective will help pharmacologically user-friendly molecules design and develop personalized medicine-oriented therapeutic strategies for diabetes. Additionally, it helps to understand the underlying mechanism of other insulin-dependent metabolic disorders. The purpose of this atlas is to review insulin from a biotechnologi-cal, basic science, and clinical perspective, explain nearly all insulin-related disorders and their underlying molecular mechanisms, explore exogenous/recombinant production strategies of patented and research-level insulin/analogs, and highlight their mechanism of action from a structural per-spective. Combined with computational analysis, comparisons of insulin and analogs also provide novel information about the structural dynamics of insulin.
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A potential approach toward the management of sepsis: the extracorporeal cytokine hemadsorption therapy
(Wiley, 2023) Yıldız, Abdullah Burak; Çöpür, Sidar; Tanrıöver, Cem; Yavuz, Furkan; Vehbi, Sezan; Hasbal, Nuri Barış; Kanbay, Mehmet; School of Medicine
Infectious diseases are among the most common cause of morbidity and mortality among hospitalized patients while systemic inflammatory response syndrome is primarily attributed to the imbalance between pro-inflammatory and anti-inflammatory cytokines. Despite the improvements in the antibiotherapy alternatives and diagnostic modalities, the morbidity and mortality rates of sepsis and septic shock are relatively high among patients admitted to the intensive care units. Extracorporeal cytokine hemadsorption therapies are therapeutic approaches for such patient group with promising early results that especially have grown during Covid-19 pandemic. In this narrative review, our aim is to evaluate the current pre-clinical and clinical knowledge regarding the use of cytokine filtration systems among patients with septic shock.
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A practical and case-based approach to thrombocytopenia in cardiology practice
(Turkish Soc Cardiology, 2018) N/A; N/A; Öztürk, Erman; Mutluer, Ferit Onur; Doctor; Faculty Member; School of Medicine; N/A; Koç University Hospital; N/A; N/A; N/A
In cardiology practice, anticoagulation and antiplatelet therapies are essential for most patients. As of yet, there is no high quality evidence regarding these treatments in thrombocytopenic patients, which continues to be an issue. Thrombocytopenia is defined as a platelet count of <150x10(9)/L and is classified as severe when the platelet count is <50x10(9)/L. Pseudothrombocytopenia, drug-induced thrombocytopenia, immune thrombocytopenia, heparin-induced thrombocytopenia, and thrombotic thrombocytopenic purpura are some of the main causes of thrombocytopenia. The current treatment suggestions are conservative, as a result of the lack of evidence, built on defensive treatment strategies and the fear of bleeding complications. Many patients with acute myocardial infarction with thrombocytopenia have undergone percutaneous coronary intervention successfully with adjunctive antiplatelet and anticoagulant use, as has been described in case reports. A risk-benefit ratio should be evaluated for antiplatelet therapy. In the relevant guidelines, while full dose low-molecular-weight heparin (LMWH) is recommended for patients with a thrombocyte count of >50x10(9)/L, a half-dose of LMWH is recommended in patients with thrombocytopenia between 25 and 50x10(9)/L. According to the current guidelines, avoiding antiplatelet and anticoagulant treatment should be restricted to patients with very severe thrombocytopenia (i.e., a platelet count <25x10(9)/L), but new data and recommendations are needed.
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A prospective, descriptive study to determine the rate and characteristics of and risk factors for the development of medical device-related pressure ulcers in intensive care units
(HMP Communications, 2016) Hanonu, Seval; N/A; Karadağ, Ayişe; Faculty Member; School of Nursing; 3549
Pressure ulcers do not develop only in areas with bony prominences; they can develop in any tissue under pressure, including pressure exerted by medical devices. A prospective, descriptive study was conducted from December 15, 2013 to March 25, 2014 to determine the prevalence, risk factors, and characteristics of medical device-related hospitalacquired pressure ulcers (MDR HAPUs) among all patients (N = 175) in 5 adult intensive care units (ICUs) in a university hospital in Turkey. The previously established point prevalence of hospital-acquired pressure ulcers (HAPUs) in these ICUs was 15%. Patients were evaluated in the first 24 hours after admission and observed 6 times thereafter in intervals of 48 hours. Demographic (eg, age, gender, body mass index) and medical device-related pressure ulcer data (eg, location, device type, stage), and Braden Scale scores were collected and analyzed; frequencies and percentages were calculated and Mann-Whitney U Test, t-test, and odds ratios were applied. Twenty-seven (27) patients (15.4%) developed nonMDR HAPUs and 70 (40.0%) developed MDR HAPUs. MDR HAPUs occurred most frequently (45.0%) in patients with an endotracheal tube. The most frequent type (42.6%) was Stage II. The highest rates of MDR HAPUs were observed among internal medicine ICU patients (OR 7.041), patients who also had a nonMDR HAPU (OR 6.6), patients in the high Braden risk score group (OR 1.8), or patients who received enteral feeding (OR 2.12). Because of the high rate of MDR HAPUs noted, policies and procedures aimed at preventing medical device-related pressure ulcers are needed.
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A review of active vibration and noise suppression of plate-like structures with piezoelectric transducers
(Sage Publications Ltd, 2015) N/A; Department of Mechanical Engineering; Arıdoğan, Mustafa Uğur; Başdoğan, İpek; PhD Student; Faculty Member; Department of Mechanical Engineering; Graduate School of Sciences and Engineering; College of Engineering; N/A; 179940
Structural vibrations are the major causes of noise problems, passenger discomforts, and mechanical failures in aerospace, Automotive, and marine systems, which are mainly composed of lightweight and flexible plate-like structures. in order to reduce structural vibrations and noise radiations of lightweight structures, passive and active treatments have been used and investigated over the last three decades. Our aim of this article is to review current state-of-the-art of active vibration and noise suppression systems for plate and plate-like structures with various kinds of boundary conditions. the reviewed articles use numerical methods and experimental tools to study different aspects of controller architectures. in particular, the focus is placed on the active vibration and noise control systems utilizing piezoelectric patches as sensors and actuators since their popularity in vibration-based applications has increased significantly during the last two decades. We first classify the controllers according to their architectures, then compare their performance in vibration and noise attenuation, and finally provide suggestions for further progress. the categorization of the information regarding the controller strategies and sensor/actuator configurations for different host structures can be used by the controller designers as a starting point for their specific configuration.
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A review of bioresorbable implantable medical devices: materials, fabrication, and implementation
(Wiley, 2020) N/A; N/A; Department of Mechanical Engineering; Department of Mechanical Engineering; Singh, Rahul; Bathaei, Mohammad Javad; İstif, Emin; Beker, Levent; PhD Student; PhD Student; Researcher; Faculty Member; Department of Mechanical Engineering; Graduate School of Sciences and Engineering; Graduate School of Sciences and Engineering; College of Engineering; College of Engineering; N/A; N/A; 354990; 308798
Implantable medical devices (IMDs) are designed to sense specific parameters or stimulate organs and have been actively used for treatment and diagnosis of various diseases. IMDs are used for long-term disease screening or treatments and cannot be considered for short-term applications since patients need to go through a surgery for retrieval of the IMD. Advances in bioresorbable materials has led to the development of transient IMDs that can be resorbed by bodily fluids and disappear after a certain period. These devices are designed to be implanted in the adjacent of the targeted tissue for predetermined times with the aim of measurement of pressure, strain, or temperature, while the bioelectronic devices stimulate certain tissues. They enable opportunities for monitoring and treatment of acute diseases. To realize such transient and miniaturized devices, researchers utilize a variety of materials, novel fabrication methods, and device design strategies. This review discusses potential bioresorbable materials for each component in an IMD followed by programmable degradation and safety standards. Then, common fabrication methods for bioresorbable materials are introduced, along with challenges. The final section provides representative examples of bioresorbable IMDs for various applications with an emphasis on materials, device functionality, and fabrication methods.
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A review of consumer embarrassment as a public and private emotion
(John Wiley and Sons Ltd, 2019) Krishna, Aradhna; Herd, Kelly B.; Department of Business Administration; Aydınoğlu, Nilüfer Zümrüt; Faculty Member; Department of Business Administration; College of Administrative Sciences and Economics; 114037
Whether the result of mispronouncing a fancy brand name, miscalculating a tip, purchasing a sensitive product, or stumbling into a product display, embarrassment is an important part of the consumer landscape. Embarrassment has traditionally been considered a social emotion, one that can only be experienced in public. In this paper, we offer a comprehensive review of consumer embarrassment and consider situations in which embarrassment can affect consumer behavior in both public and private contexts. We define embarrassment using this broader conceptualization and outline the transgressions that might trigger embarrassment in consumption contexts. We also discuss the diverse implications of embarrassment for consumer behavior, and review the strategies that both consumers and practitioners can use to mitigate embarrassment and its negative consequences. We hope this framework will stimulate new research on consumer embarrassment in both public and private contexts.
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A review of cultural heritage education in Turkish schools (1962-2011)
(Routledge Journals, Taylor & Francis Ltd, 2013) Gueler-Biyikli, Senem; Department of Archeology and History of Art; Aslan, Carolyn Chabot; Faculty Member; Department of Archeology and History of Art; College of Social Sciences and Humanities; N/A
Cultural heritage preservation has formed a key component of Turkish Social Studies instruction since the curriculum first was introduced in the 1960s. In this article, we trace changes over time in the way cultural heritage has been presented to students in Turkey. For this study, Turkish Social Studies textbooks for fourth through seventh graders (ages 9-10 to 12-13) published from 1974 to 2011 were examined, including both their texts and illustrations concerning cultural heritage and the closely related topic of tourism. Over nearly four decades, the textbook presentation of cultural heritage has shifted from a national focus to a focus on world cultural heritage, both tangible and intangible. The textbooks illustrate the high value placed on monuments and artwork that demonstrate the accomplishments and progress of Anatolian civilizations, specifically, the Seljuk and Ottoman Turks. Notably, the textbooks emphasize the economic value of monuments and sites for tourism revenues.
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A review of surface haptics: enabling tactile effects on touch surfaces
(Institute of Electrical and Electronics Engineers (IEEE) Computer Society, 2020) Giraud, Frederic; Levesque, Vincent; Choi, Seungmoon; Department of Mechanical Engineering; Başdoğan, Çağatay; Faculty Member; Department of Mechanical Engineering; College of Engineering; 125489
In this article, we review the current technology underlying surface haptics that converts passive touch surfaces to active ones (machine haptics), our perception of tactile stimuli displayed through active touch surfaces (human haptics), their potential applications (human-machine interaction), and finally, the challenges ahead of us in making them available through commercial systems. This article primarily covers the tactile interactions of human fingers or hands with surface-haptics displays by focusing on the three most popular actuation methods: vibrotactile, electrostatic, and ultrasonic.
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A review on additive manufacturing of carbon fiber-reinforced polymers: current methods, materials, mechanical properties, applications and challenges
(Wiley, 2022) N/A; Department of Mechanical Engineering; Adil, Samia; Lazoğlu, İsmail; PhD Student; Faculty Member; Department of Mechanical Engineering; Graduate School of Sciences and Engineering; College of Engineering; N/A; 179391
Additive manufacturing has new revolutionary potential for carbon fiber-reinforced polymers (CFRPs). Additive manufacturing of CFRPs combines the advantages of additive manufacturing such as customization, minimal wastage, low cost, fast prototyping and rapid manufacturing with high specific strength of carbon fiber. This article delivers a comprehensive review of additive manufacturing of short and continuous CFRPs. The article presents insight into different additive manufacturing techniques with an overview of commercially available methods for manufacturing short and continuous CFRPs. This review also includes mechanical characterization and analytical techniques discussed in the literature for CFRPs. The robust applications of short and continuous CFRPs in biomedical, electronics, and aerospace would highlight the importance of research and development in this field. In the end, drawbacks, recent innovations, and the future research directions underline the gap between research and commercialization of additive manufacturing of short and continuous CFRPs.
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A review on renal autologous cell transplantation: an investigational approach towards chronic kidney disease
(Springer Science and Business Media B.V., 2023) Covic, Adrian; N/A; N/A; N/A; Çöpür, Sidar; Yavuz, Furkan; Kanbay, Mehmet; Researcher; Undergraduate Student; Faculty Member; School of Medicine; School of Medicine; School of Medicine; 368625; N/A; 110580
Chronic kidney disease is among the most common causes of mortality and morbidity in adult population with limited therapeutic approaches including various medications and kidney replacement therapies. Kidney transplantation is the gold standard therapeutic alternative for the management of chronic kidney disease; nonetheless, important drawbacks include the lack of adequate living or deceased donors, high rates of pre- and post-operative complications including surgical complications, infectious complications and medication-induced adverse effects. With the latest preclinical and in vitro studies demonstrating the potentiality of kidney cells obtained from diseased kidneys to convert into fully functional kidney cells lead to a novel therapeutic alternative referred as autologous selected renal cell transplantation. Even though the clinical studies investigating the efficiency and adverse effects of autologous selected renal cell transplantation are limited, it is no doubt promising. The need for future large-scale studies on chronic kidney disease patients from a diversity of etiologies is clear for the better establishment of the therapeutic potential of autologous selected renal cell transplantation. In this narrative review, our aim is to evaluate the role of renal autologous stem cell therapy in the management of chronic kidney disease. © 2023, The Author(s), under exclusive licence to Springer Nature B.V.
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A review on size-dependent mechanical properties of nanowires
(Wiley, 2019) Esfahani, Mohammad Nasr; Department of Mechanical Engineering; Alaca, Burhanettin Erdem; Faculty Member; Department of Mechanical Engineering; Koç University Surface Science and Technology Center (KUYTAM) / Koç Üniversitesi Yüzey Teknolojileri Araştırmaları Merkezi (KUYTAM); College of Engineering; 115108
The primary challenge to exploit the nanowire as a truly one-dimensional building block in nanoscale devices is the clear incorporation of scale effects into the operational performance. Size-dependent behavior in physical properties of nanowires is the subject of intense experimental and computational studies for more than two decades. In this review, the measurement techniques and computational approaches to study scale effects on mechanical properties of nanowires are reviewed for fcc metallic, silicon, and zinc oxide structures. Advantages and disadvantages of each measurement tool are summarized with data reported in the literature. A similar comparison is carried out for computational techniques. Contradictions in the literature are highlighted with an assessment of research needs and opportunities, among which the plastic behavior of gold nanowires and elastic properties of silicon nanowires can be primarily mentioned. Furthermore, challenges associated with the coupling of measurement methods and modeling approaches are summarized. Finally, points of agreement between experimental measurements and computational studies are discussed paving the way for the utilization of nanowires in future nanoscale devices.
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A review on the effect of air pollution and exposure to PM, NO2, O3, SO2, CO and heavy metals on viral respiratory infections
(Tehran University of Medical Sciences, 2020) Khajeamiri, Yasaman; Moradpour, Nioosha; Khajeamiri, Alireza; Sharifi, Samira; Undergraduate Student; School of Medicine; N/A
The ambient air pollutants that have a major role in causing respiratory diseases are particulate matter, sulfur dioxide, nitrogen dioxide, ozone, carbon monoxide, and heavy metals. In addition, respiratory infections, divided into upper respiratory tract and lower respiratory tract infection, are most commonly caused by viral agents. Thus, in light of the current COVID-19 pandemic, this review has focused on the association between exposure to general air pollution including each of the mentioned air pollutants and viral respiratory infections. The gathered evidence from the reviewed studies in this article showed that most of these air pollutants have a positive correlation with mortality, severity, transmission, inflammation, and incidence of different viral respiratory infections. Whereas, some studies found contradictory results such as non-significant and negative connections between exposure to air pollutants and viral respiratory infections, which are further discussed in this text. Therefore, following the SARS-CoV-2 outbreak, these contradictions in the reported correlation between air pollution and different aspects of viral respiratory infections must be thoroughly investigated and cleared.
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A short history of posterior dynamic stabilization
(Hindawi Ltd, 2012) Gömleksiz, Cengiz; Sasani, Mehdi; Öktenoğlu, Tunç; Özer, Ali Fahir; Faculty Member; School of Medicine; 1022
Interspinous spacers were developed to treat local deformities such as degenerative spondylolisthesis. To treat patients with chronic instability, posterior pedicle fixation and rod-based dynamic stabilization systems were developed as alternatives to fusion surgeries. Dynamic stabilization is the future of spinal surgery, and in the near future, we will be able to see the development of new devices and surgical techniques to stabilize the spine. It is important to follow the development of these technologies and to gain experience using them. In this paper, we review the literature and discuss the dynamic systems, both past and present, used in the market to treat lumbar degeneration.
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A survey of 3DTV displays: techniques and technologies
(Institute of Electrical and Electronics Engineers (IEEE), 2007) Benzie, Philip; Watson, John; Surman, Phil; Rakkolainen, Ismo; Hopf, Klaus; Sainov, Ventseslav; von Kopylow, Christoph; Department of Electrical and Electronics Engineering; Ürey, Hakan; Faculty Member; Department of Electrical and Electronics Engineering; College of Engineering; 8579
The display is the last component in a chain of activity from image acquisition, compression, coding transmission and reproduction of 3-D images through to the display itself. There are various schemes for 3-D display taxonomy; the basic categories adopted for this paper are: holography where the image is produced by wavefront reconstruction, volumetric where the image is produced within a volume of space and multiple image displays where two or more images are seen across the viewing field. In an ideal world a stereoscopic display would produce images in real time that exhibit all the characteristics of the original scene. This would require the wavefront to be reproduced accurately, but currently this can only be achieved using holographic techniques.. Volumetric displays provide both vertical and horizontal parallax so that several viewers can see 3-D images that exhibit no accommodation/convergence rivalry. Multiple image displays fall within three fundamental types: holoform in which a large number of views give smooth motion. parallax and hence a hologram-like appearance, multiview where a series of discrete views are presented across viewing field and binocular where only two views are presented in regions that may occupy fixed positions or follow viewers' eye positions by employing head tracking. Holography enables 3-D scenes to be encoded into an interference pattern, however, this places constraints on the display resolution necessary to reconstruct a scene. Although holography may ultimately offer the solution for 3DTV, the problem of capturing naturally lit scenes will first have to be solved and holography is unlikely to provide a short-term solution due to limitations in current enabling technologies. Liquid crystal, digital micromirror, optically addressed liquid crystal and acoustooptic spatial light modulators (SLMs) have been employed as suitable spatial light modulation devices in holography. Liquid crystal SLMs are generally favored owing to the commercial availability. of high fill factor, high resolution addressable devices. Volumetric displays provide both vertical and horizontal parallax and several viewers are able to see a 3-D image that exhibits no accommodation/convergence rivalry. However, the principal disadvantages of these displays are: the images are generally transparent, the hardware tends to be complex and non-Lambertian intensity distribution cannot be displayed. Multiple image displays take many forms and it is likely that one or more of these will provide the solution(s) for the first generation of 3DTV displays.
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A survey of available tools and web servers for analysis of protein-protein interactions and interfaces
(Oxford University Press (OUP), 2009) Nussinov, Ruth; Department of Chemical and Biological Engineering; Department of Computer Engineering; N/A; Department of Chemical and Biological Engineering; Keskin, Özlem; Gürsoy, Attila; Makinacı, Gözde Kar; Tunçbağ, Nurcan; Faculty Member; Faculty Member; PhD Student; Faculty Member; Department of Computer Engineering; Department of Chemical and Biological Engineering; The Center for Computational Biology and Bioinformatics (CCBB); College of Engineering; College of Engineering; Graduate School of Sciences and Engineering; College of Engineering; 26605; 8745; N/A; 245513
The unanimous agreement that cellular processes are (largely) governed by interactions between proteins has led to enormous community efforts culminating in overwhelming information relating to these proteins; to the regulation of their interactions, to the way in which they interact and to the function which is determined by these interactions. These data have been organized in databases and servers. However, to make these really useful, it is essential not only to be aware of these, but in particular to have a working knowledge of which tools to use for a given problem; what are the tool advantages and drawbacks; and no less important how to combine these for a particular goal since usually it is not one tool, but some combination of tool-modules that is needed. This is the goal of this review.
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A systematic review and meta-analysis of social cognition among people living with HIV;implications for non-social cognition and social everyday functioning
(Springer, 2024) Vance, David E.; Billings, Rebecca; Lambert, Crystal Chapman; Fazeli, Pariya L.; Goodin, Burel R.; Kempf, Mirjam-Colette; Rubin, Leah H.; Wise, Jenni; Hellemann, Gerhard; Lee, Junghee; Department of Psychology; Turan, Bülent; Department of Psychology; ; College of Social Sciences and Humanities;
Social cognition-the complex mental ability to perceive social stimuli and negotiate the social environment-has emerged as an important cognitive ability needed for social functioning, everyday functioning, and quality of life. Deficits in social cognition have been well documented in those with severe mental illness including schizophrenia and depression, those along the autism spectrum, and those with other brain disorders where such deficits profoundly impact everyday life. Moreover, subtle deficits in social cognition have been observed in other clinical populations, especially those that may have compromised non-social cognition (i.e., fluid intelligence such as memory). Among people living with HIV (PLHIV), 44% experience cognitive impairment; likewise, social cognitive deficits in theory of mind, prosody, empathy, and emotional face recognition/perception are gradually being recognized. This systematic review and meta-analysis aim to summarize the current knowledge of social cognitive ability among PLHIV, identified by 14 studies focused on social cognition among PLHIV, and provides an objective consensus of the findings. In general, the literature suggests that PLHIV may be at-risk of developing subtle social cognitive deficits that may impact their everyday social functioning and quality of life. The causes of such social cognitive deficits remain unclear, but perhaps develop due to (1) HIV-related sequelae that are damaging the same neurological systems in which social cognition and non-social cognition are processed; (2) stress related to coping with HIV disease itself that overwhelms one's social cognitive resources; or (3) may have been present pre-morbidly, possibly contributing to an HIV infection. From this, a theoretical framework is proposed highlighting the relationships between social cognition, non-social cognition, and social everyday functioning.
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A systematic review of safety and adverse effects in the practice of therapeutic hypothermia
(W B Saunders Co-Elsevier Inc, 2018) Karcioglu, Ozgur; Topacoglu, Hakan; Dikme, Özgür; N/A; Dikme, Özlem; Faculty Member; School of Medicine; Koç University Hospital; N/A
Objective: To carry out a systematic review to estimate the rate and magnitude of adverse effects following therapeutic hypothermia (TH) procedure in patients resuscitated from out-of-hospital cardiac arrest (OHCA) and highlight the specific complications seen after the procedure. Methods: A systematic review of currently published studies was performed following standard guidelines. Online database searches were performed for controlled trials for the last twenty years. Papers were examined for methodological soundness before being included. Data were independently extracted by two blinded reviewers. Studies were also assessed for bias using the Cochrane criteria. The adverse effects attributed to TH in the literature were appraised critically. Results: The initial data search yielded 78 potentially relevant studies; of these, 59 were excluded for some reason. Themain reason for exclusion (n= 43, 55.8%) was that irrelevance to adverse effects of TH. Finally, 19 underwent full-text review. Studies were of high-to-moderate (n= 12, 63%) to low-to-very low (n= 7, 37%) quality. Five studies (27.7%) were found to have high risk of bias, while 8 (42.1%) had low risk of bias. Interpretation: Although adverse effects related to the practice of TH have been studied extensively, there is substantial heterogeneity between study populations and methodologies. There is a considerable incidence of side effects attributed to the procedure, e.g., from life-threatening ventricular arrhythmias to self-limited consequences. Most studies analyzed in this systematic review indicated that the procedure of TH has not caused severe adverse effects leading to significant alterations in the outcomes following resuscitation from OHCA. (C) 2018 Elsevier Inc. All rights reserved.
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A systematic review of the efficacy and toxicity of brachytherapy boost combined with external beam radiotherapy for nonmetastatic prostate cancer
(Elsevier, 2023) Slevin, F; Zattoni, F; Checcucci, E; Cumberbatch, MGK; Nacchia, A; Cornford, P; Briers, E; De Meerleer, G; De Santis, M; Eberli, D; Gandaglia, G; Gillessen, S; Grivas, N; Liew, M; Linares Espinós, EE; Oldenburg, J; Oprea-Lager, DE; Ploussard, G; Rouvière, O; Schoots, IG; Smith, EJ; Stranne, J; Smith, CT; Van Den Bergh, RCN; Van Oort, IM; Wiegel, T; Yuan, CY; Van den Broeck, T; Henry, AM; Tilki, Derya; School of Medicine; Koç University Hospital
Context: The optimum use of brachytherapy (BT) combined with external beam radiotherapy (EBRT) for localised/locally advanced prostate cancer (PCa) remains uncertain. Objective: To perform a systematic review to determine the benefits and harms of EBRT-BT. Evidence Acquisition: Ovid MEDLINE, Embase, and EBM Reviews-Cochrane Central Register of Controlled Trials databases were systematically searched for studies published between January 1, 2000 and June 7, 2022, according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Eligible studies compared low- or high-dose-rate EBRT-BT against EBRT ± androgen deprivation therapy (ADT) and/or radical prostatectomy (RP) ± postoperative radiotherapy (RP ± EBRT). The main outcomes were biochemical progression-free survival (bPFS), severe late genitourinary (GU)/gastrointestinal toxicity, metastasis-free survival (MFS), cancer-specific survival (CSS), and overall survival (OS), at/beyond 5 yr. Risk of bias was assessed and confounding assessment was performed. A meta-analysis was performed for randomised controlled trials (RCTs). Evidence Synthesis: Seventy-three studies were included (two RCTs, seven prospective studies, and 64 retrospective studies). Most studies included participants with intermediate-or high-risk PCa. Most studies, including both RCTs, used ADT with EBRT-BT. Generally, EBRT-BT was associated with improved bPFS compared with EBRT, but similar MFS, CSS, and OS. A meta-analysis of the two RCTs showed superior bPFS with EBRT-BT (estimated fixed-effect hazard ratio [HR] 0.54 [95% confidence interval {CI} 0.40-0.72], p < 0.001), with absolute improvements in bPFS at 5-6 yr of 4.9-16%. However, no difference was seen for MFS (HR 0.84 [95% CI 0.53-1.28], p = 0.4) or OS (HR 0.87 [95% CI 0.63-1.19], p = 0.4). Fewer studies examined RP ± EBRT. There is an increased risk of severe late GU toxicity, especially with low-dose-rate EBRT-BT, with some evidence of increased prevalence of severe GU toxicity at 5-6 yr of 6.4-7% across the two RCTs. Conclusions: EBRT-BT can be considered for unfavourable intermediate/high-risk localised/locally advanced PCa in patients with good urinary function, although the strength of this recommendation based on the European Association of Urology guideline methodology is weak given that it is based on improvements in biochemical control. Patient Summary: We found good evidence that radiotherapy combined with brachytherapy keeps prostate cancer controlled for longer, but it could lead to worse urinary side effects than radiotherapy without brachytherapy, and its impact on cancer spread and patient survival is less clear.