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Publication Metadata only Discrepancy between IDSA and ESGBOR in Lyme disease: individual participant meta-analysis in Türkiye(Wiley, 2024) N/A; Yıldız, Abdullah Burak; Çetin, Ecesu; Pınarlık, Fatihan; Keske, Şiran; Can, Füsun; Ergönül, Önder; Koç University İşbank Center for Infectious Diseases (KU-IS CID); School of Medicine; Graduate School of Health SciencesBackground: The evidence on the prevalence of Lyme borreliosis (LB) is limited, but there is a suspicion of overdiagnosis of LB in recent years. We reviewed the LB diagnosis and treatment-related data in Turkiye, based on the Infectious Diseases Society of America (IDSA) 2020 and European Society of Clinical Microbiology and Infectious Diseases Study Group for Lyme Borreliosis (ESGBOR) 2018 guidelines. By detecting the disagreements between these two, we outlined the areas to be improved for future guidelines. Methods: We performed a literature search according to the PRISMA guidelines in PubMed, Ovid-Medline, Web of Science, Turkish Medline, Scopus, CINAHL, ULAKBIM TR Index, Google Scholar and Cochrane Library databases. We included the published cases in a database and evaluated according to IDSA and ESGBOR guidelines. We outlined the reasons for misdiagnoses and inappropriate uses of antibiotics. Results: We included 42 relevant studies with 84 LB cases reported from Turkiye between 1990 and December 2022. Among 84 cases, the most common clinical findings were nervous system findings (n = 37, 44.0%), erythema migrans (n = 29, 34.5%) and ophthalmologic findings (n = 15, 17.9%). The IDSA 2020 and ESGBOR 2018 guidelines agreed on the diagnosis of 71 (84.5%) cases; there was an agreement that 31 cases (36.9%) were misdiagnosed and 40 cases (47.6%) were correctly diagnosed, and there was disagreement for 13 cases (15.5%). Serum immunoglobulin M (IgM), IgG measurements by ELISA and western blot were widely performed, and they were effective in definitive diagnosis merely when used according to guidelines. Inappropriate use of antibiotics was detected in 42 (50.0%) of cases which were classified in the following categories: incorrect LB diagnosis, inappropriate choice of antibiotic, inappropriate route of drug administration and prolonged antibiotic treatment. Conclusion: Overdiagnosis and non-adherence to guidelines is a common problem. The discordance between seroprevalence and clinical studies necessitates a consensus over the best clinical approach.Publication Metadata only The role of PSMA PET/CT in predicting downgrading in patients with Gleason score 4+4 prostate cancer in prostate biopsy(Springer, 2024) N/A; Aykanat, İbrahim Can; Kordan, Yakup; Seymen, Hülya; Köseoğlu, Ersin; Özkan, Arif; Esen, Barış; Tarım, Kayhan; Kulaç, İbrahim; Falay, Fikri Okan; Gürses, Bengi; Baydar, Dilek Ertoy; Canda, Abdullah Erdem; Balbay, Mevlana Derya; Demirkol, Mehmet Onur; Esen, Tarık; School of Medicine; Koç University HospitalBackground To investigate the predictable parameters associated with downgrading in patients with a Gleason score (GS) 8 (4+4) in prostate biopsy after radical prostatectomy. Methods We retrospectively analyzed 62 patients with a GS of 4+4 on prostate biopsy who underwent robotic radical prostatectomy between 2017 and 2022. Results 38 of 62 (61.2%) were downgraded. In multivariable logistic regression model, Ga-68 prostate-specific membrane antigen (PSMA) positron-emission tomography (PET)/computed tomography (CT) SUV max was independent predictor of downgrading (OR 0.904; p = 0.011) and a Logistic Regression model was constructed using the following formula: Y = 1.465-0.95 (PSMA PET/CT SUV max). The model using this variable correctly predicted the downgrading in 72.6% of patients. The AUC for PSMA PET/CT SUV max was 0.709 the cut off being 8.8. A subgroup analysis was performed in 37 patients who had no other European Association of Urology (EAU) high risk features. 25 out of 37 (67.5%) were downgraded, and 21 of these 25 had organ confined disease. Low PSMA SUV max (<8.1) and percentage of GS 4+4 biopsy cores to cancer bearing cores (45.0%) were independently associated with downgrading to GS 7. Conclusion PSMA PET/CT can be used to predict downgrading in patients with GS 4+4 PCa. Patients with GS 4+4 disease, but no other EAU high risk features, low percentage of GS 4+4 biopsy cores to cancer bearing cores, and a low PSMA PET/CT SUV max are associated with a high likelihood of the cancer reclassification to intermediate risk group.Publication Metadata only Survival benefit of nephroureterectomy in systemic therapy exposed metastatic upper tract urinary urothelial carcinoma patients(Springer, 2024) Morra, Simone; Incesu, Reha-Baris; Scheipner, Lukas; Baudo, Andrea; Jannello, Letizia Maria Ippolita; Siech, Carolin; de Angelis, Mario; Tian, Zhe; Creta, Massimiliano; Califano, Gianluigi; Colla Ruvolo, Claudia; Saad, Fred; Shariat, Shahrokh F.; Chun, Felix K. H.; de Cobelli, Ottavio; Musi, Gennaro; Briganti, Alberto; Ahyai, Sascha; Carmignani, Luca; Longo, Nicola; Karakiewicz, Pierre I.; N/A; Tilki, Derya; School of MedicineBackground It is unknown whether the stage of the primary may influence the survival (OS) of metastatic upper tract urothelial carcinoma (mUTUC) patients treated with nephroureterectomy (NU) and systemic therapy (ST). We tested this hypothesis within a large-scale North American cohort. Methods Within Surveillance Epidemiology and End Results database 2000-2020, all mUTUC patients treated with ST+NU or with ST alone were identified. Kaplan-Maier plots depicted OS. Multivariable Cox regression (MCR) models tested for differences between ST+NU and ST alone predicting overall mortality (OM). All analyses were performed in localized (T1-T2) and then repeated in locally advanced (T3-T4) patients. Results Of all 728 mUTUC patients, 187 (26%) harbored T1-T2 vs 541 (74%) harbored T3-T4. In T1-T2 patients, the median OS was 20 months in ST+NU vs 10 months in ST alone. Moreover, in MCR analyses that also relied on 3 months' landmark analyses, the combination of ST+NU independently predicted lower OM (HR 0.37, p < 0.001). Conversely, in T3-T4 patients, the median OS was 12 in ST+NU vs 10 months in ST alone. Moreover, in MCR analyses that also relied on 3 months' landmark analyses, the combination of ST+NU was not independently associated with lower OM (HR 0.85, p = 0.1). Conclusions In mUTUC patients, treated with ST, NU drastically improved survival in T1-T2 patients, even after strict methodological adjustments (multivariable and landmark analyses). However, this survival benefit did not apply to patients with locally more advanced disease (T3-T4).Publication Metadata only Goodbye Hartmann trial: a prospective, international, multicenter, observational study on the current use of a surgical procedure developed a century ago(BMC, 2024) Perrone, Gennaro; Giuffrida, Mario; Abu-Zidan, Fikri; Kruger, Vitor F.; Livrini, Marco; Petracca, Gabriele Luciano; Rossi, Giorgio; Tarasconi, Antonio; Tian, Brian W. C. A.; Bonati, Elena; Mentz, Ricardo; Mazzini, Federico N.; Campana, Juan P.; Gasser, Elisabeth; Kafka-Ritsch, Reinhold; Felsenreich, Daniel M.; Dawoud, Christopher; Riss, Stefan; Gomes, Carlos Augusto; Gomes, Felipe Couto; Teixeira Gonzaga, Ricardo Alessandro; Brattig Canton, Cassio Alfred; Pereira, Bruno Monteiro; Fraga, Gustavo P.; Zem, Leticia Goncalves; Cordeiro-Fonseca, Vinicius; Tauil, Renato de Mesquita; Atanasov, Boyko; Belev, Nikolay; Kovachev, Nikola; Melendez, L. Juan Jose; Dimova, Ana; Dimov, Stefan; Zelic, Zdravko; Augustin, Goran; Bogdanic, Branko; Moric, Trpimir; Chouillard, Elie; Bajul, Melinda; De Simone, Belinda; Panis, Yves; Esposito, Francesco; Notarnicola, Margherita; Lauka, Lelde; Fabbri, Anna; Hentati, Hassen; Fnaiech, Iskander; Aurelien, Venara; Bougard, Marie; Roulet, Maxime; Demetrashvili, Zaza; Pipia, Irakli; Merabishvili, Giorgi; Bouliaris, Konstantinos; Koukoulis, Georgios; Doudakmanis, Christos; Xenaki, Sofia; Chrysos, Emmanuel; Kokkinakis, Stamatios; Vassiliu, Panteleimon; Michalopoulos, Nikolaos; Margaris, Ioannis; Kechagias, Aristotelis; Avgerinos, Konstantinos; Katunin, Jevgeni; Lostoridis, Eftychios; Nagorni, Eleni-Aikaterini; Pujante, Antonio; Mulita, Francesk; Maroulis, Ioannis; Vailas, Michail; Marinis, Athanasios; Siannis, Ioannis; Bourbouteli, Eirini; Manatakis, Dimitrios K.; Tasis, Nikolaos; Acheimastos, Vasileios; Maria, Sotiropoulou; Stylianos, Kapiris; Kuzeridis, Harilaos; Korkolis, Dimitrios; Fradelos, Evangelos; Kavalieratos, George; Petropoulou, Thalia; Polydorou, Andreas; Papacostantinou, Ioannis; Triantafyllou, Tania; Kimpizi, Despina; Theodorou, Dimitrios; Toutouzas, Konstantinos; Chamzin, Alexandros; Frountzas, Maximos; Schizas, Dimitrios; Karavokyros, Ioannis; Syllaios, Athanasios; Charalabopoulos, Alexandros; Boura, Maria; Baili, Efstratia; Ioannidis, Orestis; Loutzidou, Lydia; Anestiadou, Elissavet; Tsouknidas, Ioannis; Petrakis, Georgios; Polenta, Eleni; Bains, Lovenish; Gupta, Rahul; Singh, Sudhir K.; Khanduri, Archana; Bala, Miklosh; Kedar, Asaf; Pisano, Marcello; Podda, Mauro; Pisanu, Adolfo; Martines, Gennaro; Trigiante, Giuseppe; Lantone, Giuliano; Agrusa, Antonino; Di Buono, Giuseppe; Buscemi, Salvatore; Veroux, Massimiliano; Gioco, Rossella; Veroux, Gastone; Oragano, Luigi; Zonta, Sandro; Lovisetto, Federico; Feo, Carlo V.; Pesce, Antonio; Fabbri, Nicolo; Lantone, Giulio; Marino, Fabio; Perrone, Fabrizio; Vincenti, Leonardo; Papagni, Vincenzo; Picciariello, Arcangelo; Rossi, Stefano; Picardi, Biagio; Del Monte, Simone Rossi; Visconti, Diego; Osella, Giulia; Petruzzelli, Luca; Pignata, Giusto; Andreuccetti, Jacopo; D'Alessio, Rossella; Buonfantino, Massimo; Guaitoli, Eleonora; Spinelli, Stefano; Sampietro, Gianluca Matteo; Corbellini, Carlo; Lorusso, Leonardo; Frontali, Alice; Pezzoli, Isabella; Bonomi, Alessandro; Chierici, Andrea; Cotsoglou, Christian; Manca, Giuseppe; Delvecchio, Antonella; Musa, Nicola; Casati, Massimiliano; Letizia, Laface; Abate, Emmanuele; Ercolani, Giorgio; D'Acapito, Fabrizio; Solaini, Leonardo; Guercioni, Gianluca; Cicconi, Simone; Sasia, Diego; Borghi, Felice; Giraudo, Giorgio; Sena, Giuseppe; Castaldo, Pasquale; Cardamone, Eugenia; Portale, Giuseppe; Zuin, Matteo; Spolverato, Ylenia; Esposito, Marialusia; Isernia, Roberta Maria; Di Salvo, Maria; Manunza, Romina; Esposito, Giuseppe; Agus, Marcello; Asti, Emanuele Luigi Giuseppe; Bernardi, Daniele Tiziano; Tonucci, Tommaso Panici; Luppi, Davide; Casadei, Massimiliano; Bonilauri, Stefano; Pezzolla, Angela; Panebianco, Annunziata; Laforgia, Rita; De Luca, Maurizio; Zese, Monica; Parini, Dario; Jovine, Elio; De Sario, Giuseppina; Lombardi, Raffaele; Aprea, Giovanni; Palomba, Giuseppe; Capuano, Marianna; Argenio, Giulio; Orio, Gianluca; Armellino, Mariano Fortunato; Troian, Marina; Guerra, Martina; Nagliati, Carlo; Biloslavo, Alan; Germani, Paola; Aizza, Giada; Monsellato, Igor; Chahrour, Ali Chaouki; Anania, Gabriele; Bombardini, Cristina; Bagolini, Francesco; Sganga, Gabriele; Fransvea, Pietro; Bianchi, Valentina; Boati, Paolo; Ferrara, Francesco; Palmieri, Francesco; Cianci, Pasquale; Gattulli, Domenico; Restini, Enrico; Cillara, Nicola; Cannavera, Alessandro; Nita, Gabriela Elisa; Sarnari, Jlenia; Roscio, Francesco; Clerici, Federico; Scandroglio, Ildo; Berti, Stefano; Cadeo, Alessandro; Filippelli, Alice; Conti, Luigi; Grassi, Carmine; Cattaneo, Gaetano Maria; Pighin, Marina; Papis, Davide; Gambino, Giovanni; Bertino, Vanessa; Schifano, Domenico; Prando, Daniela; Fogato, Luisella; Cavallo, Fabio; Ansaloni, Luca; Picheo, Roberto; Pontarolo, Nicholas; Depalma, Norma; Spampinato, Marcello; D'Ugo, Stefano; Lepre, Luca; Capponi, Michela Giulii; Campa, Rossella Domenica; Sarro, Giuliano; Dinuzzi, Vincenza Paola; Olmi, Stefano; Uccelli, Matteo; Ferrari, Davide; Inama, Marco; Moretto, Gianluigi; Fontana, Michele; Favi, Francesco; Picariello, Erika; Rampini, Alessia; Barberis, Andrea; Azzinnaro, Antonio; Oliva, Alba; Totaro, Luigi; Benzoni, Ilaria; Ranieri, Valerio; Capolupo, Gabriella Teresa; Carannante, Filippo; Caricato, Marco; Ronconi, Maurizio; Casiraghi, Silvia; Casole, Giovanni; Pantalone, Desire; Alemanno, Giovanni; Scheiterle, Maximilian; Ceresoli, Marco; Cereda, Marco; Fumagalli, Chiara; Zanzi, Federico; Bolzon, Stefano; Guerra, Enrico; Lecchi, Francesca; Cellerino, Paola; Ardito, Antonella; Scaramuzzo, Rosa; Balla, Andrea; Lepiane, Pasquale; Tartaglia, Nicola; Ambrosi, Antonio; Pavone, Giovanna; Palini, Gian Marco; Veneroni, Simone; Garulli, Gianluca; Ricci, Claudio; Torre, Beatrice; Russo, Iris Shari; Rottoli, Matteo; Tanzanu, Marta; Belvedere, Angela; Milone, Marco; Manigrasso, Michele; De Palma, Giovanni Domenico; Piccoli, Micaela; Pattacini, Gianmaria Casoni; Magnone, Stefano; Bertoli, Paolo; Pisano, Michele; Massucco, Paolo; Palisi, Marco; Luzzi, Andrea-Pierre; Fleres, Francesco; Clarizia, Guglielmo; Spolini, Alessandro; Kobe, Yoshiro; Toma, Takayuki; Shimamura, Fumihiko; Parker, Robert; Ranketi, Sinkeet; Mitei, Mercy; Svagzdys, Saulius; Pauzas, Henrikas; Zilinskas, Justas; Poskus, Tomas; Kryzauskas, Marius; Jakubauskas, Matas; Zakaria, Andee Dzulkarnaen; Zakaria, Zaidi; Wong, Michael Pak-Kai; Jusoh, Asri Che; Zakaria, Muhammad Nazreen; Cruz, Daniel Rios; Elizalde, Aurea Barbara Rodriguez; Reynaud, Alejandro Banon; Hernandez, Edgard Efren Lozada; Monroy, Jose Maria Victor Palomo; Hinojosa-Ugarte, Diego; Quiodettis, Martha; Du Bois, Maria Esther; Latorraca, Jose; Major, Piotr; Pedziwiatr, Michal; Pisarska-Adamczyk, Magdalena; Waledziak, Maciej; Kwiatkowski, Andrzej; Czyzykowski, Lukasz; da Costa, Silvia Dantas; Pereira, Bela; Ferreira, Ana Rita Oliveira; Almeida, Filipe; Rocha, Ricardo; Carneiro, Carla; Perez, Diego Pita; Carvas, Joao; Rocha, Catarina; Ferreira, Catia; Marques, Rita; Fernandes, Urania; Leao, Pedro; Goulart, Andre; Pereira, Rita Goncalves; Patrocinio, Sara Daniela Direito; de Mendonca, Nuno Goncalo Goncalves; Manso, Maria Isabel Cerqueira; Morais, Henrique Manuel Cardoso; Cardoso, Paulo Sebastiao; Calu, Valentin; Miron, Adrian; Toma, Elena Adelina; Gachabayov, Mahir; Abdullaev, Abakar; Litvin, Andrey; Nechay, Taras; Tyagunov, Alexander; Yuldashev, Anvar; Bradley, Alison; Wilson, Michael; Panyko, Arpad; Lateckova, Zuzana; Lacko, Vladimir; Lesko, Dusan; Soltes, Marek; Radonak, Jozef; Turrado-Rodriguez, Victor; Termes-Serra, Roser; Morales-Sevillano, Xavier; Lapolla, Pierfrancesco; Mingoli, Andrea; Brachini, Gioia; Degiuli, Maurizio; Sofia, Silvia; Reddavid, Rossella; Garberini, Andrea de Manzoni; Buffone, Angelica; del Pozo, Eduardo Perea; Aparicio-Sanchez, Daniel; Dos Barbeito, Sandra; Estaire-Gomez, Mercedes; Viton-Herrero, Rebeca; Gil Olarte-Marquez, Ma de los Angeles; Gil-Martinez, Jose; Alconchel, Felipe; Nicolas-Lopez, Tatiana; Rahy-Martin, Aida Cristina; Pelloni, Maria; Banolas-Suarez, Raquel; Mendoza-Moreno, Fernando; Nisa, Francisca Garcia-Moreno; Diez-Alonso, Manuel; Rodas, Maria Elisa Valle; Agundez, Maria Carmona; Perez Andres, Maria Inmaculada; Lopes Moreira, Claudia Cristina; Lizarazu Perez, Aintzane; Ponce, Inigo Augusto; Gonzalez-Castillo, Ana Maria; Membrilla-Fernandez, Estela; Salvans, Silvia; Serradilla-Martin, Mario; Pardo, Pablo Sancho; Rivera-Alonso, Daniel; Dziakova, Jana; Huguet, Jose Muguerza; Pages Valle, Naila; Colas Ruiz, Enrique; Rey Valcarcel, Cristina; Ruiz Moreno, Cristina; Moreno Salazar, Yeniffer Tatiana; Rubio Garcia, Juan Jesus; Mico, Silvia Sevila; Ruiz Lopez, Joaquin; Perez Farre, Silvia; Santamaria Gomez, Maite; Mestres Petit, Nuria; Titos-Garcia, Alberto; Aranda-Narvaez, Jose Manuel; Romacho-Lopez, Laura; Sanchez-Guillen, Luis; Aranaz-Ostariz, Veronica; Bosch-Ramirez, Marina; Martinez-Perez, Aleix; Martinez-Lopez, Elias; Sebastian-Tomas, Juan Carlos; Jimenez-Riera, Granada; Jimenez-Vega, Javier; Navas Cuellar, Jose Aurelio; Campos-Serra, Andrea; Munoz-Campana, Anna; Gracia-Roman, Raquel; Martinez Alegre, Javier; Lima Pinto, Francisca; O'Sullivan, Sara Nunez; Blanco Antona, Francisco; Munoz Jimenez, Beatriz; Lopez-Sanchez, Jaime; Gomez Carmona, Zahira; Torres Fernandez, Rocio; Blesa Sierra, Isabel; Roman Garcia de Leon, Laura; Polaino Moreno, Veronica; Iglesias, Eva; Lora Cumplido, Paola; Arango Bravo, Altea; Rey Simo, Ignacio; Lopez Dominguez, Carlota; Guerreiro Caamano, Aloia; Calleja Lozano, Rafael; Duran Martinez, Manuel; Naranjo Torres, Alvaro; Morales Bernaldo de Quiros, Javier Tomas; Pellino, Gianluca; Cloquell, Miriam Moratal; Garcia Moller, Elsa; Jalal-Eldin, Sami; Abdoun, Ahmed K.; Hamid, Hytham K. S.; Lohsiriwat, Varut; Mongkhonsupphawan, Aitsariya; Baraket, Oussama; Ayed, Karim; Abbassi, Imed; Ben Ali, Ali; Ammar, Houssem; Kchaou, Ali; Tlili, Ahmed; Zribi, Imen; Colak, Elif; Polat, Suleyman; Koylu, Zehra Alan; Guner, Ali; Usta, Mehmet Arif; Reis, Murat Emre; Mantoglu, Baris; Gonullu, Emre; Akin, Emrah; Altintoprak, Fatih; Bayhan, Zulfu; Firat, Necattin; Isik, Arda; Memis, Ufuk; Bayrak, Mehmet; Altintas, Yasemin; Kara, Yasin; Bozkurt, Mehmet Abdussamet; Kocatas, Ali; Das, Koray; Seker, Ahmet; Ozer, Nazmi; Atici, Semra Demirli; Tuncer, Korhan; Kaya, Tayfun; Ozkan, Zeynep; Ilhan, Onur; Agackiran, Ibrahim; Uzunoglu, Mustafa Yener; Demirbas, Eren; Altinel, Yuksel; Meric, Serhat; Hacim, Nadir Adnan; Tebala, Giovanni D.; Khalil, Hany; Rana, Mridul; Khan, Mansoor; Florence, Charlotte; Swaminathan, Christie; Leo, Cosimo Alex; Liasis, Lampros; Watfah, Josef; Trostchansky, Ivan; Delgado, Edward; Pontillo, Marcelo; Latifi, Rifat; Coimbra, Raul; Edwards, Sara; Lopez, Ana; Velmahos, George; Dorken, Ander; Gebran, Anthony; Palmer, Amanda; Oury, Jeffrey; Bardes, James M.; Seng, Sirivan Suon; Coffua, Lauren S.; Ratnasekera, Asanthi; Egodage, Tanya; Echeverria-Rosario, Karla; Armento, Isabella; Napolitano, Lena M.; Sangji, Naveen F.; Hemmila, Mark; Quick, Jacob A.; Austin, Tyler R.; Hyman, Theodore S.; Curtiss, William; McClure, Amanda; Cairl, Nicholas; Biffl, Walter L.; Truong, Hung P.; Schaffer, Kathryn; Reames, Summer; Banchini, Filippo; Capelli, Patrizio; Coccolini, Federico; Sartelli, Massimo; Bravi, Francesca; Vallicelli, Carlo; Agnoletti, Vanni; Baiocchi, Gian Luca; Catena, Fausto; N/A; Uymaz, Derya Salim; Omarov, Nail; Balık, Emre; School of Medicine; Koç University HospitalBackground: Literature suggests colonic resection and primary anastomosis (RPA) instead of Hartmann's procedure (HP) for the treatment of left-sided colonic emergencies. We aim to evaluate the surgical options globally used to treat patients with acute left-sided colonic emergencies and the factors that leading to the choice of treatment, comparing HP and RPA. Methods: This is a prospective, international, multicenter, observational study registered on ClinicalTrials.gov. A total 1215 patients with left-sided colonic emergencies who required surgery were included from 204 centers during the period of March 1, 2020, to May 31, 2020. with a 1-year follow-up. Results: 564 patients (43.1%) were females. The mean age was 65.9 +/- 15.6 years. HP was performed in 697 (57.3%) patients and RPA in 384 (31.6%) cases. Complicated acute diverticulitis was the most common cause of left-sided colonic emergencies (40.2%), followed by colorectal malignancy (36.6%). Severe complications (Clavien-Dindo >= 3b) were higher in the HP group (P < 0.001). 30-day mortality was higher in HP patients (13.7%), especially in case of bowel perforation and diffused peritonitis. 1-year follow-up showed no differences on ostomy reversal rate between HP and RPA. (P = 0.127). A backward likelihood logistic regression model showed that RPA was preferred in younger patients, having low ASA score (<= 3), in case of large bowel obstruction, absence of colonic ischemia, longer time from admission to surgery, operating early at the day working hours, by a surgeon who performed more than 50 colorectal resections. Conclusions: After 100 years since the first Hartmann's procedure, HP remains the most common treatment for left-sided colorectal emergencies. Treatment's choice depends on patient characteristics, the time of surgery and the experience of the surgeon. RPA should be considered as the gold standard for surgery, with HP being an exception.Publication Metadata only Family disaster: the origins of gender violence legislation in Turkey(Sage Publications Inc, 2024) N/A; Birelma, Ayşe Alnıaçık; The Center for Gender Studies (KOÇ-KAM) / Koç Üniversitesi Toplumsal Cinsiyet ve Kadın Çalışmaları Araştırma ve Uygulama Merkezi (KOÇ-KAM); N/AThis article provides a case study regarding struggles over framing gender violence as a political issue. It looks at how gender violence initially entered political discourse and state legislation in Turkey. It identifies the main political actors as feminists, Islamists, and Kemalists, and examines their impacts on state policy-making processes and outcomes. It argues that, in the Turkish context, the Islamism-Kemalism divide contoured the limits and possibilities of frame institutionalization in legislation and characterized state responses to gender violence through familial ideology, which prioritized family privacy and unity over women's right to live free from violence.Publication Metadata only Uncovering the penile clock: expression of molecular clock proteins in human penile cavernous tissue(Korean Soc Sexual Medicine and Andrology, 2024) Alkan, Ilter; Bozkurt, Muammer; Canat, Halil Lutfi; N/A; Durkut, Begüm; Uçak, Melike; Özenci, Çiler Çelik; Koç University Research Center for Translational Medicine (KUTTAM); Graduate School of Health Sciences; School of MedicinePurpose: To evaluate the expression of core molecular clock genes/proteins in penile cavernous tissue from healthy male subjects and to determine whether their expression has circadian variation. Materials and Methods: Corpus cavernosum biopsy samples were obtained from 10 healthy males with penile deviation or fracture who underwent surgical intervention during the day and night. The daytime group (n=5) underwent corpus cavernosum tissue sampling during zeitgeber time (ZT) 8-12, while the nighttime group (n=5) underwent sampling during ZT 20-24. The expression and localization of BMAL1, CLOCK, PER1, PER2, PER3, CRY1, and CRY2 proteins were analyzed using immunohistochemistry and quantified using H-score analysis. RT-qPCR analysis was performed to assess the expression of core molecular clock genes in the corpus cavernosum tissue of 5 additional daytime patients. Results: The expression of core molecular clock proteins was detected in vascular endothelial cells (VECs) and smooth muscle cells (SMCs) in corpus cavernosum during daytime and nighttime. BMAL1 exhibited the most significant nuclear expression during daytime in both cell types, whereas its expression decreased significantly at night. In VECs, a significant decrease in the nuclear expression of CRY1 was observed at night. In SMCs, a significant decrease in the cytoplasmic expression of PER3 was observed at night. The expression patterns of the core molecular clock genes were ascertained through a RT-qPCR analysis. Conclusions: Our research provides compelling evidence that core molecular clock genes are distinctly expressed in penile tissue in humans. Furthermore, we observed the expression of molecular clock proteins within the VECs and SMCs of the corpus cavernosum, with BMAL1 being the most prominently expressed. The discovery of core molecular clock genes in penile tissue, as well as proteins within the SMCs and VECs of the corpus cavernosum, introduces the potential significance of the molecular clock mechanism in the physiology of penile erection.Publication Metadata only Virtual reality simulation-based training in otolaryngology(Springer London Ltd, 2023) N/A; Ünsaler, Selin; Hafız, Ayşenur Meriç; Gökler, Ozan; Özkaya, Yasemin Sıla; School of Medicine; Koç University HospitalVR simulators will gain wider place in medical education in order to ensure high quality surgical training. The integration of VR simulators into residency programs is actually required more than ever in the era after the pandemic. In this review, the literature is reviewed for articles that reported validation results of different VR simulators designed for the field of otolaryngology. A total of 213 articles searched from Pubmed and Web of Science databases with the key words "virtual reality simulation" and "otolaryngology" on January 2022 are retrieved. After removal of duplicates, 190 articles were reviewed by two independent authors. All the accessible articles in english and which report on validation studies of virtual reality systems are included in this review. There were 33 articles reporting validation studies of otolaryngology simulators. Twenty one articles reported on otology simulator validation studies, eight articles reported rhinology simulator validation studies and four articles reported on pharyngeal and laryngeal surgery simulators. Otology simulators are shown to increase the performance of the trainees. In some studies, efficacy of simulators has been found comparable to cadaveric bone dissections and trainees reported that VR simulators was very useful in facilitating the learning process and improved the learning curves. Rhinology simulators designed for endoscopic sinus surgery are shown to have the construct validity to differentiate the surgeons of different level of expertise. Simulators in temporal bone surgery and endoscopic sinus surgery can mimic the surgical environment and anatomy along with different surgical scenarios, thus can be more implemented in surgical training and evaluation of the trainees in the future. Currently there are no validated surgical simulators for pharyngeal and laryngeal surgery.Publication Metadata only Do women with severely diminished ovarian reserve undergoing modified natural cycles benefit from earlier trigger at smaller follicle size?(Wiley, 2024) Lawrenz B; Melado L; Del Gallego R; Elkhatib I; Fatemi H.; N/A; Kalafat, Erkan; Ata, Mustafa Barış; School of MedicineObjective To evaluate whether trigger and oocyte collection at a smaller follicle size decreases the risk of premature ovulation while maintaining the reproductive potential of oocytes in women with a severely diminished ovarian reserve undergoing modified natural-cycle in-vitro fertilization. Methods This was a retrospective cohort study including women who had at least one unsuccessful cycle (due to no response) of conventional ovarian stimulation with a high dosage of gonadotropins and subsequently underwent a modified natural cycle with a solitary growing follicle (i.e. only one follicle > 10 mm at the time of trigger). The association between follicle size at trigger and various cycle outcomes was tested using regression analyses. Results A total of 160 ovarian stimulation cycles from 110 patients were included in the analysis. Oocyte pick-up (OPU) was performed in 153 cycles and 7 cycles were canceled due to premature ovulation. Patients who received their trigger at smaller follicle sizes (<= 15 mm) had significantly lower rates of premature ovulation and thus higher rates of OPU (98.9% vs 90.8%; odds ratio, 9.56 (95% CI, 1.58-182.9); P = 0.039) compared with those who received their trigger at larger follicle sizes (> 15 mm). On multivariable analysis, smaller follicle sizes at trigger (> 10 to 13 mm, > 13 to 15 mm, > 15 mm to 17 mm) were not associated significantly with a lower rate of cumulus-oocyte complex (COC) retrieval, metaphase-II (MII) oocytes or blastulation when compared to the > 17-mm group. On sensitivity analysis including only the first cycle of each couple, the maturity rate among those with COC retrieval was highest in follicle sizes > 15 to 17 mm (92.3%) and > 13 to 15 mm (91.7%), followed by > 10 to 13 mm (85.7%) and lowest in the > 17-mm group (58.8%). During the study period, five euploid blastocysts developed from 48 fertilized MII oocytes with follicle sizes of 12 mm (n = 3), 14 mm (n = 1) and 16 mm (n = 1) at trigger. Of those, four were transferred and resulted in two live births, both of which developed from follicles with a size at trigger of 12 mm. Conclusions The ideal follicle size for triggering oocyte maturation may be smaller in women with a severely diminished ovarian reserve managed on a modified natural cycle when compared to conventional cut-offs. The risk of OPU cancellation was significantly higher in women triggered at follicle size > 15 mm and the yield of mature oocytes was not adversely affected in women triggered at follicle size > 13 to 15 mm compared with > 15 to 17 mm. Waiting for follicles to reach sizes > 17mm may be detrimental to achieving optimal outcome.Publication Metadata only Neutralizing antibody levels and cellular immune response against Omicron variant in pregnant women vaccinated with mRNA and inactivated SARS-CoV-2 vaccines(Wiley, 2023) Demirci, O.; Ayaz, R.; N/A; Kalafat, Erkan; Talay, Zeynep Gülce; Can, Füsun; Çelik, Ebru; Koç University İşbank Center for Infectious Diseases (KU-IS CID); Graduate School of Health Sciences; School of MedicinePublication Metadata only Association of fetal growth restriction and stillbirth in twin compared with singleton pregnancies(Wiley, 2024) Martínez-Varea A.; Prasad, S.; Domenech, J.; Morales-Roselló, J.; Khalil, A.; N/A; Kalafat, Erkan; School of MedicineObjectives Twin pregnancies are at higher risk of stillbirth compared to singletons. Fetal growth restriction (FGR) is a major cause of perinatal mortality, but its impact on twins vs singletons remains unclear. The primary objective of this study was to investigate the association of FGR and small-for-gestational age (SGA) with stillbirth in twin compared with singleton pregnancies. A secondary objective was to assess these associations stratified by gestational age at delivery. Furthermore, we aimed to compare the associations of FGR and SGA with stillbirth in twin pregnancies using twin-specific vs singleton birth-weight charts, stratified by chorionicity. Methods This was a retrospective cross-sectional study of pregnancies receiving obstetric care and giving birth between 1999 and 2022 at St George's Hospital, London, UK. The exclusion criteria included triplet and higher-order pregnancies, those resulting in miscarriage or live birth at <= 23 + 6 weeks, termination of pregnancy and missing data regarding birth weight or gestational age at birth. Birth-weight data were collected and FGR and SGA were defined as birth weight <5th and <10th centiles, respectively. While standard logistic regression was used for singleton pregnancies, the association of FGR and SGA with stillbirth in twin pregnancies was investigated using mixed-effects logistic regression models. For twin pregnancies, intercepts were allowed to vary for twin pairs to account for intertwin dependency. Analyses were stratified by gestational age at delivery and chorionicity. Statistical significance was set at P <= 0.001. Results The study included 95 342 singleton and 3576 twin pregnancies. There were 494 (0.52%) stillbirths in singleton and 41 (1.15%) stillbirths in twin pregnancies (17 dichorionic and 24 monochorionic). SGA and FGR were associated significantly with stillbirth in singleton pregnancies across all gestational ages at delivery: the odds ratios (ORs) for SGA and FGR were 2.36 ((95% CI, 1.78-3.13), P < 0.001) and 2.67 ((95% CI, 2.02-3.55), P < 0.001), respectively, for delivery before 32 weeks; 2.70 ((95% CI, 1.71-4.31), P < 0.001) and 2.82 ((95% CI, 1.78-4.47), P < 0.001), respectively, for delivery between 32 and 36 weeks; and 3.85 ((95% CI, 2.83-5.21), P < 0.001) and 4.43 ((95% CI, 3.16-6.12), P < 0.001), respectively, for delivery after 36 weeks. In twin pregnancies, when stratified by gestational age at delivery, both SGA and FGR determined by twin-specific birth-weight charts were associated with increased odds of stillbirth for those delivered before 32 weeks (SGA: OR, 3.87 (95% CI, 1.56-9.50), P = 0.003 and FGR: OR, 5.26 (95% CI, 2.11-13.01), P = 0.001), those delivered between 32 and 36 weeks (SGA: OR, 6.67 (95% CI, 2.11-20.41), P = 0.001 and FGR: OR, 9.54 (95% CI, 3.01-29.40), P < 0.001) and those delivered beyond 36 weeks (SGA: OR, 12.68 (95% CI, 2.47-58.15), P = 0.001 and FGR: OR, 23.84 (95% CI, 4.62-110.25), P < 0.001). However, the association of stillbirth with SGA and FGR in twin pregnancies was non-significant when diagnosis was based on singleton charts (before 32 weeks: SGA, P = 0.014 and FGR, P = 0.005; 32-36 weeks: SGA, P = 0.036 and FGR, P = 0.008; after 36 weeks: SGA, P = 0.080 and FGR, P = 0.063). Conclusion Our study demonstrates that SGA and, especially, FGR are associated significantly with an increased risk of stillbirth across all gestational ages in singleton pregnancies, and in twin pregnancies when twin-specific birth-weight charts are used.