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Permanent URI for this collectionhttps://hdl.handle.net/20.500.14288/3
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Publication Metadata only Entrapped surgical needle in the valveless AirSeal trocar: a case report and literature review(Elsevier Science Inc., 2024) N/A; Aykanat, İbrahim Can; Balbay, Mevlana Derya; School of Medicine; Koç University HospitalBackground: Valveless trocars like AirSeal system are maintain a stable pneumoperitoneum and reduce instrument friction. Case presentation: A 65-year-old man's robotic radical cystectomy was complicated by a missing needle while using AirSeal system. The needle was detected via backward inspection using the endo camera inserted through the trocar, tip at its most distal end let the visualization of the needle within the air channels and confirmed with a trocar X-ray. Conclusion: Our findings suggest that retrograde inspection and targeted radiography of the trocar, prior to patient imaging, can be helpful in locating the lost needle and prevent prolongation of surgeries.Publication Metadata only Investigation of childhood pneumonia with thoracic ultrasound: a comparison between X-ray and ultrasound(Lippincott Williams and Wilkins, 2023) Buz Yaşar, Ayşenur; Tarhan, Merve; Atalay, Basak; Girit, Saniye; N/A; School of Medicine; Koç University HospitalChildhood pneumonia is a common entity, and chest x-rays are widely used as an initial diagnostic step. To avoid radiation exposure in the pediatric age group, we assessed whether the diagnostic accuracy of ultrasound (US) imaging is sufficient in the diagnosis. One hundred thirty-three children with pneumonia (72 girls/61 boys) were participated to study between 2019 and 2021. All participants had a chest x-ray. Radiologists who perform the US scans and interpret the x-rays were blinded to each other. A comparative analysis was also done to assess US findings on pneumonia for different age groups. We compare the diagnostic accuracy of US and x-rays by McNemar test and receiver operating characteristic curves. Intraclass correlation coefficient values were calculated for the assessment of interobserver agreement of x-ray evaluation. The participants' ages ranged from 1 month to 17 years and 8 months with a median age of 24 months (Q1: 8 and Q3: 66 months). Hospital stay lengths were longer, consolidation depths were greater, and presence of air bronchogram or pleural effusion was more frequent in school-age children. The proportion of consolidation seen on chest x-ray and transthoracic US scan was significantly different (P < 0.001). The area under the curve was greater in the US than in the chest x-ray (area under the curve, 0.94 and 0.76 respectively). There was a good agreement between the 2 interpreters on chest x-ray assessment (κ = 0.661). The thoracic US can be used as a safe and efficient imaging tool in the diagnosis of pediatric pneumonia. © Wolters Kluwer Health, Inc. All rights reserved.Publication Metadata only The effect of 3D modeling on family quality of life, surgical success, and patient outcomes in congenital heart diseases: objectives and design of a randomized controlled trial(Turkish National Pediatric Society, 2024) Sümengen, Aylin Akça; İsmailoğlu, Abdul Veli; İsmailoğlu, Pelin; Çeliker, Alpay; Namlısesli, Deniz; Poyraz, Ezgi; Subaşı, Damla Özçevik; Erdem, Ceren Zeren; Çakır, Gökçe Naz; N/A; Gümüş, Terman; N/A; Koç University HospitalBackground. Understanding the severity of the disease from the parents’ perspective can lead to better patient outcomes, improving both the child’s health-related quality of life and the family’s quality of life. The implementation of 3-dimensional (3D) modeling technology in care is critical from a translational science perspective. Aim. The purpose of this study is to determine the effect of 3D modeling on family quality of life, surgical success, and patient outcomes in congenital heart diseases. Additionally, we aim to identify challenges and potential solutions related to this innovative technology. Methods. The study is a two-group pretest-posttest randomized controlled trial protocol. The sample size is 15 in the experimental group and 15 in the control group. The experimental group’s heart models will be made from their own computed tomography (CT) images and printed using a 3D printer. The experimental group will receive surgical simulation and preoperative parent education with their 3D heart model. The control group will receive the same parent education using the standard anatomical model. Both groups will complete the Sociodemographic Information Form, the Surgical Simulation Evaluation Form-Part I-II, and the Pediatric Quality of Life Inventory (PedsQL) Family Impacts Module. The primary outcome of the research is the average PedsQL Family Impacts Module score. Secondary outcome measurement includes surgical success and patient outcomes. Separate analyses will be conducted for each outcome and compared between the intervention and control groups. Conclusions. Anomalies that can be clearly understood by parents according to the actual size and dimensions of the child’s heart will affect the preoperative preparation of the surgical procedure and the recovery rate in the postoperative period. © 2024, Turkish National Pediatric Society. All rights reserved.Publication Metadata only Outcome and risk factors for mortality in peritoneal dialysis patients: 22 years of experience in a Turkish center(AVES, 2024) Caliskan, Yasar; Goksoy, Yagmur; Sacli, Fadime Sevgi; Mutlu, Ummu; Turkmen, Aydin; Bozfakioglu, Semra; N/A; Demir, Erol; Koç University Transplant Immunology Research Centre of Excellence (TIREX); Graduate School of Health SciencesBackground: European peritoneal dialysis populations have identified and reported mortality and morbidity risk factors. However, no reports are pointing out the factors affecting the outcomes of these patients during more than 2 decades of follow-up in T & uuml;rkiye. This single -center study aims to evaluate patient mortality and peritonitis rates and estimate confounding factors affecting patient mortality over 22 years. Methods: Adult patients who underwent peritoneal dialysis at our center between December 1994 and December 2016 were enrolled in this retrospective cohort study. The primary outcome of the present study was mortality, and the secondary outcomes were technical failure and peritonitis. Results: Two hundred fifty patients were included in this study. The patients were followed up for a median of 39.5 months (range 17-71). Forty-eight (19.2%) patients died. Survival rates at 5, 10, and 15 years were 86.8% (217/250), 64.6% (86/133), and 41.1% (30/73), respectively. The prevalence of diabetes mellitus [14 (29.2%) vs. 20 (9.9%); P < .001] and cardiovascular disease [16 (33.3%) vs. 24 (11.9%); P < 0.001] were significantly higher in the deceased group compared to the survival group. Cardiovascular disease was the leading cause of death [26 (54.1%)]. Age (hazard ratio (HR) 1.06; 95% CI, 1.04-1.09; P < .001), male sex (HR 2.07; 95% CI, 1.10-3.90; P = .024), and transfer to peritoneal dialysis due to vascular access problems (HR 3.91; 95% CI, 1.90-8.07; P < .001) were associated with mortality in multivariate analysis. Also, catheter exit -site infection, peritonitis rate, catheter removal, and technical complications were similar between the groups. The peritonitis rate was 0.2 episodes per patient per year. Conclusion: The mortality rate of the patient population in our center was similar to Europe and the United States. Cardiovascular diseases and diabetes are the leading causes of death in Turkish peritoneal dialysis patients, as in other populations.Publication Metadata only Radiofrequency ablation of metastatic lymph nodes in a patient requiring secondary operation for papillary thyroid carcinoma metastasis(Turkish Surgical Assoc., 2024) Öner, Gizem; Özçınar, Beyza; Aksakal, Nihat; Salmaslıoğlu, Artur; Yücel, Cem; Erbil, Yeşim; N/A; Ağcaoğlu, Orhan; School of MedicineRadiofrequency ablation is a minimally invasive modality performed as an alternative to surgery in patients with benign thyroid nodules and recurrent thyroid cancers. As far we know there is scant data regarding the safety of radiofrequency ablation for metastatic lymph nodes. In this report, our aim was to evaluate the safety and efficacy of radiofrequency ablation for metastatic lymph nodes in patients with recurrent papillary thyroid cancer metastasis. A 63-year old man, who underwent bilateral total thyroidectomy procedure in a different hospital with the diagnosis of papillary thyroid cancer one year ago, was diagnosed to have papillary thyroid cancer metastasis in single lymph nodes bilaterally in his follow-up. He underwent percutaneous radiofrequency ablation under ultrasound guidance. He was discharged home on post-operative day one uneventfully and his first control ultrasonography revealed a decrease in nodule size larger than 50% in right side of the neck and also the nodule in the left side disappeared. In conclusion, radiofrequency ablation is a safe and feasible technique for the treatment of metastatic lymph nodes in patients requiring secondary surgery due to papillary thyroid cancer metastasis. © Copyright 2024 by Turkish Surgical Society Available online at www.turkjsurg.com./ÖZET Radyofrekans ablasyonu, iyi huylu tiroid nodülü ve tekrarlayan tiroid kanserli hastalarda ameliyata alternatif olarak uygulanan minimal invaziv bir yöntemdir. Metastatik lenf nodları için radyofrekans ablasyon tedavisinin etkinliğine ilişkin az veri bulunmaktadır. Bu yazı, tekrarlayan papiller tiroid kanseri metastazı olan hastalarda metastatik lenf nodları için radyofrekans ablasyonun güvenliğini ve etkinliğini değerlendirmektedir. Bir yıl önce papiller tiroid kanseri tanısıyla farklı bir hastanede bilateral total tiroidektomi işlemi uygulanan 63 yaşında bir erkek hastanın kontrolleri sırasında bilateral lenf nodlarında papiller tiroid kanseri metastazı saptandı. Ultrason eşliğinde perkütan radyofrekans ablasyonu yapıldı. Hasta postoperatif birinci günde sorunsuz bir şekilde taburcu edildi ve ilk kontrol ultrasonografisinde nodül boyutunda boynun sağ tarafında %50’den daha büyük bir azalma olduğu ve sol taraftaki nodülün kaybolduğu görüldü. Sonuç olarak, radyofrekans ablasyon, papiller tiroid kanseri metastazı nedeniyle sekonder cerrahi gerektiren hastalarda metastatik lenf nodlarının tedavisi için güvenli ve uygulanabilir bir tekniktir.Publication Metadata only Kidney transplantation in patients recovered from Coronavirus disease 2019(AVES, 2023) Artan, Ayse Serra; Sadioglu, Rezzan Eren; Yalcin, Funda; Demir, Erol; Keven, Kenan; Safak, Seda; Alpay, Nadir; Guller, Nurana; Memikoglu, Osman; Sengul, Sule; N/A; Yelken, Berna; Okan, Ayşe; Türkmen, Aydın; N/A; Koç University HospitalObjective: There is limited information about kidney transplant recipients who recovered from the Coronavirus disease 2019. This study is conducted to investigate the safety of transplantation in this patient population. Methods: Nineteen patients with prior coronavirus disease 2019 were included. We present demographics, clinical characteristics, laboratory findings, and immunosuppressive regimen. Graft functions and patient and allograft outcomes were compared to 19 kidney transplant recipients who did not have coronavirus disease 2019. Results: The median age of participants was 38 (interquartile range, 26-51) years. Most of the recipients were men (n = 30, 78.9%). The most common presenting symptoms of kidney transplant recipients with prior coronavirus disease 2019 were fever (36.8%), fatigue (21.1%), dyspnea (15.8%), cough (10.5%), and myalgia (5.3%). Eight patients (42.2%) were hospitalized, while none required intensive care unit admission and mechanical ventilation. The median wait time for transplantation after the initial diagnosis of coronavirus disease 2019 was 82 days (interquartile range, 57-172). Most recipients in both groups received antithymocyte globulin as an induction agent. Standard doses of maintenance immunosuppression consisting of tacrolimus, mycophenolate derivatives, and corticosteroids were administered. During a follow-up duration of 85 (interquartile range, 39-154) and 134 (interquartile range, 56-240) days for patients and controls, respectively, the rate of complications and graft functions were not statistically significant between groups. Graft and patient survival was 100%. Conclusion: Our study results support the safety of kidney transplantation in patients with prior coronavirus disease 2019. Transplant candidates and donors should be carefully screened for coronavirus disease 2019. We suggest continuing the standard doses of induction and maintenance immunosuppression, especially in patients who recovered without pulmonary sequelae.Publication Metadata only Exploring the Russian perspective on the war in Ukraine: demography's power and Ukraine's uniqueness(Turkish Policy Quarterly, 2022) N/A; Kılıçer, Aybars Arda; Graduate School of Social Sciences and HumanitiesWestern officials and media have portrayed Russia as a rogue state that seeks to undermine the fundamental foundations of the Western lifestyle, which are based on democratic and liberal principles, especially more since the invasion of the remaining Ukrainian territories began on 24 February 2022. According to this perspective, Russia allegedly launched its strike to prevent Ukraine from joining the club of liberal nations. This move would have been a clear message to any other post-Soviet countries, further strengthening Russian control over them. It would be unfair to completely dismiss this argument, yet, justifying the simplification of the procedure and the continuation of conflict on these reasons goes much beyond presenting the facts. A thorough examination of the many issues involved is necessary to comprehend the Russian motivations for the ongoing war. This calls for an in-depth analysis of the Crimean Question, focusing on how Russia uses demographics in its foreign strategy. In addition, within the broader context of The Russian World (Russkiy Mir) Vision, it is crucial to understand the relevance of Russia's unique perspective on Ukraine. The objective of this study is to provide an analytical framework concentrating on these apparently most visible factors for Russia's willingness to raise tensions in Eastern Europe further and invade the remaining territory under the sovereignty of Ukraine.Publication Metadata only Current induction therapy strategies and Anti-T lymphocyte globulin usage in kidney transplantation: consensus-based recommendations by a Turkish expert panel(AVES, 2024) Cakir, Uelkem; Dinckan, Ayhan; Karadogan, Nayim; Keven, Kenan; Kocak, Hueseyin; Koc, Serkan Kubilay; Sezer, Siren; Toez, Hueseyin; Usalan, Celalettin; Yildiz, Alaattin; N/A; Türkmen, Aydın; N/A; Koç University HospitalThis advisory committee convened to review national and global kidney transplantation dynamics and provide recom-mendations on the use of anti-T lymphocyte globulin (ATLG) for prevention and treatment of rejection after allogeneic kidney transplantation. A critical evaluation of 6 relevant articles released up to October 2022 was performed to reveal their importance in clinical practice. Additionally, 27 key questions on the indication, dosage of ATLG, and risk stratification were used for the Delphi technique with 8 members of the Turkish Society of Nephrology including 5 kidney transplanta-tion (KTx) subcommittee members and a surgeon experienced in solid organ transplantation. The committee declared that T & uuml;rkiye had great potential in KTx; however, increase in transplantation would be possible in the case of raise in the deceased donor transplantation. As a consensus, ATLG was strongly recommended for induction and rejection treatment. Also, committee members recommended the safe dosage range in steroid resistant acute rejection as 2.5-3 mg/kg daily for 5-7 days, and the median of preferred dosage in induction sounded as 2-2.5 mg/kg daily for 3 days in intermediate risk state. Additionally, post-transplant infection and malignancy cases due to immunosuppression were much rarely encoun-tered than they were in the pastPublication Metadata only Comparison of the adolescent pregnancy outcomes between refugees and Turkish citizens(Turkish National Pediatric Society, 2024) Arslan, Oğuz; Tuğ, Niyazi; N/A; Giray, Burak; School of MedicineBackground. Adolescent pregnant women have significant risk factors in terms of preterm birth, low birth weight, gestational and neonatal complications, and neonatal and infant deaths. In many countries, living as a refugee differs from living as a local citizen regarding education level, access to health services, and lifestyle. We aimed to compare the obstetric, perinatal, and neonatal outcomes of Turkish and refugee adolescent pregnant women admitted to a tertiary maternity center. Methods. The study was planned as a retrospective cross-sectional. We included adolescent pregnant women who delivered between February 2018 and August 2023. Adolescent pregnant women were divided into two groups, the Turkish group and the Syrian refugee group, and compared with each other. Results. One thousand and fifty-one Turkish and 742 refugee adolescent pregnant women were included in the study. Adolescent pregnancy rates are higher in refugees than in the Turkish group (p < 0.001). We found that maternal age (p < 0.001), preeclampsia rates (p=0.029), gestational age at delivery (p < 0.001), and cesarean delivery rates (p=0.02) were lower in refugee adolescent pregnant women. Furthermore, we found that the anemia rates (p < 0.001) and low birth weight newborn rates (p = 0.011) were higher in refugee adolescent pregnant women. Conclusions. Enhancing the outcomes of adolescent pregnancies among refugees necessitates a heightened focus on education regarding sexual reproduction, increased prenatal follow-ups, and enhanced training in family planning. © 2024, Turkish National Pediatric Society. All rights reserved.Publication Metadata only Predicting chronic kidney disease progression from cardiac fibrosis: an interplay between two major organ systems(AVES, 2024) N/A; Çöpür, Sidar; Dokuyan, Haydar Can; Gümüş, Terman; Kalemoğlu, Ecem; Hasbal, Nuri Barış; Kanbay, Mehmet; School of Medicine; Koç University HospitalObjective: Cardiovascular disease and chronic kidney disease are two major medical conditions leading to significant morbidity, mortality, and medical spending globally; nevertheless, the exact underlying pathophysiological background linking those two conditions is missing without known predictive variables. Methods: We have performed a retrospective cohort study in a tertiary university hospital on 12 patients in order to investigate the association between fibrosis score on cardiac magnetic resonance imaging study and estimated glomerular filtration rate over a 24-month follow-up period. We have referred to fibrosis scores below 1050 as no fibrosis, fibrosis scores between 1050 and 1100 as mild-to-moderate fibrosis, and scores above 1100 as severe fibrosis on T1-weighted imaging. Results: Twelve patients, 9 males and 3 females, with a mean age of 49.3 have been included in this cohort study. We have demonstrated that T1-weighted magnetic resonance imaging global fibrosis score, basal segment fibrosis score, and septal fibrosis score have been negatively associated with baseline and follow-up estimated glomerular filtration rate measurements while only T1-weighted mid-segment fibrosis score has been linked to delta estimated glomerular filtration rate. Additionally, we have demonstrated that the T1-weighted cardiac fibrosis score has been linked to serum C-reactive protein level. Conclusion: We have demonstrated the association between T1-weighted cardiac magnetic resonance imaging fibrosis scores and kidney functions in our cohort study. Our study is significant by being the first clinical study investigating such an association. Nevertheless, there is a clear need for future large-scale randomized clinical trials in order to better understand the link between cardiac fibrosis and kidney functions. © 2024 Turkish Society of Nephrology. All rights reserved.