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Permanent URI for this collectionhttps://hdl.handle.net/20.500.14288/3
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Publication Metadata only Neuro-ophthalmic and neuro-otologic evaluation in individuals with motion sickness susceptibility(Aves, 2024) Aydin, Kubra; Kara, Eyyup; Uzun Adatepe, Nurten; Ataş, Ahmet; School of Medicine; Koç University HospitalBACKGROUND: Since the physiological background of motion sickness is not entirely clear, it was aimed to examine the physiological differences in groups consisting of individuals susceptible and non-susceptible to motion sickness. METHODS: Sixty subjects [motion sickness (MS) group: 33 female, 3 male; 28.8 ± 8.1 years; control group: 19 female, 5 male; 24.5 ± 4.3 years] were included in the study. Near visual acuity test on the treadmill in the presence of visual stimulation, pattern visual-evoked potentials, oculomo-tor tests, and computerized dynamic posturography were applied. Receiver operating characteristic analysis was performed to determine the parameter that provides the excellent discrimination between the groups. RESULTS: The most effective parameter in differentiating the study groups was determined as dynamic visual acuity with 77.8% sensitivity and 95.8% specificity. Significant differences were found in the vestibular (mean ± standard deviation: 0.63 ± 0.17), visual (0.77 ± 0.18), and composite scores (73.11 ± 11.89) of the patients (P = .000) in posturographic evaluation. In the visual-evoked potential examination, a significant decrease was found in the amplitude values between the P100-N145 waves in the binocular (5.0 ± 2.8, P = .002), right eye (7.6 ± 3.2, P = .009) and left eye (7.9 ± 2.9, P = .016) in the symptomatic patients. In binocular oculomotor evaluation, directional asymmetric findings were obtained. CONCLUSION: It has been shown that the most effective test parameter that distinguishes the MS susceptible and non-susceptible individuals is the dynamic visual acuity value. Based on the results of neuro-physiological tests, it was suggested that a possible visual-vestibular integration disorder in individuals susceptible to motion sickness may affect visual and vestibular performance.Publication Metadata only Novel vaginal cerclage assisted laparoscopic cervico-sacropexy technique for uterovaginal prolapse(SAGE Publications Ltd, 2024) Aydın, Serdar; Çekiç, Sebile Güler; School of Medicine; Koç University HospitalAim Laparoscopic hysteropexy is a complicated procedure that requires specialized surgical skills, including precise dissection and suturing. The aim is to describe the technical considerations for performing a new, feasible, and minimally invasive technique to correct apical and concurrent apical and anterior vaginal wall defects.Method A retrospective analysis was conducted on 70 consecutive women who underwent surgery for stage >= 3 uterovaginal prolapse. As a part of the technique, an anterior 2-cm long transverse incision was made at the anterior cervicovaginal junction, and the bladder was dissected through blunt and sharp dissection to the level of the isthmus. A posterior colpotomy was performed. A polypropylene tape was inserted into the cervical connective tissue, and the free arms of the tape were inserted into the peritoneum via the posterior colpotomy. Two arms of the tape were passed from the tunnel parallel and medial to a right sacrouterine fold, then fixed to the anterior longitudinal ligament via the laparoscopic route.Results The tape can be inserted into the cervix in a median of 15 min, and the laparoscopy procedure can be completed in 24 min. No mesh erosion or long-term complications occurred. At a 1-year control, there were no cases of recurrence.Conclusions This novel cervico-sacrocolpopexy technique is a feasible and safe, minimally invasive way to correct apical or multicompartment defects, with a short operation time and an anatomical result that mimics the normal sacrouterine ligament.Publication Metadata only Molecular pathology of prostate cancer(W B SAUNDERS CO-ELSEVIER INC, 2024) Roudier, Martine P.; Haffner, Michael C.; Kulaç, İbrahim; School of MedicineProstate cancer (PC) is the most common noncutaneous malignancy in men in the United States and makes up almost 20% of all newly diagnosed cancer cases. 1 The initial presentation and clinical course of PC can vary greatly between patients. The clinical spectrum ranges from indolent disease with an exceedingly low risk of progression to highly aggressive disease variants with early recurrence and high rates of cancer-related death. 234 Given this disease heterogeneity, understanding factors that predict the future clinical behavior of PC in an individual patient has been of the highest interest in the field. For decades, the assessment of histopathologic features such as Gleason grade and grade group tumor grade, tumor volume, and tumor stage have been the most pertinent prognostic parameters on which clinical decision-making is based. This factor strongly emphasizes the important relevance of the pathologist in the care of PC patients. Over the past years, molecular diagnostic applications have been penetrating more and more into the daily practice of genitourinary pathology. Many of these novel molecular tools have the potential to improve diagnostic accuracy and predictive values and ultimately lead to better clinical outcomes. In the multidisciplinary care for patients with PC, pathologists will play an essential role in bridging molecular studies and clinical decision-making. In this review, we aim to provide a concise overview of relevant molecular alterations in PC and highlight opportunities for precision pathology in clinical practice, as well as delineate the challenges posed by the complex biology of PC.Publication Metadata only The use of theory or model in studies on postpartum care: a narrative review(John Wiley and Sons Inc, 2024) Tümkaya, Maide Nur; Eroğlu, Kafiye; Graduate School of Health Sciences; School of NursingPurpose: It is aimed to raise awareness about the science of nursing for women's health and the use of nursing theories and models in research by reviewing the studies using theories or models in postpartum care. Data sources: The data of the study were obtained by searching YÖK National Thesis Center, EBSCOhost, PubMed, Web of Science, Cochrane, and ScienceDirect databases. Reviewed studies were analyzed in terms of the type of research, sample characteristics, purpose, the field of use of theory and model in the research, and research results. Conclusions: As a result of the review, it was noted that in the studies, Orem's Self-Care Deficit Nursing Theory/Model (n = 9), Roy's Adaptation Theory (n = 7), and Kolcaba's Theory of Comfort (n = 7) were the most used theories, theories and models were not used in a systematic structure at every stage of the research, and positive outcomes were obtained with the theory and model-based nursing interventions. Implications for nursing practice: The application of theory and model in postpartum care can be chosen by nurses as it improves patient outcomes. Furthermore, the use of theories and models in research to develop nursing knowledge will benefit nursing science while increasing professional autonomy.Publication Metadata only The percentage of ALK-positive cells and the efficacy of first-line alectinib in advanced non-small cell lung cancer: is it a novel factor for stratification? (Turkish Oncology Group Study)(Springer Science and Business Media Deutschland Gmbh, 2023) Hizal,M.; Bilgin,B.; Paksoy,N.; Atcı,M.M.; Kahraman,S.; Kılıçkap,S.; Güven,D.C.; Keskinkılıç,M.; Ayhan,M.; Eren,O.; Mustafayev,F.N.A.; Yaman,Ş.; Bayram,E.; Ertürk,İ.; Özcan,E.; Korkmaz,M.; Akagündüz,B.; Erdem,D.; Telli,T.A.; Aksoy,A.; Üskent,N.; Baytemür,N.K.; Gülmez,A.; Aydın,D.; Şakalar,T.; Arak,H.; Tatlı,A.M.; Ergün,Y.; Ak,N.; Ünal,Ç.; Özgün,M.A.; Yalçın,B.; Öztop,İ.; Algın,E.; Sakin,A.; Aydıner,A.; Şendur,M.A.N.; Yumuk, Perran Fulden; School of MedicineIntroduction: Alectinib is an effective second-generation ALK tyrosine kinase inhibitor (TKI) used in the first-line treatment of patients with advanced ALK-positive NSCLC. Recent studies demonstrated that the percentage of ALK-positive tumor cells in patient groups receiving crizotinib might affect outcomes. This study aimed to investigate whether the percentage of ALK-positive cells had a predictive effect in patients with advanced NSCLC who received first-line Alectinib as ALK-TKI. Materials and methods: This retrospective study included patients with advanced-stage NSCLC who received alectinib as a first-line ALK-TKI and whose percentage of ALK-positive cells was determined by FISH at 27 different centers. Patients who received any ALK-TKI before alectinib were not included in the study. Patients were separated into two groups according to the median (40%) value of the percentage of ALK-positive cells (high-positive group ≥ 40% and low-positive group < 40%). The primary endpoint was PFS, and the secondary endpoints were OS, ORR, and PFS of the subgroups based on different threshold values for the percentage of ALK-positive cells. Results: 211 patients were enrolled (48.3% female, 51.7% male) to study. 37% (n = 78) of the patients had received chemotherapy previously. After a median of 19.4 months of follow-up, the median PFS was not reached in the high-positive group (n = 113), but it was 10.8 months in the low-positive group (n = 98) (HR 0.39; 95% CI 0.25–0.60, p < 0.001). The median OS in the high-positive group was not reached, whereas it was 22.8 months in the low-positive group (HR 0.37; 95% CI 0.22–0.63, p < 0.001). ORR was significantly higher in the high-positive group (87.2 vs. 68.5%; p = 0.002). According to the cut-off values of < 20%, 20–39%, 40–59%, and ≥ 60%, the median PFS was 4.5, 17.1, and 26 months, respectively, and could not be reached in the ≥ 60% group. Conclusion: Our study demonstrated that the efficacy of alectinib varies significantly across patient subgroups with different percentages of ALK-positive cells. If these findings are prospectively validated, the percentage of ALK-positive cells may be used as a stratification factor in randomized trials comparing different ALK-TKIs.Publication Metadata only Prognostic significance of mucinous histology in left‑sided metastatic colorectal cancers with wild‑type RAS and evaluation of backbone chemotherapy regimens(Spandidos Publ Ltd, 2023) Arikan, Rukiye; Atci, Muhammed Mustafa; Ay, Seval; Ayhan, Murat; Demircan, Nazim Can; Telli, Tugba Akin; Celebi, Abdussamet; Yasar, Alper; Isik, Selver; Celikel, Cigdem; Balvan, Ozlem; Bayoglu, Ibrahim Vedat; Kostek, Osman; Dane, Faysal; Yumuk, Perran Fulden; School of MedicineMucinous colorectal adenocarcinoma (MCAC) is a distinct subtype of colorectal carcinoma (CRC). The prognostic and predictive significance of mucinous histology remains controversial. It was aimed to investigate the prognostic and/or predictive role of mucinous histology in left-sided metastatic CRC (mCRC) with wild-type RAS. This is a retrospective multicenter study of mCRC treated with first line anti-EGFR combined 5-fluorouracil based chemotherapy (CT). Patients were stratified according to presence (>50% extracellular mucin) or absence of mucinous histology. Survival analyses were performed firstly regardless of treatment options and then performed as separating according to CT regimens. Additional analyses were performed for MCAC patients considering backbone CT regimens. A total of 125 patients were included, consisting of 40 (32.0%) patients with MCAC and 85 (68.0%) patients with non-MCAC. Median follow-up time was 19.7 months. Median progression-free survival (PFS) was 10.7 months in all patients, and PFS was lower in MCAC than non-MCAC (9.9 vs. 12.0 months, respectively, P=0.005). Median overall survival (OS) was 25.7 months in all patients. OS was lower in MCAC than non-MCAC (22.8 vs. 29.7 months, respectively, P=0.005). When considering backbone CT regimens, in multivariate analyses, mucinous histology was an independent prognostic factor for OS in both for mFOLFOX6 (HR: 1.92, P=0.04) and FOLFIRI (HR: 2.04, P=0.04) groups and was associated with poor PFS in only mFOLFOX6 (HR: 3.86, P<0.001) group. When outcomes were analyzed for the MCAC group, median OS of MCAC patients receiving mFOLFOX6 and FOLFIRI was 22.47 and 14.22 months, respectively (P=0.41). Median PFS of MCAC patients receiving mFOLFOX6 and FOLFIRI was 10.15 and 8.11 months, respectively (P=0.73). The study revealed poor prognosis of mucinous histology, both in whole study population and in backbone CT groups. Moreover, lower PFS of MCAC patients was revealed in only mFOLFOX6 group and this finding may be a valuable issue for the future research. However, considering all analyses, the present results did not indicate a special benefit of any backbone CT regimen for MCAC patients.Publication Metadata only Prognostic significance of 18F-FDG PET/CT indices in metastatic renal cell cancer and evaluation of revised IMDC risk model by including 18F-FDG PET-CT parameters(Sage Publications Inc., 2023) Arikan,R.; Ozguven,S.; Telli,T.A.; Isik,S.; Demircan,N.C.; Basoglu,T.; Yasar,A.; Celebi,A.; Filizoglu,N.; Ustun,H.S.; Tinay,I.; Ones,T.; Turoglu,H.T.; Erdil,T.Y.; Ozturk,M.A.; Ercelep,O.; Bayoglu,V.; Kostek,O.; Dane,F.; Yumuk, Perran Fulden; School of MedicineBackground: Prognostic markers in metastatic renal cell cancer (mRCC) are still insufficient. Any prognostic model objectively determines disease burden. Purpose: To investigate the relationship between 18-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) parameters and outcomes in mRCC, and to define a revised International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) model for the intermediate-risk group. Material and Methods: A retrospective study of mRCC was conducted. To investigate the prognostic significance of 18F-FDG PET/CT parameters, maximum standardized uptake value (SUVmax), total lesion glycolysis (TLG), and metabolic tumor volume (MTV) were determined in pre-treatment images. Cutoff values were defined by ROC curve analyses and their association with outcomes was analyzed. Additionally, a TLG-adjusted IMDC model was created by stratifying intermediate-risk group patients according to TLG levels. Results: The study included 52 patients. The disease control rate (DCR) was 61.5% and median overall survival (OS) was 18 months (95% confidence interval=9.2–25.8). In the univariate analyses, IMDC score, MTV, and TLG were prognostic factors for Disease Control Rate (DCR), and Eastern Cooperative Oncology Group (ECOG)-Performance Status (PS), IMDC score, lactate dehydrogenase (LDH), treatment option, MTV, and TLG were prognostic factors for OS (P < 0.05 each). In the multivariate analyses, MTV was an independent prognostic factor for DCR, and ECOG-PS, LDH, IMDC score, and TLG were independent prognostic factors for OS. According to the revised-IMDC model, the intermediate-favorable group showed longer OS than the intermediate-unfavorable group. Conclusion: Pretreatment MTV was independent prognostic factor for DCR and ECOG-PS, LDH, IMDC score, and TLG were independent prognostic factors for OS. Revised-IMDC model could identify patients with a worse prognosis among the IMDC intermediate-risk group.Publication Metadata only Could kyphotic posture disturb body balance in young healthy population?(Elsevier, 2023) Yildiz, Aysel; Youssef, Hussein; Koç University Research Center for Translational Medicine (KUTTAM) / Koç Üniversitesi Translasyonel Tıp Araştırma Merkezi (KUTTAM); Graduate School of Health SciencesBackground: Kyphosis is roughly a slight forward curvature of the spine. A slight kyphosis or posterior curvature is normal throughout the human body and is present in every individual. Hyperkyphotic is a kyphotic angle greater than 40 degrees commonly measured on a lateral X-ray measured by the Cobb method between C7 and T12. Postural instability and loss of balance can result from shifting the center of mass beyond the support base's limits. Studies are showing that kyphotic posture affects the center of gravity and affects falls in the elderly, but there are limited studies on the effect of balance in young individuals. Objectives: the correlation between the balance and thoracic kyphosis angle has been investigated. Methods: Forty-three healthy individuals over the age of 18 participated in the study. Participants who met the criteria were split into two groups based on their kyphosis angle. For measuring thoracic kyphosis, Flexi Curve is used. Objective evaluation of static balance was made with NeuroCom Balance Manager (R) static posturography device. Results: In terms of mean difference, there was no significant difference between the kyphotic and control groups in the balance measures, and there was no correlation between the kyphosis angle and balance measures, ac-cording to statistical analysis. Conclusion: According to our study, no significant relationship was found between body balance and thoracic kyphosis in the young population.Publication Metadata only Influence of soft segment structure, hydrogen bonding, and diisocyanate symmetry on morphology and properties of segmented thermoplastic polyurethanes and polyureas(Tubitak Scientific & Technological Research Council Turkey, 2023) Department of Chemistry; Yılgör, Emel; Yılgör, İskender; Department of Chemistry; College of SciencesA comprehensive review of the structure-morphology-property relations in segmented thermoplastic polyurethanes and polyureas (TPU) is provided. Special emphasis is given to the influence of the soft segment structure, polarity, and molecular weight, diisocyanate symmetry and the nature, extent, and strength of hydrogen bonding on the morphology and thermal and mechanical properties of TPUs. Experimental results obtained on composition-dependent TPU morphology and properties by various techniques were also compared by the morphology profiles generated by computational methods such as quantum mechanical calculations and molecular dynamics simulations.Publication Metadata only Role and effectiveness of progestins in pituitary suppression during ovarian stimulation for assisted reproductive technology: a systematic review and a meta-analysis(Edizioni Minerva Medica, 2023) Yıldız, Şule; Türkgeldi, Engin; Ata, Mustafa Barış; School of MedicineIntroduction: despite the many unknowns about its exact mechanism, progesterone and progestins are being successfully used to prevent luteinizing hormone (lH) surge during ovarian stimulation for assisted reproductive technology (art). We will review progestin primed ovarian stimulation (PPOs) protocols in comparison with gonadotropin releasing hormone (GnrH) analogues and each other. Evidence Acquisition: MedliNe via PubMed; cochrane central register of controlled trials (ceNtral); scopus; Web of science were screened with keywords related to assisted reproductive technology, ovarian stimulation progesterone, GnrH analogue and progesterone in several combinations. search period was from the date of inception of each database until 20 May 2022. Evidence Synthesis: live birth or ongoing pregnancy rate per embryo transfer (et) was similar in PPOs and GnrH antagonist cycles (rr=1.16, 95% ci: 0.93-1.44). clinical pregnancy rate per et was likewise similar (rr=1.12, 95% ci: 0.92-1.37). Miscarriage rate per pregnancy was similar with PPOs and GnrH antagonists in autologous cycles (rr=1.01, 95% ci: 0.65-1.55). Pooled analyses showed similar live birth rate between progestins and short GnrH agonist protocols (RR=1.01, 95% CI: 0.49-2.09), however, clinical pregnancy rates per ET were significantly higher with progestins (rr=1.31, 95% ci: 1.06-1.62). Miscarriage rate per pregnancy was similar with progestins (rr=0.82, 95% ci: 0.55-1.21). Conclusions: Progestins seem to be an efficient option for pituitary suppression during ovarian suppression, providing similar outcomes for stimulation and pregnancy. They can be especially beneficial for women for whom fresh ET is not considered.