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Permanent URI for this collectionhttps://hdl.handle.net/20.500.14288/3
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Publication Metadata only Expert opinion on screening, diagnosis and management of diabetic peripheral neuropathy: a multidisciplinary approach(Frontiers Media SA, 2024) Atmaca, Aysegul; Sahin, Ibrahim; Sengun, Ihsan Sukru; Oner, Ramazan Ilyas; Tilki, Hacer Erdem; Adas, Mine; Soyleli, Hatice; Demir, Tevfik; Ketenci, Ayşegül; School of MedicineThe proposed expert opinion aimed to address the current knowledge on conceptual, clinical, and therapeutic aspects of diabetic peripheral neuropathy (DPN) and to provide a guidance document to assist clinicians for the best practice in DPN care. The participating experts consider the suspicion of the disease by clinicians as a key factor in early recognition and diagnosis, emphasizing an improved awareness of the disease by the first-admission or referring physicians. The proposed "screening and diagnostic" algorithm involves the consideration of DPN in a patient with prediabetes or diabetes who presents with neuropathic symptoms and/or signs of neuropathy in the presence of DPN risk factors, with careful consideration of laboratory testing to rule out other causes of distal symmetric peripheral neuropathy and referral for a detailed neurological work-up for a confirmative test of either small or large nerve fiber dysfunction in atypical cases. Although, the first-line interventions for DPN are currently represented by optimized glycemic control (mainly for type 1 diabetes) and multifactorial intervention (mainly for type 2 diabetes), there is a need for individualized pathogenesis-directed treatment approaches for DPN. Alpha-lipoic acid (ALA) seems to be an important first-line pathogenesis-directed agent, given that it is a direct and indirect antioxidant that works with a strategy targeted directly against reactive oxygen species and indirectly in favor of endogenous antioxidant capacity for improving DPN conditions. There is still a gap in existing research in the field, necessitating well-designed, robust, multicenter clinical trials with sensitive endpoints and standardized protocols to facilitate the diagnosis of DPN via a simple and effective algorithm and to track progression of disease and treatment response. Identification of biomarkers/predictors that would allow an individualized approach from a potentially disease-modifying perspective may provide opportunities for novel treatments that would be efficacious in early stages of DPN, and may modify the natural course of the disease. This expert opinion document is expected to increase awareness among physicians about conceptual, clinical, and therapeutic aspects of DPN and to assist them in timely recognition of DPN and translating this information into their clinical practice for best practice in the management of patients with DPN.Publication Metadata only Therapeutic targets of probiotics in Parkinson disease: a systematic review of randomized controlled trials(Iran University of Medical Sciences, 2024) Atak, Elif Sina; Yildiz, Dilara; Kocaturk, Ruemeysa Rabia; Ozcan, Oznur Ozge; Erguzel, Turker Tekin; Karahan, Mesut; Tarhan, Nevzat; Temizyürek, Arzu; School of MedicineIntroduction: Parkinson disease is the world's second most prevalent neurological disease. In this disease, intracytoplasmic neuronal inclusions are observed in enteric neurons in the gastrointestinal tract, and the composition of the intestinal microbiome is altered. These changes correlate with the motor phenotype. A systematic review was conducted to determine the effect of using probiotics in Parkinson disease. Methods: Scopus, PubMed, Web of Science, the Cochrane Library, ScienceDirect, and Ov & imath;dLWW were searched until April 2021. A total of 27395 records were found according to inclusion and exclusion criteria with the following outcomes: Parkinson disease rating, oxidative stress, and gastrointestinal system markers. Data search, article selection, and data extraction assessments were performed according to the PRISMA (preferred reporting items for systematic reviews and meta -analyses) guidelines. The Jadad scale was used to rate the evidence's quality. Results: Our study information was gathered from 5 randomized controlled trials involving 350 individuals with Parkinson disease receiving probiotic supplements. Parkinson disease rating and non -motor symptoms test were performed in the samples. Also, oxidative stress (glutathione, malondialdehyde) and gastrointestinal system symptoms (bowel opening frequency, gut transit time, complete bowel movement, spontaneous bowel movements) were evaluated during 4-12 weeks of using probiotics in these patients. Conclusion: While all high -quality studies demonstrate improvement in disease symptoms of the patients, currently sufficient data are not available to recommend the use of probiotics for people with Parkinson disease in clinical practice.Publication Metadata only ICS educational module: the practice of uroflowmetry in adults(Elsevier B.V., 2024) Agarwal, Mayank Mohan; Rubilotta, Emanuele; De Nunzio, Cosimo; Rosier, Peter; Tarcan, Tufan; Acar, Ömer; School of MedicineAim: To present the body of evidence behind the International Continence Society (ICS) educational module on “Practice of uroflowmetry in adults” which consists of a PowerPoint® presentation. Methods: This evidence review has been prepared by a working group instituted by the ICS Urodynamics Committee. The method used included systematic literature review, consensus formation by the members of the Working Group, and review by members of the ICS Urodynamics Committee core panel. Results: A total of 104 articles were included in this systematic review. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Evidence analysis was conducted along the following themes: physiology of voiding, pathophysiology of lower urinary tract dysfunction, technique of uroflowmetry, quality check of the uroflowmetry test, interpretation and reporting of uroflowmetry findings. Conclusions: Uroflowmetry is the most commonly utilized diagnostic test in the evaluation of adults presenting with lower urinary tract symptoms. The practice of uroflowmetry exhibits variations which might lead to inconclusive or inaccurate assessments. The ICS educational module on the Practice of Uroflowmetry in Adults provides up-to-date and evidence-based guidance in an effort to establish standards in the technique, interpretation, and reporting of uroflowmetry.Publication Metadata only Efficacy and perioperative safety of different future liver remnant modulation techniques: a systematic review and network meta-analysis(Elsevier B.V., 2024) Sijberden, Jasper P.; Kasai, Meidai; Abu Hilal, Mohammad; Bozkurt, Emre; Koç University HospitalBackground: In daily clinical practice, different future liver remnant (FLR) modulation techniques are increasingly used to allow a liver resection in patients with insufficient FLR volume. This systematic review and network meta-analysis aims to compare the efficacy and perioperative safety of portal vein ligation (PVL), portal vein embolization (PVE), liver venous deprivation (LVD) and associating liver partition and portal vein ligation for staged hepatectomy (ALPPS). Methods: A literature search for studies comparing liver resections following different FLR modulation techniques was performed in MEDLINE, Embase and Cochrane Central, and pairwise and network meta-analyses were conducted. Results: Overall, 23 studies comprising 1557 patients were included. LVD achieved the greatest increase in FLR (17.32 %, 95% CI 2.49–32.15), while ALPPS was most effective in preventing dropout before the completion hepatectomy (OR 0.29, 95% CI 0.15–0.55). PVL tended to be associated with a longer time to completion hepatectomy (MD 5.78 days, 95% CI -0.67–12.23). Liver failure occurred less frequently after LVD, compared to PVE (OR 0.35, 95% CI 0.14–0.87) and ALPPS (OR 0.28, 95% CI 0.09–0.85). Discussion: ALPPS and LVD seem superior to PVE and PVL in terms of achieved FLR increase and subsequent treatment completion. LVD was associated with lower rates of post hepatectomy liver failure, compared to both PVE and ALPPS. A summary of the protocol has been prospectively registered in the PROSPERO database (CRD42022321474). © 2024 International Hepato-Pancreato-Biliary Association Inc.Publication Metadata only Current standards for training in robot-assisted surgery and endourology: a systematic review(Elsevier B.V., 2024) Basile, Giuseppe; Gallioli, Andrea; Diana, Pietro; Gallagher, Anthony; Larcher, Alessandro; Graefen, Markus; Harke, Nina; Traxer, Olivier; Van Der Poel, Henk; Emiliani, Esteban; Angerri, Oriol; Wagner, Christian; Montorsi, Francesco; Wiklund, Peter; Somani, Bhaskar; Buffi, Nicolò; Mottrie, Alex; Liatsikos, Evangelos; Breda, Alberto; Tilki, Derya; School of MedicineBackground and objective: Different training programs have been developed to improve trainee outcomes in urology. However, evidence on the optimal training methodology is sparse. Our aim was to provide a comprehensive description of the training programs available for urological robotic surgery and endourology, assess their validity, and highlight the fundamental elements of future training pathways. Methods: We systematically reviewed the literature using PubMed/Medline, Embase, and Web of Science databases. The validity of each training model was assessed. The methodological quality of studies on metrics and curricula was graded using the MERSQI scale. The level of evidence (LoE) and level of recommendation for surgical curricula were awarded using the educational Oxford Centre for Evidence-Based Medicine classification. Key findings and limitations: A total of 75 studies were identified. Many simulators have been developed to aid trainees in mastering skills required for both robotic and endourology procedures, but only four demonstrated predictive validity. For assessment of trainee proficiency, we identified 18 in robotics training and six in endourology training; however, the majority are Likert-type scales. Although proficiency-based progression (PBP) curricula demonstrated superior outcomes to traditional training in preclinical settings, only four of six (67%) in robotics and three of nine (33%) in endourology are PBP-based. Among these, the Fundamentals of Robotic Surgery and the SIMULATE curricula have the highest LoE (level 1b). The lack of a quantitative synthesis is the main limitation of our study. Conclusions and clinical implications: Training curricula that integrate simulators and PBP methodology have been introduced to standardize trainee outcomes in robotics and endourology. However, evidence regarding their educational impact remains restricted to preclinical studies. Efforts should be made to expand these training programs to different surgical procedures and assess their clinical impact. Patient summary: Simulation-based training and programs in which progression is based on proficiency represent the new standard of quality for achieving surgical proficiency in urology. Studies have demonstrated the educational impact of these approaches. However, there are still no standardized training pathways for several urology procedures.Publication Metadata only Treatment endpoints for chronic hepatitis D(John Wiley and Sons Inc, 2023) Metin, Olga; Zeybel, Müjdat; Yurdaydın, Cihan; School of MedicineManagement of chronic hepatitis D (CHD) has entered a new era. In this new era, the virus entry inhibitor bulevirtide has received conditional approval as a treatment for compensated CHD. Three phase 3 studies with two new compounds are ongoing for the treatment of CHD. In this context, surrogate markers of treatment efficacy have been well defined for chronic hepatitis B (CHB) (7) and chronic hepatitis C (8) but not for CHD. The aim of this review is to give a perspective on treatment endpoints in CHD. For this, we took guidance from CHB studies and tried to make suggestions which differed according to finite versus prolonged treatment durations and also took into account the different characteristics of the new compounds.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 Microfluidic pulse shaping methods for molecular communications(Elsevier, 2023) Department of Electrical and Electronics Engineering; Kahvazi Zadeh, Maryam; Bolhassan, Iman Mokari; Kuşcu, Murat; Department of Electrical and Electronics Engineering; Graduate School of Sciences and Engineering; College of EngineeringMolecular Communication (MC) is a bio-inspired communication modality that utilizes chemical signals in the form of molecules to exchange information between spatially separated entities. Pulse shaping is an important process in all communication systems, as it modifies the waveform of transmitted signals to match the characteristics of the communication channel for reliable and high-speed information transfer. In MC systems, the unconventional architectures of components, such as transmitters and receivers, and the complex, nonlinear, and time-varying nature of MC channels make pulse shaping even more important. While several pulse shaping methods have been theoretically proposed for MC, their practicality and performance are still uncertain. Moreover, the majority of recently proposed experimental MC testbeds that rely on microfluidics technology lack the incorporation of programmable pulse shaping methods, which hinders the accurate evaluation of MC techniques in practical settings. To address the challenges associated with pulse shaping in microfluidic MC systems, we provide a comprehensive overview of practical microfluidic chemical waveform generation techniques that have been experimentally validated and whose architectures can inform the design of pulse shaping methods for microfluidic MC systems and testbeds. These techniques include those based on hydrodynamic and acoustofluidic force fields, as well as electrochemical reactions. We also discuss the fundamental working mechanisms and system architectures of these techniques, and compare their performances in terms of spatiotemporal resolution, selectivity, system complexity, and other performance metrics relevant to MC applications, as well as their feasibility for practical MC applications.Publication Metadata only Emerging drugs for hepatitis D(Taylor & Francis Ltd, 2023) Keskin, Onur; Yurdaydın, Cihan; School of MedicineIntroduction: Chronic hepatitis delta (CHD) is the most severe form of chronic viral hepatitis. Until recently, its treatment consisted of pegylated interferon alfa (pegIFN) use. Areas covered: Current and new drugs for treating CHD. Virus entry inhibitor bulevirtide has received conditional approval by the European Medicines Agency. Prenylation inhibitor lonafarnib and pegIFN lambda are in phase 3 and nucleic acid polymers in phase 2 of drug development. Expert opinion: Bulevirtide appears to be safe. Its antiviral efficacy increases with treatment duration. Combining bulevirtide with pegIFN has the highest antiviral efficacy short-term. The prenylation inhibitor lonafarnib prevents hepatitis D virus assembly. It is associated with dose-dependent gastrointestinal toxicity and is better used with ritonavir which increases liver lonafarnib concentrations. Lonafarnib also possesses immune modulatory properties which explains some post-treatment beneficial flare cases. Combining lonafarnib/ritonavir with pegIFN has superior antiviral efficacy. Nucleic acid polymers are amphipathic oligonucleotides whose effect appears to be a consequence of phosphorothioate modification of internucleotide linkages. These compounds led to HBsAg clearance in a sizable proportion of patients. PegIFN lambda is associated with less IFN typical side effects. In a phase 2 study it led to 6 months off treatment viral response in one third of patients.Publication Metadata only Immunotherapy for lung cancer(Turkiye Klinikleri, 2023) Karadurmuş,N.; Akyürek,N.; Aydiner,A.; Savaş,R.; Sönmez,Ö.; Şendur,M.A.N.; Oyan,B.; Yalman,D.; Yilmaz,M.U.; Yilmaz,Ü.; Göker,E.; Yumuk, Perran Fulden; School of MedicineLung cancer is one of the leading causes of cancer-related deaths in men and women. Similar to the approach with other cancer types, lung cancer staging is crucial in planning an effective treatment plan and predicting patient prognosis. Effective immunotherapies for patients with non-small cell lung cancer and non-genomic driver mutations are rapidly evolving. Moreover, anti-programmed death re-ceptor-1 (PD-1)/programmed death ligand 1 (PD-L1)-based treatments have become the first-line standard of care. Despite shortcomings, PD-L1 expression level seems currently to be a relatively reliable predictor of the clinical efficacy of treatment with anti-PD-1/PD-L1 anti-bodies. However, additional biomarkers are required to better personalize treatment options for these patients. This review aimed to increase awareness of lung cancer and immunotherapy treatment options, depending on patient and disease stage characteristics.