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Permanent URI for this collectionhttps://hdl.handle.net/20.500.14411/22

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  • Article
    Evaluation of Anti-Tetanus IgG Antibody Levels and Influencing Factors in Patients Undergoing Hemodialysis
    (Frontiers Media Sa, 2025) Ozsoy, Metin; Ozturk, Hakki; Tuna, Aysegul; Varlibas, Artuner; Cesur, Salih; Aksoy, Altan; Demir, Mehmet Emin
    Aim: This study aimed to assess anti-tetanus IgG antibody levels and identify determinants of inadequate tetanus immunity among maintenance hemodialysis (HD) patients. <bold>Methods:</bold> In this cross-sectional study, anti-tetanus IgG levels were measured by quantitative ELISA in 162 adult HD patients from two dialysis centers in Ankara, Turkey. Protective immunity was evaluated using both international (>= 0.1 IU/mL) and robust (>= 0.5 IU/mL) cut-offs. Demographic and clinical factors associated with immunity were analyzed by multivariate logistic regression. <bold>Results:</bold> Only 16.7% of HD patients achieved robust protection (>= 0.5 IU/mL), whereas 49.8% had minimal protection (>= 0.1 IU/mL). Protective immunity was independently associated with younger age (OR 1.07 per year; p = 0.004), shorter dialysis duration (OR 1.07; p = 0.030), male sex (female OR 2.92; p = 0.048), and recent booster vaccination within 10 years (OR 0.11; p < 0.001). Diabetes mellitus was not an independent factor. <bold>Conclusion:</bold> Most HD patients lacked durable tetanus immunity, particularly older females on long-term dialysis. The findings highlight the need for regular antibody monitoring, early revaccination, and structured booster programs to maintain adequate protection in this high-risk population.
  • Article
    Citation - WoS: 2
    Citation - Scopus: 3
    Incidental Detection of Ectopic Liver Tissue During Elective Cholecystectomy: a Case Report
    (Frontiers Media Sa, 2025) Emral, Ahmet Cihangir
    Introduction Ectopic liver tissue (ELT) is a rare embryological anomaly most commonly found in the abdominal region, particularly on the gallbladder. It is generally asymptomatic and is often discovered incidentally during surgery or autopsy. Although histologically similar to the main liver, ELT should be excised due to the potential risk of malignancy.Case presentation This study presents a case of incidental ELT discovered during elective cholecystectomy in a 34-year-old female patient. Preoperative imaging revealed multiple gallstones, and during laparoscopic exploration, an ectopic liver tissue lesion was found on the gallbladder fundus. The lesion, measuring 10 x 5 mm, was excised en bloc with the gallbladder and sent for pathological examination, which showed no malignancy.Discussion The rarity and asymptomatic nature of ELT make it difficult to diagnose preoperatively, but its association with malignant transformation warrants careful management. In cases of suspected malignancy, further surgical approaches such as extended surgical margins and regional lymph node dissection should be considered.Conclusion This case underscores the importance of early detection and excision of ectopic liver tissue due to its potential for malignant transformation.
  • Article
    Investigation of Hepatitis E Virus Seroprevalence and Risk Factors in Hemodialysis Patients
    (Frontiers Media Sa, 2025) Ozturk, Hakki; Ozsoy, Metin; Tuna, Aysegul; Varlibas, Artuner; Cesur, Salih; Aksoy, Altan; Demir, Mehmet Emin
    Background: Hemodialysis patients are at increased risk for hepatitis E virus (HEV) infection due to their immunocompromised status and frequent exposure to invasive medical procedures. HEV can lead to chronic infections and severe complications, particularly in high-risk populations. This study aimed to determine HEV-IgG seroprevalence among hemodialysis patients in Ankara, Turkey, and evaluate associated risk factors. Methods: A total of 160 hemodialysis patients from three private dialysis centers in Ankara were included in this prospective, cross-sectional study. Anti-HEV-IgG antibodies were detected using the ELISA method. Demographic characteristics and potential risk factors, including dialysis duration, comorbidities, blood transfusion history, drinking water source, dietary habits, and involvement in animal husbandry, were assessed via structured surveys. Statistical analyses were conducted using SPSS Version 22.0, with Pearson's chi-square and Fisher's exact tests applied to categorical variables. Logistic regression analysis was performed to identify independent risk factors for HEV seropositivity. Results: HEV-IgG seropositivity was detected in 42 patients (26.25%). Seroprevalence increased significantly with age, rising from 6.7% in patients under 55 years to 47.4% in those over 65 years (p < 0.001). Extended dialysis duration (>5 years) was also significantly associated with HEV seropositivity (p = 0.02). However, no significant associations were found between HEV seropositivity and gender, blood transfusion history, source of drinking water, consumption of raw meat, or involvement in animal husbandry (p > 0.05). Conclusion: The HEV-IgG seroprevalence among hemodialysis patients in Ankara was higher than previously reported rates in Turkey. Age and prolonged dialysis duration emerged as significant risk factors, underscoring the importance of screening and preventive strategies in this vulnerable population. Further multi-regional studies are needed to better understand HEV transmission dynamics and improve management strategies in hemodialysis patients.
  • Article
    Citation - WoS: 6
    Citation - Scopus: 6
    Evaluating Efficacy and Outcomes: Comparison of Laser Treatment and Crystallized Phenol in Pilonidal Sinus Disease
    (Frontiers Media Sa, 2025) Emral, Ahmet Cihangir; Gulen, Merter; Ege, Bahadir
    Objective The aim of this study is to comprehensively evaluate the efficacy of laser ablation and crystallized phenol application in the treatment of pilonidal sinus disease, focusing on treatment success, recurrence rates, complications, and the patients' return to normal life.Material and method Data from patients treated for pilonidal sinus disease with laser ablation and crystallized phenol application at our clinic between January 2020 and September 2023 were retrospectively reviewed. Preoperative data including pit counts, disease stage, preoperative pilonidal abscess history, disease duration (week), treatment success, recurrence/persistent disease, postoperative complications, healing time (days), and visual analogue scale (VAS) scores on postoperative days 1 and 7, as well as return to normal life (days), were analyzed.Results A total of 121 patients were included in the study, with 51 receiving laser ablation and 70 receiving crystallized phenol application. The postoperative outcomes revealed that the wound healing period and postoperative VAS values were statistically significantly better in the laser ablation group.Conclusion Wound healing was faster and postoperative pain was less in the laser group compared to the phenol group. According to this study, both methods can successfully treat the disease in selected cases.
  • Article
    Citation - WoS: 2
    Citation - Scopus: 2
    The Detailed Transseptal Puncture Technique for Optimal Closure in Patients With a Patent Foramen Ovale
    (Frontiers Media Sa, 2024) Ilkay, Erdogan; Saricam, Ersin; Kacmaz, Fehmi; Yakici, Aysel; Koca, Cigdem; Ozeke, Ozcan; Onal, Mehmet Zulkuf
    Background The closure of a patent foramen ovale (PFO) using transseptal puncture has particular advantages and disadvantages. Thus, transseptal puncture should be re-evaluated in detail. Aims We aimed to assess the effectiveness of the detailed transseptal puncture technique in patients who underwent PFO closure due to cryptogenic stroke or transient ischemic attack in terms of residual shunts and atrial fibrillation. Methods We prospectively analyzed 144 consecutive patients who underwent PFO closure by the detailed transseptal puncture technique between February 2013 and April 2023 in two centers. All of the patients had a >10 mm long-tunnel PFO. Results The procedural success rate was 100%. However, after the procedure, moderate pericardial effusion developed in one patient (0.7%) and an acute pulmonary embolism related to femoral vein thrombosis was observed in one patient (0.7%) during the first month. Complications related to the procedure were noted in two patients (1.4%) during the first month of follow-up. Residual shunts were observed in 1.4% of cases after PFO closure. Conclusion We demonstrated that the detailed transseptal technique is safe and effective for PFO closure. The detailed transseptal PFO closure technique significantly reduced the risk of atrial fibrillation, and the occurrence of residual shunts was significantly low following the closure.
  • Editorial
    Editorial: Quality Assurance and Workflow Optimization for the Diagnosis and Treatment of Head and Neck Cancer
    (Frontiers Media Sa, 2024) Elicin, Olgun; Hosal, Sefik
    [No Abstract Available]
  • Article
    Evaluation of the Relationship Between Dietary Acid Load and Cardiovascular Risk Factors in Patients With Type 2 Diabetes: a Case-Control Study
    (Frontiers Media Sa, 2024) Gungor, Sedef; Saka, Mendane
    Backround Diets high in dietary acid load are thought to be associated with metabolic diseases. However, the number of studies examining the relationship between dietary acid load and metabolic diseases in Turkey is insufficient. The aim of this study was to investigate the relationship between cardiovascular disease risk factors and dietary acid load in individuals with type 2 diabetes.Materials and methods In this case-control study, 51 participants aged 30-65 years with type 2 diabetes and 59 participants in the control group were included. Blood pressure and biochemical findings were measured. Anthropometric measurements and body composition measurements were made. Dietary intake was assessed using a 3-day (1 day on weekends, 2 days on weekdays) food consumption record. Dietary acid load scores, including potential renal acid load (PRAL) and net endogenous acid production (NEAP), were calculated based on dietary intake. NEAP and PRAL scores were categorized as low and high according to the median value. Smoking status, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), trigylceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL), waist-hip ratio (WHR), waist-to- height ratio (WtHR), hemoglobin and fat mass (%) were evaluated as cardiovascular risk factors.Results The cut-off values of PRAL and NEAP were 3.61 and 44.78 mEq/d, respectively. After adjustment for various covariates, a significant positive association between PRAL and TG levels was observed in the diabetic group [odds ratio (OR), 5.98; 95% CI, 1.45-24.67; p = 0.013]. In contrast, a negative association was found between PRAL and SBP in the control group [odds ratio (OR), 0.21; 95% CI, 0.05-0.83; p = 0.026]. However, these associations were not observed for NEAP values in either group.Conslusions A higher PRAL value was consistently associated with higher TG level, but other cardiovascular risk factors were not. More longitudinal and interventional studies are needed to better establish a causal effect between dietary acid load and cardiovascular risk factors in individuals with diabetes.
  • Article
    Citation - WoS: 4
    Citation - Scopus: 5
    Individualized Luteal Phase Support in Frozen-Thawed Embryo Transfer After Intramuscular Progesterone Administration Might Rectify Live Birth Rate
    (Frontiers Media Sa, 2024) Boynukalin, Fazilet Kubra; Tohma, Yusuf Aytac; Yarkiner, Zalihe; Gultomruk, Meral; Bozdag, Gurkan; Ozkavukcu, Sinan; Demir, Berfu
    Background: The serum P concentrations are suggested to have an impact on pregnancy outcome. However there is no consensus about the optimal progesterone cut-off during the luteal phase. Few studies evaluated the effectiveness of a "rescue protocol" for low serum P concentrations and most of these studies used vaginal progesterone administration. There is paucity of data on the effectiveness of rescue protocol using intramuscular progesterone (IM-P) in frozen-thawed embryo transfer (FET). Methods: This study is a retrospective cohort study included 637 single or double blastocyst FETs with artificially prepared endometrium receiving 100 mg IM progesterone (P) after incremental estrogen treatment. Serum P concentrations were evaluated using blood samples obtained 117-119 hours after the first IM-P administration and 21 +/- 2 hours after the last IM-P administration. Patients with serum P concentrations <20.6 ng/ml on the ET day were administrated 400 mg vaginal progesterone for rescue. Results: Demographic and cycle characteristics were similar between patients receiving rescue vaginal P (embryo transfer (ET)-day P concentration < 20.6 ng/ml) and patients who did not need rescue vaginal P (ET-day P concentration >= 20.6 ng/ml). Clinical pregnancy, miscarriage, and live birth rates were similar between two groups: 52.9%(45/85) vs 59.6%(326/552), p=0.287; 11.1%(5/45) vs 14.1%(46/326), p=0.583; and 47.1%(40/85) vs 50.7%(280/552), p=0.526, respectively. Logistic regression analysis revealed that the female age (p = 0.008, OR=0.942, 95% CI = 0.902-0.984) and embryo quality (ref: good quality for moderate: p=0.02, OR=0.469, 95% CI =0.269-0.760; for poor: p=0.013, OR= 0.269, 95% CI = 0.092-0.757) were independent variables for live birth. Following rescue protocol implementation, ET-day P concentration was not a significant predictor of live birth. Conclusions: Rescue vaginal P administration for low ET day serum P concentrations following IM-P yields comparable live birth rates.
  • Review
    Citation - WoS: 13
    Citation - Scopus: 14
    Current Surgical Techniques for the Management of Pediatric Glaucoma: a Literature Review
    (Frontiers Media Sa, 2023) Aktas, Zeynep; Ikiz, Gokcen Deniz Gulpinar; Gulpinar Ikiz, Gokcen Deniz; Surgical Sciences; Surgical Sciences
    Pediatric glaucoma surgery is challenging due to its diverse and complex pathophysiology, altered anterior segment anatomy, greater potential for failure, and complications compared to adult patients. Moreover, numerous challenges are associated with long-term postoperative management. Thus, when dealing with childhood glaucoma, it is important to consider the potential complications in addition to the benefits of each intervention. The purpose of this article is to review recently published literature to shed light on the most recent surgical techniques for the safe and effective treatment of childhood glaucoma. Current literature shows that goniotomy and trabeculotomy are the first choices for the management of primary congenital glaucoma. Although older children with phakic eyes seem to benefit from trabeculectomy with adjunctive mitomycin C, it carries a long-term risk of bleb-related endophthalmitis. Glaucoma drainage devices may be preferred for patients with secondary or refractory glaucoma. However, hypotony or tube-related complications are common and encountered more often in children than in adults. Cyclodestructive procedures are also an option for cases in which filtering surgery has failed, but they can also be used as a temporizing measure to reduce the rate of complications in high-risk patients. However, their outcomes can be unpredictable, in terms of efficiency and complications. Finally, minimally invasive glaucoma surgery (MIGS) as the sole alternative treatment or as an adjunctive surgical procedure is a relatively new path for pediatric patients.
  • Article
    Citation - WoS: 10
    Citation - Scopus: 13
    Distinguishing Intermediate and Novice Surgeons by Eye Movements
    (Frontiers Media Sa, 2020) Menekse Dalveren, Gonca Gokce; Cagiltay, Nergiz Ercil
    Surgical skill-level assessment is key to collecting the required feedback and adapting the educational programs accordingly. Currently, these assessments for the minimal invasive surgery programs are primarily based on subjective methods, and there is no consensus on skill level classifications. One of the most detailed of these classifications categorize skill levels as beginner, novice, intermediate, sub-expert, and expert. To properly integrate skill assessment into minimal invasive surgical education programs and provide skill-based training alternatives, it is necessary to classify the skill levels in as detailed a way as possible and identify the differences between all skill levels in an objective manner. Yet, despite the existence of very encouraging results in the literature, most of the studies have been conducted to better understand the differences between novice and expert surgical skill levels leaving out the other crucial skill levels between them. Additionally, there are very limited studies by considering the eye-movement behaviors of surgical residents. To this end, the present study attempted to distinguish novice- and intermediate-level surgical residents based on their eye movements. The eye-movement data was recorded from 23 volunteer surgical residents while they were performing four computer-based simulated surgical tasks under different hand conditions. The data was analyzed using logistic regression to estimate the skill levels of both groups. The best results of the estimation revealing a 91.3% recognition rate of predicting novice and intermediate surgical residents on one scenario were selected from four under the dominant hand condition. These results show that the eye-movements can be potentially used to identify surgeons with intermediate and novice skills. However, the results also indicate that the order in which the scenarios are provided, and the design of the scenario, the tasks, and their appropriateness with the skill levels of the participants are all critical factors to be considered in improving the estimation ratio, and hence require thorough assessment for future research.