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Permanent URI for this collectionhttps://hdl.handle.net/20.500.14411/22
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Article Endoscopic Management of Congenital Middle Ear Ossicular Chain Anomalies: A Multicenter Study(Lippincott Williams & Wilkins, 2026) Orhan, Kadir Serkan; Celik, Mehmet; Ozdek, Ali; Gulsen, Secaattin; Yorgancilar, Ediz; Surmelioglu, Ozgur; Guneri, Enis Alpin; Surmelıoglu, OzgurObjective: This study evaluates the surgical and audiological outcomes of transcanal endoscopic ear surgery (TEES) in patients with congenital ossicular chain anomalies (COCAs) using the Teunissen-Cremers classification system. Study design: Multicenter, retrospective clinical study. Setting: Tertiary referral centers with experienced endoscopic ear surgeons. Patients: A total of 51 patients were diagnosed with COCAs and treated with TEES. Patients with chronic otitis media, cholesteatoma, tympanosclerosis, otosclerosis, or those requiring microscopic/endaural/retroauricular approaches were excluded. Intervention: Transcanal endoscopic ossicular chain reconstructions were performed using various techniques, including stapedotomy, partial and total ossicular prosthesis or autologous bone or cartilage graft placements, and bone cement bridging. Main outcome measures: Air-bone gap (ABG) closure, operation duration, hospital stay, and postoperative complications. Results: The mean preoperative ABG was 42.5 +/- 10.9 dB HL, which improved to a mean postoperative ABG of 20.3 +/- 12.3 dB HL, yielding a mean ABG closure of 22.3 +/- 12.2 dB HL. Patients classified as Class 1, 2, and 3 demonstrated significantly greater ABG closure rates compared with Class 4 cases ( P <0.059). The mean surgical duration was 72.1 +/- 19.9 minutes, and the mean hospital stay was 29.6 +/- 15.3 hours. No intraoperative or immediate postoperative complications were observed. Five patients required revision surgery due to recurrent conductive hearing loss. Conclusions: TEES is a safe and effective technique for managing COCAs, offering significant ABG improvement, particularly in Class 1 to 3 anomalies. The minimally invasive nature of TEES, combined with superior exposure and visualization, results in favorable audiological outcomes with minimal complications and reduced hospital stay.Article Development and Validation of an ICF-Based New Scale-Atilim Kinesiophobia Scale: A Methodological Study(Lippincott Williams & Wilkins, 2025) Ulug, Naime; Parmaksiz, Ayhan; Begen, Sena Nur; Can Karahan, Zehra; Yilmaz, Seval; Adali, Mehmet Fatih; Kilic, Erden; Er, Dudu MelekIt is important to assess kinesiophobia, which increases the risk of disability by limiting physical activity. In this cross-sectional study, we aimed to develop a scale that assesses kinesiophobia with the multidimensional structure of International Classification of Functioning, Disability and Health (ICF). Atilim Kinesiophobia Scale (AKS) was developed in Turkish by an expert panel using questionnaires replied by 367 subjects. Finally, 38 questions based on the sub-domains of the ICF described by World Health Organization. In the scope of this cross-sectional study content validity and reliability were assessed; construct validity (both convergent and divergent validity) was checked against Tampa Kinesiophobia Scale-17 and Visual Analog Scale. AKS demonstrated good internal consistency and convergent validity, with significant correlations observed with the Tampa Scale for Kinesiophobia-17 (r = 0.478, P < .001). Divergent validity was supported by insignificant correlations with the Visual Analog Scale (r = 0.019, P = .855). The Cronbach alpha coefficient of 0.862 indicates a high level of internal consistency for the AKS. Based on these findings, the final version of AKS was refined to include 4 factors and 14 items, demonstrating good internal validity. We developed and validated the AKS to assess kinesophobia in patients with acute and/or chronic musculoskeletal pain. This new ICF-based scale can be used to assess kinesiophobia; however further studies are required to prove its validity and reliability in other languages.Article Citation - WoS: 2Citation - Scopus: 2Association Between the Degree of Nonalcoholic Fatty Liver Disease and Nocturnal Hypertension(Lippincott Williams & Wilkins, 2025) Astan, Ramazan; Kacmaz, Fehmi; Saricam, Ersin; Ozyer, Esref Umut; Ilkay, ErdoganNighttime blood pressure (BP) decreases have prognostic significance owing to circadian patterns. The prevalence of nonalcoholic fatty liver disease (NAFLD) has rapidly increased in recent years. We aimed to investigate circadian blood pressure changes in patients with NAFLD. The present study included 114 patients diagnosed with nonalcoholic fatty liver disease and no previous hypertension diagnosis. Thirty patients comprised the control group (no hepatosteatosis and no hypertension). The patients were divided into 3 groups based on nocturnal BP dipping. Blood pressure patterns using night-day ratios were classified as dipper (ratio <= 0, 9), nondipper (0, 9 < ratio <= 1, 0), or nocturnal hypertension (ratio > 1, 0). There were no significant differences in sex, age, presence of diabetes, or biochemical test results between the groups. According to the blood pressure pattern, the nondipper rate in the hepatosteatosis group was significantly higher than that in the control group. Patients were compared in terms of the presence and severity of hepatosteatosis according to night blood pressure patterns. A significant difference was observed between the groups (P < .001 and P = .001, respectively). We found an association between hepatosteatosis severity and night blood pressure patterns. Patients with nonalcoholic fatty liver disease have a higher incidence of nocturnal hypertension. We observed impaired circadian blood pressure changes in patients with nonalcoholic fatty liver disease.Article Citation - WoS: 55Citation - Scopus: 54Hopelessness, Death Anxiety, and Social Support of Hospitalized Patients With Gynecologic Cancer and Their Caregivers(Lippincott Williams & Wilkins, 2019) Uslu-Sahan, Fatma; Terzioglu, Fusun; Koc, GultenBackground Gynecologic cancer can create hopelessness and death anxiety and alter the lifestyle of the affected women and their caregivers. Perceived social support may facilitate coping with this illness. Objective The aim of this study was to determine whether hospitalized patients with gynecologic cancer and their caregivers differ in feelings of hopelessness and death anxiety and how those conditions may be related to their social support. Methods Two hundred patients with gynecologic cancer and their 200 caregivers from 1 university hospital were enrolled in this descriptive correlational study. Study measures included a demographic form, the Perceived Social Support Scale, the Beck Hopelessness Scale, and the Thorson-Powell's Death Anxiety Scale. Data were analyzed using Student t test, Pearson correlation test, and linear regression analyses. Results Patients had higher hopelessness and death anxiety compared with caregivers (P < .001). Patients' perceived social support explained 35% of the total variance in hopelessness and 28% of the variance in death anxiety; caregivers' perceived social support explained 40% of the total variance in hopelessness and 12% of the variance in death anxiety. Conclusion Patients felt hopelessness and death anxiety in greater rates than caregivers. Social support had a significant effect on hopelessness and death anxiety of patients and their caregivers.Article Citation - WoS: 60Citation - Scopus: 74Effects of Massage and Acupressure on Relieving Labor Pain, Reducing Labor Time, and Increasing Delivery Satisfaction(Lippincott Williams & Wilkins, 2020) Gonenc, Ilknur Munevver; Terzioglu, FusunBackground: Several recent studies have documented the effects of massage and acupressure in reducing labor pain and labor time and in satisfaction with the delivery. However, few studies have investigated the comparative effects of these two therapies. Purpose: The aim of this study was to compare the effects of massage and acupressure on labor-related pain management, duration, and satisfaction with delivery. Methods: This randomized controlled trial (n = 120) included three intervention groups (massage only, acupressure only, and massage + acupressure) and one control group, in which patients received no massage or acupressure treatment. A personal information form, Pregnant Watch Form, and Visual Analog Scale (VAS) were used to collect data. Frequency and percentage calculations, chi-square test, Student's t test, Tukey's honestly significant difference test, and one-way variance analysis were used for data analysis. Results: In the latent phase of labor, the mean VAS scores of the massage-only group and massage + acupressure group were lower (4.56 +/- 1.36 and 4.63 +/- 1.52, respectively) than that of the control group (6.16 +/- 1.46; p < .01). In the active and transition phases, the mean VAS scores of the massage-only group, acupressure-only group, and massage + acupressure group were significantly lower than that of the control group (p < .01 and p < .001, respectively). During postpartum, the mean VAS score of the massage + acupressure group was lower (2.30 +/- 0.70) than that of the control group (2.96 +/- 0.72; p = .003). Cervical dilatation completion time and 1- and 5-minute Apgar scores were similar among all of the groups (p > .05). The three intervention groups reported relatively more positive feelings than the control group, and all three of the interventions were found to be effective in improving satisfaction.Review Citation - WoS: 32Citation - Scopus: 37The Effectiveness of Simulation-Based Team Training in Obstetrics Emergencies for Improving Technical Skills a Systematic Review(Lippincott Williams & Wilkins, 2020) Yucel, Cigdem; Hawley, Glenda; Terzioglu, Fusun; Bogossian, FionaThis review explores the effectiveness of simulation-based team training in obstetric emergencies for improving technical skills. A literature search was conducted that included all articles to January 2018. A total of 21 articles were included from a potential 1327 articles. Each included study was assessed for impact of the training program using Kirkpatrick's 4-level model. Only the performance of technical skills was evaluated. Five studies reported on acceptance of simulation as an education tool at a level 1. Level 2 outcomes were reported in 7 studies where staff demonstrated improved skills in an educational setting. Three studies reported improved performance in a clinical setting at a level 3. Ten studies were categorized as level 4 and found that simulation learning was translated into improved techniques or maneuvers in reduced time frames in emergency situations of shoulder dystocia and postpartum hemorrhage. There was evidence that neonatal outcomes were improved.Article Citation - WoS: 2Citation - Scopus: 2Endoscopic Retrograde Cholangiopancreatography-Oriented Surgery for Accomplished Treatment of Mirizzi Syndrome: a Single-Center Experience(Lippincott Williams & Wilkins, 2023) Karaahmet, Fatih; Kekilli, MuratBackgroundMirizzi syndrome is a gallstone disease characterized by compression of extrahepatic biliary duct with an impacted stone. Our aim is to identify and describe the incidence, clinical presentation, operative details and the association postoperative complication of Mirizzi syndrome in patients undergoing endoscopic retrograde cholangiopancreatography (ERCP). MethodsThe ERCP procedures were held in Gastroenterology Endoscopy Unit and retrospectively evaluated. The patients were divided into two groups, the cholelithiasis + common bile duct (CBD) stone group and the Mirizzi syndrome group. These groups were compared with the demographic characteristics, ERCP procedures, types of Mirizzi syndrome and surgical technique. ResultsA total of 1018 consecutive patients who underwent ERCP were scanned retrospectively. Of the 515 patients fulfilling the criteria for ERCP, 12 had Mirizzi syndrome and 503 had cholelithiasis and CBD stones. Half of the Mirizzi syndrome patients were diagnosed with pre-ERCP ultrasonography. The mean diameter of choledoc was found to be 10 mm in ERCP. ERCP-related complication rates (pancreatitis, bleeding and perforation) were the same in the two groups; 66.6% of the Mirizzi syndrome patients applied cholecystectomy and placement of T-tube surgical procedures, and there were no postoperative complications. ConclusionSurgery is the definitive treatment of Mirizzi syndrome. Thus patients should have a correct preoperative diagnosis for an appropriate and safe surgery. We think that ERCP could be the best guide for this. Also, we believe that intraoperative cholangiography with ERCP and hybrid procedures for guiding surgical treatment may become an advanced treatment option in the future.Article Citation - WoS: 36Citation - Scopus: 41Outcomes of Prolene Gonioscopy Assisted Transluminal Trabeculotomy in Primary Open Angle Glaucoma and Pseudoexfoliation Glaucoma: a Comparative Study(Lippincott Williams & Wilkins, 2022) Aktas, Zeynep; Zeydanli, Ece Ozdemir; Uysal, Betul Seher; Yigiter, Ahmet; Ozdemir Zeydanli, EcePrecis: Gonioscopy-assisted transluminal trabeculotomy (GATT) provides greater intraocular pressure (TOP) reduction in pseudoexfoliative glaucoma (PXG) than in primary open angle glaucoma (POAG) in the first year of surgery; however, the difference between groups equalizes in the long term. Purpose: To compare outcomes of GATT in eyes with POAG and PXG. Methods: Single-center, retrospective, comparative case-series. A total of 202 eyes (91 eyes of POAG; 111 eyes of PXG) were included. GATT was performed as a standalone procedure or in combination with cataract extraction. Outcome measures were change in IOP and number of medications at all time points (1, 3, 6, 9, 12, 18, 24, and 36 mo after surgery), success rate (IOP reduction >= 20% from baseline or IOP between 6 and 21 mmHg, without further glaucoma surgery), and complication rate. Cumulative success probabilities were compared using Kaplan-Meier survival analyses. Results: The mean IOP decreased by 8.8 mmHg (34.4%) in the POAG group with a mean decrease of 2 glaucoma medications at final visit. In the PXG group, the mean IOP decreased by 12.8 mm Hg (44.6%) on 2.3 fewer medications. Mean IOP reduction was significantly higher in PXG than POAG at all time points up to 2-year visit (P < 0 .0 5 for all), after which the difference was not significant. Cumulative success probability during the first year was significantly higher in PXG (97.6%) than in POAG (86.8%) (P = 0.01); no significant difference was found at 2-year (P = 0.07) and 3-year visits (P = 0.24). Conclusion: GATT was safe and effectively reduced the IOP and medication burden in patients with POAG and PXG. In the first year after GATT, a significantly higher success rate was noted in PXG compared with POAG; however, in subsequent years, the success rate was similar at similar to 75%.Article Citation - WoS: 3Citation - Scopus: 3Risk Factors for Trabeculotomy Failure in Primary Congenital Glaucoma(Lippincott Williams & Wilkins, 2022) Aktas, Zeynep; Ucgul, Ahmet Y.; Boluk, Ceyda E.; Atalay, Hatice T.Precis:This study demonstrates that a baseline corneal diameter >12.25, initial age <4 months at diagnosis, higher baseline IOP than 24 mm Hg, bilaterality, or inability to perform circumferential trabeculotomy, increases the risk of surgical failure of trabeculotomy in patients with primary congenital glaucoma (PCG). Purpose:The aim of this study was to identify clinical predictive factors for surgical failure and to evaluate potential prognostic factors affecting surgical success in patients with PCG who underwent trabeculotomy. Patients and Methods:The medical charts of 123 eyes of 75 patients who underwent trabeculotomy surgery for the treatment of PCG were retrospectively reviewed. At baseline and each visit, intraocular pressure (IOP), corneal diameter, cup to disc ratio, axial length, number of medications, and need for further glaucoma surgery were noted. Surgical success was defined as an IOP <= 18 mm Hg and 20% IOP reduction from baseline with (qualified) or without (complete) medication and without any further IOP-lowering surgery. Results:The mean age at surgery was 4.2 +/- 6.6 months and the mean follow-up time was 60.0 +/- 37.6 months. The receiver operating characteristic curve showed 4 following best cutoff values to predict surgical failure: the first for age at surgery was 4.5 months; the second baseline IOP was 24.0 mm Hg; the third for baseline cup to disc ratio was 0.4; and the fourth for baseline corneal diameter was 12.25 mm. Multivariate logistic regression analysis revealed that baseline IOP more than 24 mm Hg increased the risk of surgical failure by 2 times, baseline mean corneal diameter >12.25 mm did by 4.2 times, younger age than 4 months did by 2.5 times, bilaterality did by 1.5 times. Conclusions:A higher baseline IOP, younger age, larger corneal diameter, and bilaterality were identified as risk factors for trabeculotomy failure in congenital glaucoma. The presence of one or more of these should be considered in the decision-making process when considering surgical options to manage glaucoma in these patients.Article Effects of Cold Therapy on Pain and Anxiety During Needle Removal From Implanted Ports(Lippincott Williams & Wilkins, 2023) Bahar, Arzu; Aktas, Demet; Sonmez, MunevverThis study was conducted as a quasiexperimental, single-blind study to examine the effect of cold therapy on pain and anxiety during port needle removal. Patients in the experimental group received cold therapy 10 minutes before port needle removal. Patients in the control group received no intervention before port needle removal. Data were collected using the visual analog scale (VAS) and State-Trait Anxiety Inventory (STAI). After cold therapy was applied to the patients in the experimental group, the second and third VAS scores were found to be statistically significant and lower than those in the control group (P < .05). There was no statistically significant difference between the anxiety levels of the experimental group and the control group before cold therapy (P> .005). However, the STAI scores of the experimental group were found to be statistically and significantly lower than those of the control group after cold therapy (P < .05). This study determined that cold therapy before port needle removal reduces pain and anxiety. Cold therapy may be recommended as an effective nonpharmacological pain control method with ease of application to prevent pain induced by port needle removal.