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1. Variability of temperature measurements recorded by a wearable device by biological sex.

Author: Bruce, Lauryn, Kasl, Patrick, Soltani, Severine, Viswanath, Varun, Hartogensis, Wendy, Dilchert, Stephan, Hecht, Frederick, Chowdhary, Anoushka, Anglo, Claudine, Pandya, Leena, Altintas, Ilkay, Mason, Ashley, Smarr, Benjamin, Gupta, Amarnath, and Dasgupta, Subhasis
Subjects: Humans, Male, Female, Mice, Animals, Young Adult, Adult, Middle Aged, Aged, Temperature, Menstrual Cycle, Periodicity, Sex Characteristics, Wearable Electronic Devices
Abstract: BACKGROUND: Females have been historically excluded from biomedical research due in part to the documented presumption that results with male subjects will generalize effectively to females. This has been justified in part by the assumption that ovarian rhythms will increase the overall variance of pooled random samples. But not all variance in samples is random. Human biometrics are continuously changing in response to stimuli and biological rhythms; single measurements taken sporadically do not easily support exploration of variance across time scales. Recently we reported that in mice, core body temperature measured longitudinally shows higher variance in males than cycling females, both within and across individuals at multiple time scales. METHODS: Here, we explore longitudinal human distal body temperature, measured by a wearable sensor device (Oura Ring), for 6 months in females and males ranging in age from 20 to 79 years. In this study, we did not limit the comparisons to female versus male, but instead we developed a method for categorizing individuals as cyclic or acyclic depending on the presence of a roughly monthly pattern to their nightly temperature. We then compared structure and variance across time scales using multiple standard instruments. RESULTS: Sex differences exist as expected, but across multiple statistical comparisons and timescales, there was no one group that consistently exceeded the others in variance. When variability was assessed across time, females, whether or not their temperature contained monthly cycles, did not significantly differ from males both on daily and monthly time scales. CONCLUSIONS: These findings contradict the viewpoint that human females are too variable across menstrual cycles to include in biomedical research. Longitudinal temperature of females does not accumulate greater measurement error over time than do males and the majority of unexplained variance is within sex category, not between them.
Published: 2023

2. Astrocytic outer retinal layer thinning is not a feature in AQP4-IgG seropositive neuromyelitis optica spectrum disorders

Author: Lu, Angelo, Zimmermann, Hanna G, Specovius, Svenja, Motamedi, Seyedamirhosein, Chien, Claudia, Bereuter, Charlotte, Lana-Peixoto, Marco A, Fontenelle, Mariana Andrade, Ashtari, Fereshteh, Kafieh, Rahele, Dehghani, Alireza, Pourazizi, Mohsen, Pandit, Lekha, D'Cunha, Anitha, Kim, Ho Jin, Hyun, Jae-Won, Jung, Su-Kyung, Leocani, Letizia, Pisa, Marco, Radaelli, Marta, Siritho, Sasitorn, May, Eugene F, Tongco, Caryl, De Sèze, Jérôme, Senger, Thomas, Palace, Jacqueline, Roca-Fernández, Adriana, Leite, Maria Isabel, Sharma, Srilakshmi M, Stiebel-Kalish, Hadas, Asgari, Nasrin, Soelberg, Kerstin Kathrine, Martinez-Lapiscina, Elena H, Havla, Joachim, Mao-Draayer, Yang, Rimler, Zoe, Reid, Allyson, Marignier, Romain, Cobo-Calvo, Alvaro, Altintas, Ayse, Tanriverdi, Uygur, Yildirim, Rengin, Aktas, Orhan, Ringelstein, Marius, Albrecht, Philipp, Tavares, Ivan Maynart, Bichuetti, Denis Bernardi, Jacob, Anu, Huda, Saif, de Castillo, Ibis Soto, Petzold, Axel, Green, Ari J, Yeaman, Michael R, Smith, Terry J, Cook, Lawrence, Paul, Friedemann, Brandt, Alexander U, and Oertel, Frederike Cosima
Subjects: Eye Disease and Disorders of Vision, Brain Disorders, Neurosciences, Neurodegenerative, Adult, Aquaporin 4, Astrocytes, Autoantibodies, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Neuromyelitis Optica, Retina, Tomography, Optical Coherence, vision, clinical neurology, ophthalmology, GJCF International Clinical Consortium for NMOSD, Medical and Health Sciences, Psychology and Cognitive Sciences, Neurology & Neurosurgery
Abstract: BackgroundPatients with anti-aquaporin-4 antibody seropositive (AQP4-IgG+) neuromyelitis optica spectrum disorders (NMOSDs) frequently suffer from optic neuritis (ON) leading to severe retinal neuroaxonal damage. Further, the relationship of this retinal damage to a primary astrocytopathy in NMOSD is uncertain. Primary astrocytopathy has been suggested to cause ON-independent retinal damage and contribute to changes particularly in the outer plexiform layer (OPL) and outer nuclear layer (ONL), as reported in some earlier studies. However, these were limited in their sample size and contradictory as to the localisation. This study assesses outer retinal layer changes using optical coherence tomography (OCT) in a multicentre cross-sectional cohort.Method197 patients who were AQP4-IgG+ and 32 myelin-oligodendrocyte-glycoprotein antibody seropositive (MOG-IgG+) patients were enrolled in this study along with 75 healthy controls. Participants underwent neurological examination and OCT with central postprocessing conducted at a single site.ResultsNo significant thinning of OPL (25.02±2.03 µm) or ONL (61.63±7.04 µm) were observed in patients who were AQP4-IgG+ compared with patients who were MOG-IgG+ with comparable neuroaxonal damage (OPL: 25.10±2.00 µm; ONL: 64.71±7.87 µm) or healthy controls (OPL: 24.58±1.64 µm; ONL: 63.59±5.78 µm). Eyes of patients who were AQP4-IgG+ (19.84±5.09 µm, p=0.027) and MOG-IgG+ (19.82±4.78 µm, p=0.004) with a history of ON showed parafoveal OPL thinning compared with healthy controls (20.99±5.14 µm); this was not observed elsewhere.ConclusionThe results suggest that outer retinal layer loss is not a consistent component of retinal astrocytic damage in AQP4-IgG+ NMOSD. Longitudinal studies are necessary to determine if OPL and ONL are damaged in late disease due to retrograde trans-synaptic axonal degeneration and whether outer retinal dysfunction occurs despite any measurable structural correlates.
Published: 2022

3. Detection of COVID-19 using multimodal data from a wearable device: results from the first TemPredict Study

Author: Mason, Ashley E, Hecht, Frederick M, Davis, Shakti K, Natale, Joseph L, Hartogensis, Wendy, Damaso, Natalie, Claypool, Kajal T, Dilchert, Stephan, Dasgupta, Subhasis, Purawat, Shweta, Viswanath, Varun K, Klein, Amit, Chowdhary, Anoushka, Fisher, Sarah M, Anglo, Claudine, Puldon, Karena Y, Veasna, Danou, Prather, Jenifer G, Pandya, Leena S, Fox, Lindsey M, Busch, Michael, Giordano, Casey, Mercado, Brittany K, Song, Jining, Jaimes, Rafael, Baum, Brian S, Telfer, Brian A, Philipson, Casandra W, Collins, Paula P, Rao, Adam A, Wang, Edward J, Bandi, Rachel H, Choe, Bianca J, Epel, Elissa S, Epstein, Stephen K, Krasnoff, Joanne B, Lee, Marco B, Lee, Shi-Wen, Lopez, Gina M, Mehta, Arpan, Melville, Laura D, Moon, Tiffany S, Mujica-Parodi, Lilianne R, Noel, Kimberly M, Orosco, Michael A, Rideout, Jesse M, Robishaw, Janet D, Rodriguez, Robert M, Shah, Kaushal H, Siegal, Jonathan H, Gupta, Amarnath, Altintas, Ilkay, and Smarr, Benjamin L
Subjects: Prevention, Clinical Research, Good Health and Well Being, Adolescent, Adult, Aged, Aged, 80 and over, Algorithms, Body Temperature, COVID-19, Female, Humans, Male, Middle Aged, SARS-CoV-2, Wearable Electronic Devices, Young Adult
Abstract: Early detection of diseases such as COVID-19 could be a critical tool in reducing disease transmission by helping individuals recognize when they should self-isolate, seek testing, and obtain early medical intervention. Consumer wearable devices that continuously measure physiological metrics hold promise as tools for early illness detection. We gathered daily questionnaire data and physiological data using a consumer wearable (Oura Ring) from 63,153 participants, of whom 704 self-reported possible COVID-19 disease. We selected 73 of these 704 participants with reliable confirmation of COVID-19 by PCR testing and high-quality physiological data for algorithm training to identify onset of COVID-19 using machine learning classification. The algorithm identified COVID-19 an average of 2.75 days before participants sought diagnostic testing with a sensitivity of 82% and specificity of 63%. The receiving operating characteristic (ROC) area under the curve (AUC) was 0.819 (95% CI [0.809, 0.830]). Including continuous temperature yielded an AUC 4.9% higher than without this feature. For further validation, we obtained SARS CoV-2 antibody in a subset of participants and identified 10 additional participants who self-reported COVID-19 disease with antibody confirmation. The algorithm had an overall ROC AUC of 0.819 (95% CI [0.809, 0.830]), with a sensitivity of 90% and specificity of 80% in these additional participants. Finally, we observed substantial variation in accuracy based on age and biological sex. Findings highlight the importance of including temperature assessment, using continuous physiological features for alignment, and including diverse populations in algorithm development to optimize accuracy in COVID-19 detection from wearables.
Published: 2022

4. Retinal Optical Coherence Tomography in Neuromyelitis Optica.

Author: Oertel, Frederike, Specovius, Svenja, Zimmermann, Hanna, Chien, Claudia, Motamedi, Seyedamirhosein, Bereuter, Charlotte, Cook, Lawrence, Lana Peixoto, Marco, Fontanelle, Mariana, Kim, Ho, Hyun, Jae-Won, Palace, Jacqueline, Roca-Fernandez, Adriana, Leite, Maria, Sharma, Srilakshmi, Ashtari, Fereshteh, Kafieh, Rahele, Dehghani, Alireza, Pourazizi, Mohsen, Pandit, Lekha, DCunha, Anitha, Aktas, Orhan, Ringelstein, Marius, Albrecht, Philipp, May, Eugene, Tongco, Caryl, Leocani, Letizia, Pisa, Marco, Radaelli, Marta, Martinez-Lapiscina, Elena, Stiebel-Kalish, Hadas, Siritho, Sasitorn, de Seze, Jérome, Senger, Thomas, Havla, Joachim, Marignier, Romain, Cobo-Calvo, Alvaro, Bichuetti, Denis, Tavares, Ivan, Asgari, Nasrin, Soelberg, Kerstin, Altintas, Ayse, Yildirim, Rengin, Tanriverdi, Uygur, Jacob, Anu, Huda, Saif, Rimler, Zoe, Reid, Allyson, Mao-Draayer, Yang, Soto de Castillo, Ibis, Petzold, Axel, Green, Ari, Yeaman, Michael, Smith, Terry, Brandt, Alexander, and Paul, Friedemann
Subjects: Adult, Aquaporin 4, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Neuromyelitis Optica, Optic Neuritis, Retinal Neurons, Retrospective Studies, Tomography, Optical Coherence, Young Adult
Abstract: BACKGROUND AND OBJECTIVES: To determine optic nerve and retinal damage in aquaporin-4 antibody (AQP4-IgG)-seropositive neuromyelitis optica spectrum disorders (NMOSD) in a large international cohort after previous studies have been limited by small and heterogeneous cohorts. METHODS: The cross-sectional Collaborative Retrospective Study on retinal optical coherence tomography (OCT) in neuromyelitis optica collected retrospective data from 22 centers. Of 653 screened participants, we included 283 AQP4-IgG-seropositive patients with NMOSD and 72 healthy controls (HCs). Participants underwent OCT with central reading including quality control and intraretinal segmentation. The primary outcome was thickness of combined ganglion cell and inner plexiform (GCIP) layer; secondary outcomes were thickness of peripapillary retinal nerve fiber layer (pRNFL) and visual acuity (VA). RESULTS: Eyes with ON (NMOSD-ON, N = 260) or without ON (NMOSD-NON, N = 241) were assessed compared with HCs (N = 136). In NMOSD-ON, GCIP layer (57.4 ± 12.2 μm) was reduced compared with HC (GCIP layer: 81.4 ± 5.7 μm, p < 0.001). GCIP layer loss (-22.7 μm) after the first ON was higher than after the next (-3.5 μm) and subsequent episodes. pRNFL observations were similar. NMOSD-NON exhibited reduced GCIP layer but not pRNFL compared with HC. VA was greatly reduced in NMOSD-ON compared with HC eyes, but did not differ between NMOSD-NON and HC. DISCUSSION: Our results emphasize that attack prevention is key to avoid severe neuroaxonal damage and vision loss caused by ON in NMOSD. Therapies ameliorating attack-related damage, especially during a first attack, are an unmet clinical need. Mild signs of neuroaxonal changes without apparent vision loss in ON-unaffected eyes might be solely due to contralateral ON attacks and do not suggest clinically relevant progression but need further investigation.
Published: 2021

5. Effect of CPAP on New Endothelial Dysfunction Marker, Endocan, in People With Obstructive Sleep Apnea.

Author: Altintas, Nejat, Mutlu, Levent Cem, Akkoyun, Dursun Cayan, Aydin, Murat, Bilir, Bulent, Yilmaz, Ahsen, and Malhotra, Atul
Subjects: Humans, Sleep Apnea, Obstructive, Vascular Diseases, Proteoglycans, Neoplasm Proteins, Polysomnography, Continuous Positive Airway Pressure, Risk Factors, Adult, Aged, Middle Aged, Female, Male, Carotid Intima-Media Thickness, Biomarkers, biomarkers, carotid intima media thickness, endocan, flow-mediated dilatation, obstructive sleep apnea, Cardiovascular System & Hematology, Clinical Sciences
Abstract: Obstructive sleep apnea (OSA) is associated with increased cardiovascular (CV) morbidity and mortality. Endocan is a surrogate endothelial dysfunction marker that may be associated with CV risk factors. In this study, we tested whether serum endocan is a biomarker for OSA. Serum endocan levels were measured at baseline in 40 patients with OSA and 40 healthy controls and after 3 months of continuous positive airway pressure (CPAP) treatment in the patients with OSA. All participants were evaluated by full polysomnography. Flow-mediated dilatation (FMD) and carotid intima media thickness (cIMT) were measured in all participants. Endocan levels were significantly higher in patients with OSA than in healthy controls. After adjusting confounders, endocan was a good predictor of OSA. Endocan levels correlated with OSA severity (measured by the apnea-hypopnea index [AHI]). After 3 months of CPAP treatment, endocan levels significantly decreased. Endocan levels were significantly and independently correlated with cIMT and FMD after multiple adjustments. The cIMT and FMD also had significant and independent correlation with AHI. Endocan might be a useful marker for the predisposition of patients with OSA to premature vascular disease.
Published: 2016

6. Low sCD163/TWEAK Ratio at First Day After Acute Myocardial Infarction Associated with Adverse Cardiac Remodeling in Non-Elderly Patients

Author: Mehmet Sait Altintas, Nilnur Eyerci, Orhan Karayigit, Bekir Demirtas, Murat Gok, and Emrullah Kiziltunc
Subjects: Adult, Ventricular Remodeling, Myocardial Infarction, Humans, ST Elevation Myocardial Infarction, Heart, Apoptosis, Middle Aged, Cardiology and Cardiovascular Medicine
Abstract: Aim In this study, we aimed to investigate the role of sCD163 / tumor necrosis factor-like weak apoptosis-inducing (TWEAK) ratio in cardiac remodeling in non-elderly patients diagnosed with first acute myocardial infarction (MI).Material and Methods Forty-four patients (age ranges: 40–64 years) diagnosed with first-time acute ST-elevation MI in the emergency department were evaluated with cardiac magnetic resonance (CMR) imaging. Adverse remodeling (AR) was defined the increases of left ventricular end-diastolic volume by ≥12 % by CMR at 6‑month post-MI TWEAK and sCD163 were measured at the first day (baseline), 2 weeks and 6 weeks post-MI.Results The average age of patients included in the study was 53.6±5.1 years. AR was detected in 18 patients at the 6 months post-MI. At the first day post-MI, median sCD163 concentration (116 069 vs 86 394 pg / mL, p=0.040) and median TWEAK concentration (759.4 vs 220.1 pg / mL, pConclusion In the early phase post-MI, the relationship between sCD163 – TWEAK may have an important role in AR pathogenesis. A lower sCD163 / TWEAK ratio on the first day after MI was associated with an increase in left ventricular end-diastolic volume after 6 months of follow-up.
Published: 2022

7. Systematic analysis of physical examination characteristics of 94 individuals with Joubert syndrome: Keys to suspecting the diagnosis

Author: RaeLynn Forsyth, Melissa A. Parisi, Burak Altintas, May Christine Malicdan, Thierry Vilboux, Jasmine Knoll, Brian P. Brooks, Wadih M. Zein, William A. Gahl, Camilo Toro, and Meral Gunay‐Aygun
Subjects: Adult, Male, Kidney Diseases, Cystic, Magnetic Resonance Imaging, Article, Retina, Cerebellum, Genetics, Humans, Muscle Hypotonia, Abnormalities, Multiple, Female, Eye Abnormalities, Child, Physical Examination, Genetics (clinical)
Abstract: Joubert syndrome (JS) is a neurodevelopmental disorder characterized by hypotonia and developmental delay, as well as the obligatory molar tooth sign on brain imaging. Since hypotonia and developmental delay are nonspecific features, there must be a high level of clinical suspicion of JS so that the diagnostic brain imaging and/or molecular testing for the >38 genes associated with JS is/are obtained. The goal of this study was to analyze clinical photographs of a cohort of patients with JS to define a list of physical examination features that should prompt investigation for JS. Analysis of photographs from 94 individuals with JS revealed that there is a recognizable pattern of facial features in JS that changes over time as individuals age. Macrocephaly, head tilting even when looking straight ahead, eye movement abnormalities (oculomotor apraxia, nystagmus, strabismus), and ptosis are common in those with JS. Distinctive features in younger children include triangular-shaped open mouth with tongue protrusion; in older children and adults, mandibular prognathia and prominent nasal bridge are common.
Published: 2022

8. Nutritional practices in medical intensive care units: Multicenter, one-day point prevalence study.

Author: Ferlicolak, Leyla, Altintas, Neriman Defne, Halacli, Burcin, Temel, Sahin, Cakin, Ozlem, Turkoglu, Melda, Comert, Bilgin, Taskin, Gurhan, Zerman, Avsar, Akbas, Turkay, Karakoc, Emre, Gonderen, Kamil, Akbudak, Ismail Hakkı, Gundogan, Kursat, and Topeli, Arzu
Subjects: *INTENSIVE care units, *MEDICAL care, *CRITICALLY ill patient care, *DIET therapy, *NUTRITIONAL status, *CRITICAL care medicine
Abstract: Nutritional planning is an important aspect of Intensive Care Unit (ICU) care. The present study aimed to evaluate the nutritional practices adopted in medical ICUs in Turkiye and to investigate their compliance with current international guidelines. This multicenter, cross-sectional study was performed on a predetermined study date. Centers were required to fill three groups of questionnaires: One on ICU characteristics and facilities, one on patients included, and one on outcomes of patients. Forms on patients had questions on demographics and their nutritional status. A total of 12 sites participated and 132 patients were recorded in the study and 109 patients were included in analyses. The median age was 72 [57–83] years and 55 (50%) of them was female. The median APACHE II score was 23 [18–29], median SOFA score was 6 [4–9] and median BMI was 25.32 [21.22–29.38]. More than 50% of patients were fed enterally; for most, it was started within the first 24 hours of admission. On the study day, the median energy intake of the patients during the last 24 hours was 21.62 [15.9–27.3] kcal/kg and the median amount of protein intake was 1.02 [0.7–1.3] g/kg, representing 83.1% and 78.9% of the targets, respectively. A total of 64 (58.7%) patients were alive on the 28th day of the study, of them 23 (21.1% of all patients) were still in the ICU. Nutrition therapy in medical ICUs was initiated early after ICU admission, the enteral route was preferred and target calories were calculated using weight-based formulas. These results suggest that multi-dimensional planning of critical care management of patients by intensivists may provide better nutritional care for the critically ill. [ABSTRACT FROM AUTHOR]
Published: 2023
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9. Understanding potential associations between anatomic and other factors in OSA severity

Author: Tolga Ersözlü, Erdogan Gultekin, Nevin Fazlıoğlu, Nejat Altintas, and Mahmut Deniz
Subjects: Male, Adult, medicine.medical_specialty, Polysomnography, Oropharynx, Disorders of Excessive Somnolence, Young Adult, stomatognathic system, Internal medicine, medicine, Humans, Prospective Studies, Prospective cohort study, Aged, Sleep Apnea, Obstructive, medicine.diagnostic_test, business.industry, Apnea, Middle Aged, Anthropometry, medicine.disease, nervous system diseases, respiratory tract diseases, Obstructive sleep apnea, Otorhinolaryngology, Cohort, Female, Neurology (clinical), Rhinomanometry, medicine.symptom, business, Body mass index, Hypopnea
Abstract: The aim of this prospective study was to investigate associations between nasal/oropharyngeal structures and a range of factors including age, gender, daytime sleepiness, and body mass index (BMI). Patients with OSA were prospectively selected as research participants in rhinomanometric analysis as well as for otolaryngological evaluation. Participants were grouped as follows according to their apnea/hypopnea index (AHI) scores: no OSA (AHI
Published: 2021

10. Perioperative SARS-CoV-2 infection among women undergoing major gynecologic cancer surgery in the COVID-19 era: A nationwide, cohort study from Turkey

Author: Suayip Birinci, Erdal Demirtas, Koray Aslan, Mehmet Mutlu Meydanli, Ali Ayhan, Huseyin Akilli, Mufide Iclal Altintas, Nazlı Topfedaisi Özkan, Mustafa Mahir Ulgu, Osman Celik, and Murat Oz
Subjects: Adult, 0301 basic medicine, medicine.medical_specialty, Adolescent, Turkey, Genital Neoplasms, Female, Article, law.invention, Young Adult, 03 medical and health sciences, 0302 clinical medicine, law, Obstetrics and Gynaecology, Coronavirus infection, medicine, Humans, Perioperative, Perioperative Period, Aged, Retrospective Studies, Aged, 80 and over, Cervical cancer, SARS-CoV-2, business.industry, Mortality rate, Endometrial cancer, Gynecologic neoplasms, COVID-19, Obstetrics and Gynecology, Middle Aged, Vulvar cancer, medicine.disease, Intensive care unit, Surgery, 030104 developmental biology, Severe acute respiratory syndrome, Oncology, Period, 030220 oncology & carcinogenesis, Female, business, Ovarian cancer, Cohort study
Abstract: Objective The objective of this study was to determine the rate of perioperative SARS-CoV-2 infection among gynecologic cancer patients undergoing major surgery. Methods The database of the Turkish Ministry of Health was searched in order to identify all consecutive gynecologic cancer patients undergoing major surgery between March 11, 2020 and April 30, 2020 for this retrospective, nationwide, cohort study. The inclusion criteria were strictly founded on a final histopathological diagnosis of a malignant gynecologic tumor. COVID-19 cases were diagnosed by reverse transcriptase- polymerase chain reaction testing for SARS-CoV-2. The rate of perioperative SARS-CoV-2 infection and the 30-day mortality rate of COVID-19 patients were investigated. Results During the study period, 688 women with gynecologic cancer undergoing major surgery were identified nationwide. The median age of the patients was 59 years. Most of the surgeries were open (634/688, 92.2%). There were 410 (59.6%) women with endometrial cancer, 195 (28.3%) with ovarian cancer, 66 (9.6%) with cervical cancer, 14 (2.0%) with vulvar cancer and 3 (0.4%) with uterine sarcoma. The rate of SARS-CoV-2 infections confirmed within 7 days before or 30 days after surgery was 46/688 (6.7%). All but one woman was diagnosed postoperatively (45/46, 97.8%). The rates of intensive care unit admission and invasive mechanical ventilation were 4/46 (8.7%) and 2/46 (4.3%), respectively. The 30-day mortality rate was 0%. Conclusion In the COVID-19 era, gynecologic cancer surgery may be performed with an acceptable rate of perioperative SARS-CoV-2 infection if the staff and the patients strictly adhere to the established infection control measures., Highlights • This is the first nationwide study describing the feasibility of major gynecologic cancer surgery during COVID-19 pandemic. • COVID-19 will be one of the most important concerns of health care systems for a long time. • Gynecologic cancer surgery may be performed with an acceptable rate of perioperative SARS-CoV-2 infection. • Improved surgical outcomes can be achieved by strictly adhering to restricted infectious triage protocols. • As the pandemic persists, the risk of disease progression associated with treatment delay will become a more critical issue.
Published: 2021

11. Hypofractionated frameless gamma knife radiosurgery for large metastatic brain tumors

Author: Yavuz Samanci, Selçuk Peker, Sebile Sarioglu, Samira Sharifi, Yasemin Bolukbasi, Ali Ihsan Atasoy, Uluman Sisman, and Alara Altintas
Subjects: Adult, Male, 0301 basic medicine, Cancer Research, medicine.medical_specialty, medicine.medical_treatment, Gamma knife radiosurgery, Radiosurgery, Single Center, 03 medical and health sciences, 0302 clinical medicine, Unresected, Surgical oncology, Neoplasms, Internal medicine, medicine, Humans, Aged, Retrospective Studies, Aged, 80 and over, Hematology, Brain Neoplasms, business.industry, Retrospective cohort study, General Medicine, Middle Aged, Survival Rate, Radiation necrosis, Treatment Outcome, 030104 developmental biology, Oncology, 030220 oncology & carcinogenesis, Female, Radiation Dose Hypofractionation, Radiology, business, Follow-Up Studies
Abstract: Hypofractionated stereotactic radiosurgery has become an alternative for metastatic brain tumors (METs). We aimed to analyze the efficacy and safety of frameless hypofractionated Gamma Knife radiosurgery (hfGKRS) in the management of unresected, large METs. All patients who were managed with hfGKRS for unresected, large METs (> 4 cm3) between June 2017 and June 2020 at a single center were reviewed in this retrospective study. Local control (LC), progression-free survival (PFS), overall survival (OS), and toxicities were investigated. A total of 58 patients and 76 METs with regular follow-up were analyzed. LC rate was 98.5% at six months, 96.0% at one year, and 90.6% at 2 years during a median follow-up of 12 months (range, 2-37). The log-rank test indicated no difference in the distribution of LC for any clinical or treatment variable. PFS was 86.7% at 6 months, 66.6% at 1 year, and 58.5% at 2 years. OS was 81% at 6 months, 63.6% at one year, and 50.7% at 2 years. On the log-rank test, clinical parameters such as control status of primary cancer, presence of extracranial metastases, RTOG-RPA class, GPA group, and ds-GPA group were significantly associated with PFS and OS. Patients presented with grade 1 (19.0%), grade 2 (3.5%) and grade 3 (5.2%) side effects. Radiation necrosis was not observed in any patients. Our current results suggest that frameless hfGKRS for unresected, large METs is a rational alternative in selected patients with promising results.
Published: 2021

12. Safety of hospital discharge before return of bowel function after elective colorectal surgery

Author: J Chapman, S, Blanco-Colino, R, Pérez-Ajates, S, O Anabitarte Bautista, Hodson, J, C Glasbey, J, Pata, F, Pellino, G, Sgrò, A, Soares, A, T van Elst, S Van Straten, Nepogodiev, D, Borakati, A, F Bath, M, H Yasin, I, Mclean, K, Arthur, T, Kovacevic, M, Delibegovic, S, Karamanliev, M, Swamad, M, Žebrák, R, Paramasivam, R, Martensen, A, M Larsen, H, Rädeker, L, E Frey, P, Kechagias, A, Venara, A, Duchalais, E, Ioannidis, A, Pasquali, S, Simioni, A, Farina, V, Podda, M, Lorenzon, L, Schaeff, V, Otto, A, Jakubauskas, M, R van Elst, T, Chu, M, Pvb, Fagan, I Wells, C, A Alagoa João, Juloski, J, Y El Kasmy El Kasmi, Espin-Basany, E, Clerc, D, Ciubotaru, C, Popescu, S, Yanishev, A, Lee, S, B Ozkan, B, A Yagız Sen, K Aktas, M, E Baki, B, Yüksek, B, Kamarajah, S, A Khaw, R, Mills, E, Goodson, R, Thakral, N, D Ablett, A, Adra, M, Kwek, I, M Khan, S, Quinn, P, R Manley, L, Badran, A, Ramjeeawon, A, Campbell, A, L Tan, H, S Rye, D, Rajaraman, N, G Norman, J, Vutipongsatorn, K, Solomou, G, Akhbari, M, Ali, A, Murray, V, M Baker, D, D Brandao, B, Stainer, B, Thavayogan, R, Jones, D, O Onafowokan, O, Gharooni, A, Dabab, N, Carlton-Carew, S, Kungwengwe, G, Gabriel, M, Sewart, E, C Shortland, T, Lawday, S, Pockney, P, Dawson, A, D Brumfitt, C, Stewart, P, B, Ng, K Luong, J, Ivanov, V, Borisova, A, Neykov, V, Kunčarová, K, Kološová, B, Antonova, T, Farkašová, M, L Harbjerg, J, Brandsborg, S, Brinck, S, D Kjaer, M, Mark-Christensen, A, P Unbehaun, K, Dalsgaard, P, D Lycke, K, Lenaoures, P, Brigand, C, Dumange, E, Gout, M, Moehwald, C, Prem, M, Alhalabi, O, Sliwinski, S, Krupp, J, Gablenz, E, Schmitzer, L, Kopp, A, Steinle, J, Gsenger, J, J Pohl, L, Riccardi, M, M Christodoulou, I, Konstantinidis, M, Machairas, N, Zoikas, A, Balalis, D, K Manatakis, D, L Aguilera, M, Marano, L, Fleres, F, Lovisetto, F, Sasia, D, Segalini, E, Pata, G, Lucchi, A, Sagnotta, A, Campagnaro, T, Petrelli, F, Gallo, G, Papandrea, M, Testa, V, Sinibaldi, G, F Di Candido, Colombo, F, Perrone, G, Aresu, S, Biancafarina, A, Canonico, G, Pagnanelli, M, Curletti, G, Bini, R, A de Manzoni Garberini, Impellizzeri, H, Cillara, N, Tutino, R, Picciariello, A, Coletta, D, Savino, G, Ferrara, F, Tamini, N, Talamo, G, Parini, D, Giamundo, P, A Lo Conte, Pagano, G, Ripetti, V, Pesce, A, Menduni, N, Giudicissi, R, Goldin, E, Rega, D, Belli, A, Andriola, V, Gordini, L, Foppa, C, Piccolo, G, Birindelli, A, Ferrari, C, Ballarini, Z, Tirelli, F, Milone, M, M De Rosa, S Pipitone Federico, N, Molteni, B, L Tilocca, P, Sancini, G, N Piozzi, G, Lauretta, A, Poillucci, G, Mulas, S, Simcikas, D, Portelli, L, Jwm van Wijnbergen, L Dinger, T, Sfh Ten Doesschate, Ashm van Dalen, D van den Bos, D, Hansmann, M, J Medina Feliz, Z Kuiper, S, Abdulrahman, Z, R Pruijssers, S, Farik, S, M Elliott, B, P Geneta, V, Wilton, S, Kandelaki, H, L Peng, S, Campbell, S, K Lim, Y, S Yassaie, S, Murray, M, Haran, C, Tan, J, Castro, J, Laranjeira, A, Catarino, S, Neves-Marques, C, G Correia, J, N Vieira, B, C Quintela, A, L Serra, M, Maciel, J, Cunha, M, J Aparício, D, Neves, J, Azevedo, J, Romano, M, Eiró, F, Romano, J, Monteiro, C, Claro, M, R Almeida, M, Peyroteo, M, D Machado, N, Capote, H, Ferreira, M, Sousa, X, Devesa, H, Cavadas, D, Guerreiro, I, Costa, M, Rosete, M, Salman, M, English, C, Mohammed, N, Litvin, A, V Ćuk, V, Mészárosová, K, Jaich, R, H De Lima, Brooks, S, Marx, M, M Nshalati Salvation, J García Cardo, Mora-Guzmán, I, J Sancho Muriel, U de Andres Olabarria, Muriel, P, C Jimenez Viñas, Alconchel, F, O Esteban Sinovas, C Fairén Oro, M López Otero, S Figueroa Jiménez, O Claramonte Bellmunt, J Martínez Caballero, Rubio-Pérez, I, M Aguilar-Martínez, M, J Segura-Sampedro, J, C Olmedo Moreno, D Negre Parra, M Estévez Diz, A, Martín-Balbuena, R, C Bustamante Recuenco, E Licardie Bolaños, R, Fernández, P, A Díaz Padillo, Forero-Torres, A, I Alberdi San Román, H Salvador Rosés, M Merayo Álvarez, P Villarejo Campos, C Lopes Moreira, C, P Uriol Peralta, M Serrano Navidad, Ripollés-Melchor, J, Garcea, A, H Gómez Facundo, P Troncoso Pereira, V Pérez Guarinos, C, Blaser, B, Piazza, G, Gagliardi, B, Serin, H, S Yurdaor, S, Arslan, E, Kopac, O, Uyanik, A, B Ozmen, B, Tiftik, E, Aksoy, B, Yalcinkaya, A, Ozoglu, F, D Kocer, M, Bilicen, G, N Cinar, E, Uslu, Ö, Kaya, Y, Demirci, K, Wong, J, Mmh, Farhan-Alanie, Suresh, G, Asif, A, J Finch, B, Bhahirathan, Y, Herron, J, Z Yi Tew, Obukofe, R, Russell, C, Suchett-Kay, I, Netke, T, Williams, L, Kisiel, A, Y Liu, F, Claireaux, H, James, P, Mondal, A, Kalderon, R, H Nadama, H, Al-Saraff, Z, Jph, Tam, Powell-Chandler, A, Wood, F, Rebecca, Gorgievska, Ragavoodoo, A, Thakrar, C, Rojoa, D, Palmer, C, Davidson, K, Giacci, L, Hale, J, W Gan, F, Makin-Taylor, R, Y Hey, C, Toh, C, M Findlay, J, Griffiths, N, Ganesananthan, S, Jasionowska, S, Poustie, M, Wong, C, Turner, T, Pyc, W, Sloper, W, Warner, C, Coey, J, Mason, D, Sait, S, Kowal, M, Owen, M, Saiyed, A, Ashworth, I, Akbari, K, Curran, M, Martin, P, Parker, D, Kwok, K, Lye, C, Ghaly, M, Sammour, T, Lewis, D, Mundasad, R, Wilkes, A, Ctercteko, G, Maslyankov, S, Dimov, R, Iliev, S, Dimitrov, D, Marek, F, Örhalmi, J, Skalický, P, Skalický, T, Chrz, K, Christensen, P, Worsøe, J, S Kristensen, E, J Emmertsen, K, S Loeve, U, L Mihaljevic, A, Herrle, F, M Konstantinidis, K, Korkolis, D, Karanikas, I, Vincenti, L, Anania, G, Borghi, F, Agresta, F, Maretto, I, Parisi, A, Bucci, L, G De Palma, Guglielmi, A, Cucinotta, E, F La Torre, Cianchi, F, Guerrieri, M, Trompetto, M, Persiani, R, Micheletto, G, Delrio, P, Cantafio, S, Ronconi, M, Pag, Bisagni, M De Prizio, Franceschi, A, Galleano, R, Cavallini, M, Brescia, A, D'Ambra, L, Benevento, A, Niolu, P, Calgaro, M, Colangelo, E, Grottola, T, F Altomare, D, Puleo, S, Salamone, G, Pietrabissa, A, Poggioli, G, Erdas, E, Ottonello, R, Tonini, V, Selvaggi, F, Sammarco, G, Ceccarelli, G, C De Nisco, Surgo, D, Taglietti, L, Ozolins, A, Sivinš, A, Poskus, T, Psaila, J, A Bemelman, W, J Graat, L, Langenhoff, B, Bpl, Wijnhoven, Ahw van de 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Kenny R., Kan P., Lee D.E., Khosla S., Samake M., Shaban F., Aftab R., Gough M., Woodburn B., Vayalapra S., McMurrugh K., Jimulia D., Deol S., Pike S., Embury-Young Y., Patel M., Kilgallon E., Keating R., Walsh A., Khan H., Logue G., Orekoya M., Alasmar M., Charalambides M., Llavall A.C., Williamson E., Bharwada Y., Zearmal S., Evans H., Panikkar M., de la Cruz G., Caplan J., Ruparelia A., Tanvir T., Soare C., Pang Y.L., Trotter J., Zaidi A., Thakrar V., Pulickal P., Ahmed H., Parnell J., Lennock S., Ford V., Brignall R., O'Neill D., Hanna R., Kane R., Nicola M., Rajput K., Xiao Y., Michael S., Wright E., Juniper S., Thompson E., Hoskyns L., Kanitkar A., Ross C., Unsworth A., Rshaidat H., Demarre K., Chiang A., Bareh A., van Dellen J., Faqihinejad C., Gadhvi A., Grant R., Lewsey J., Morris A., Martin H., McClarty C., Sanyal S., Alsaif A., Palkhi A., Bhopal S., Burford C., Huq T., Irwin E., Matthews L., Ngu W.S., Hosfield T., Muneeb F., Page O., Zeb E., Al-Azzawi A., McIntosh J., Vucicevic A., Hughes M., Brooks L., Fanibi B., Dixon M., Njoku P., Morris D., Jobson J., Chowdhury H., Joseph N., Zulkefley N., Hunt G., Christodoulou T., Wright O., Soman S., Jamal M., Beqiri S., Borgas P., Christie S., Pereira F., Browne S., Yiu J., Dworkin A., Brayley J., Palmer A., Charalambos M., Jones C.S., Toner S., Cowden R., Lee L., Nicol P., Holman O., Imtiaz M., Albert V., Leung S.P., Erotocritou M., Stroud R., Wilkin R., Thomson W., Mackee L., Kler A., Reynolds L., Mohamed S.H., Majeed Y., Fakim B., Jones A., Liversedge G., Carrington Z., Windebank J., Izzarina A., Akbani U., Craven J., Aldarragi A., Harding S., Millward A., Bedford M., Gopalan V., Midgen A., Khadka P., Cheng O., Taneja S., Manobharath N., Kok J.Y., Lim D.W.E., Buick T., Boland M., Piya S., Devlin R., Fairfield C.J., George R.J., Rahi M., Zaman S., Hajiev S., Ross T., Crisp E., Thompson C., Charalambous A., Hollywood J.L., Hammond R.F.L., Matthews J., Mendonca V., Spinty J., Khan K., Cheng J., Glynn N., 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M., Frade S., Senhorinho R., Peixoto R., Alves-Vale C., Lamas M., O'Connor D.B., Hoo M., Gopaul A., Scanlon K., O'Dwyer N., Jovanovic M., Panyko A., Van Vuuren S., Centeno A., Bernado I.R., Senorans M.P.G., Amor L.G., Ramirez A.C., Abrisqueta J., Gomez M.E., Arroyo A., Cerdan C., Romeu N.G., Enriquez-Navascues J.M., Collado-Roura F., Curchod P., Gaspar S., Imadalou L., Mutlu D., Akyol C., Uygur F.A., Eray I.C., Biyiklioglu O., Cetin M.F., Isik A.E., Karip B., Dogan H., Sarigul L., Tunc E., Aydin T., Bodur S., Karabulut K., Francis A.A., Al-hadithi A., Lau I.S.F., Smith E., Mahapatra S., McAuliffe O., Imam L., Akram B., Hossaini S., Davies R., Ko M., Collins J., Pandya A., Reilly S., Archer J., Livie J., Chaudhry F.A., Ntakomyti E., Diallo R., Bylinski T., Wright J., Masiha E., Tung J., Shirazi B., Neilson A., Epton S., Patel N., Trussell S., Couldrey A., Donnelly C., Eftychiou S., Salman M., Skejo, Licari L., Men, Chapman, S. 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Z., Abdulrahman, Z., Pruijssers, S. R., Geneta, V. P., Chu, M., Wilton, S., Kandelaki, H., Peng, S. L., Campbell, S., Lim, Y. K., Yassaie, S. S., Murray, M., Haran, C., Tan, J., Castro, J., Laranjeira, A., Catarino, S., Neves-Marques, C., Correia, J. G., Vieira, B. N., Quintela, A. C., Serra, M. L., Maciel, J., Cunha, M., Aparicio, D. J., Neves, J., Azevedo, J., Romano, M., Eiro, F., Romano, J., Monteiro, C., Claro, M., Capote, H., Ferreira, M., Sousa, X., Peyroteo, M., Machado, N. D., Guerreiro, I., Costa, M., Rosete, M., Salman, M., English, C., Mohammed, N., Litvin, A., Cuk, V. V., Meszarosova, K., Jaich, R., De Lima, H., Brooks, S., Marx, M., Salvation, M. N., Cardo, J. G., Mora-Guzman, I., Muriel, J. S., de Andres Olabarria, U., Muriel, P., Vinas, C. J., Alconchel, F., Sinovas, O. E., Oro, C. F., Otero, M. L., Jimenez, S. F., Bellmunt, O. C., Caballero, J. M., Rubio-Perez, I., Aguilar-Martinez, M. M., Segura-Sampedro, J. J., Moreno, C. O., Parra, D. N., Diz, A. M. 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M., Griffiths, N., Ganesananthan, S., Jasionowska, S., Poustie, M., Wong, C., Turner, T., Pyc, W., Sloper, W., Warner, C., Coey, J., Mason, D., Sait, S., Kowal, M., Owen, M., Saiyed, A., Ashworth, I., Akbari, K., Curran, M., Martin, P., Parker, D., Kwok, K., Lye, C., Ghaly, M., Sammour, T., Lewis, D., Mundasad, R., Wilkes, A., Ctercteko, G., Maslyankov, S., Dimov, R., Iliev, S., Dimitrov, D., Marek, F., Orhalmi, J., Skalicky, P., Skalicky, T., Chrz, K., Christensen, P., Worsoe, J., Kristensen, E. S., Emmertsen, K. J., Loeve, U. S., Mihaljevic, A. L., Herrle, F., Konstantinidis, K. M., Korkolis, D., Karanikas, I., Vincenti, L., Anania, G., Borghi, F., Agresta, F., Maretto, I., Parisi, A., Bucci, L., De Palma, G., Guglielmi, A., Cucinotta, E., La Torre, F., Cianchi, F., Guerrieri, M., Trompetto, M., Persiani, R., Micheletto, G., Delrio, P., Cantafio, S., Ronconi, M., Bisagni, P. A. 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G., Hubner, M., Petermann, D., Sauvain, M. O., Ozben, V., Gecim, I. E., Disci, E., Rencuzogullari, A., Kurt, A., Bisgin, T., Pehlivan, M., Isik, A., Onur, E., Leventoglu, S., Keskin, M., Guner, A., Sahin, S. T., Ozbalci, G. S., Pergel, A., Albayrak, D., Bruce, D., Fearnhead, N., Arthur, J., Harron, M., Beattie, G., Titu, L., Saunders, M., Phillips, J., Dindyal, S., Cresswell, B., Gercek, Y., Lee, J., Linn, T., Faulkner, G., Lockwood, S., Rees, J., Charalabopoulos, A., Campbell, B., Kontovounisios, C., Amarnath, T., Johnson, M., Epanomeritakis, E., Vigs, S., Nastro, P., Gilliam, A., Smolarek, S., Wilson, T., Orbell, J., Mcintyre, R., Agarwal, T., Hainsworth, P., Patel, P., Vijay, J., Liu, B., Rao, P. D., Roxburgh, C., Vipond, M., Youssef, H., Thorn, C., Schizas, A., Denley, S., Bowley, D., Das, K., Cuming, T., Saha, A., Chung, L., Pitt, J., Davis, P., Jones, O., Taylor, M., Bhargava, A., Haji, A., Watson, N., Bloom, I., Singh, B., Norwood, M., Gurjar, S., Stylianides, N., Mirza, S., Evans, M., Williams, G., Patil, P., Hernon, J., Finch, G., Green, S., Chapple, K., Fafemi, O., Warusavitarne, J., Samee, A., Carden, C., Ong, L., Verma, K., Joseph, A., Rawat, N., Pinkney, T., Oke, O., Glen, P., Maxwell-Armstrong, C., Oliphant, R., Garner, J., Moug, S. J., Middleton, S., Lund, J. N., Smart, N. J., Osborn, G., Moore, T., Raymond, T., Knowles, C. H., Hany, T. S., Clarke, R., Khera, G., Brady, R., Sellahewa, C., Mason, C., Torrance, A., Lasithiotakis, K., Knight, J., Pullybank, A., Ainsworth, P., Reid, F., Ramwell, A., Maslekar, S., George, R., Skull, A., Holtham, S., Muhammad, K., Lal, R., Varcada, M., Smith, F. M., Howlader, M., Defriend, D., Kirk, S., Richards, T., Evans, C., Borg, C. 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W., Gabbas, G., Marziali, I., Mazzocato, S., Vergari, R., Piazzai, F., Kubolli, I., Aggiusti, A., Paolucci, A., Ortenzi, M., Olivieri, M., Belluco, C., Antona, A. D., Basso, S., Morino, M., Mistrangelo, M., Clerico, G., De Santi, G., Bitonti, M. F., Frattalone, M., Fico, V., Santullo, F., Belia, F., Spinelli, A., Marco, M., Bevilacqua, M., Tringali, D., Bevilacqua, E., Panizzo, V., La Manna, V., Migliore, G., Aversano, A., Bucci, A. F., Marino, F., Carbone, F., Incollingo, P., Romano, F. M., Zalla, T., Baraghini, M., Romoli, L., Calussi, M., Vellei, S., Genzano, C., Feroci, F., Vita, M., Barberis, A., Serra, D., Grassia, M., Romelli, M., Ruggiero, S., Percassi, A., Piccinini, A. 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X., Peckham, H., Yeoh, T., Yong, S. Q., Chen, J. Y., Siva, S., Sam, Z. H., Gilani, M., Goh, Y. N., Muthukumar, M. G., Phillips, S., Tjoakarfa, J., Giri, A., Suresan, S., Thomas, P., Johnson, T. A., Williams, R. I., Rashid, A., Kushairi, A., Rais, A., James, A., Bugelli, M., Chechelnitskaya, Y., Sandhu, N., Tandon, R., Gray, M., Kumar, A., Ciurleo, C., Nyamali, I., Hiremath, S., Sinha, S., Chowdhary, M., Bradley, E., Mctiernan, M., Macdonald, S., Sharkey, S., Mclaughlin, N., Amey, C., Kraria, L., Skan, O., Kind, C., Tupper, P., Van Rhee, C., Honeyman, S. I., Menon, G., Jegatheeswaran, L., Madhavan, A., Warne, M., Malcolm, F. L., Lessware, T., Wilkerson, H. T., Chatterjee-Woolman, S., Yoong, A., Ahmed, W. U. R., Longshaw, A., Flannery, O., Green, R., Leaning, M., Cragg, J., Sharriff, H., Doherty, C., Kwan, K. W. L., Sanders-Crook, L., Bhatia, S., Eames, S., Lewis, F., Kirupananthan, P., Boh, Z. Y., Dass, S., Soma, A., Newton, A., Hill, M., Shafiq, Y., Brkljac, M., Boyce, L., English, W. J., Lam, S., Chipeta, C., Jain, C., Garofalidou, T., Novotny, S. A., Locke, S., Bowman, C., Begaj, A., Murphy, C., Radcliffe, K., Chong, J. T., Jeffrey, E., Chaudhury, N., Rajendran, K., Akbar, Z., Walters, B., Kulendrarajah, B., Tran, N., Shrestha, S., Parmar, S., Gallagher, C., Hennessy, L., Pentti, E., Badhrinarayanan, S., Fung, A., Mansoor, M., Kenny, R., Kan, P., Lee, D. E., Khosla, S., Samake, M., Shaban, F., Aftab, R., Gough, M., Woodburn, B., Vayalapra, S., Mcmurrugh, K., Jimulia, D., Deol, S., Pike, S., Embury-Young, Y., Patel, M., Kilgallon, E., Keating, R., Walsh, A., Khan, H., Logue, G., Orekoya, M., Alasmar, M., Charalambides, M., Llavall, A. C., Williamson, E., Bharwada, Y., Zearmal, S., Evans, H., Panikkar, M., de la Cruz, G., Caplan, J., Ruparelia, A., Tanvir, T., Soare, C., Pang, Y. L., Trotter, J., Zaidi, A., Thakrar, V., Pulickal, P., Ahmed, H., Parnell, J., Lennock, S., Ford, V., Brignall, R., O'Neill, D., Hanna, R., Kane, R., Nicola, M., Rajput, K., Xiao, Y., Michael, S., Wright, E., Juniper, S., Thompson, E., Hoskyns, L., Kanitkar, A., Ross, C., Unsworth, A., Rshaidat, H., Demarre, K., Chiang, A., Bareh, A., van Dellen, J., Faqihinejad, C., Gadhvi, A., Grant, R., Lewsey, J., Morris, A., Martin, H., Mcclarty, C., Sanyal, S., Alsaif, A., Palkhi, A., Bhopal, S., Burford, C., Huq, T., Irwin, E., Matthews, L., Ngu, W. S., Hosfield, T., Muneeb, F., Page, O., Zeb, E., Al-Azzawi, A., Mcintosh, J., Vucicevic, A., Hughes, M., Brooks, L., Fanibi, B., Dixon, M., Njoku, P., Morris, D., Jobson, J., Chowdhury, H., Joseph, N., Zulkefley, N., Hunt, G., Christodoulou, T., Wright, O., Soman, S., Jamal, M., Beqiri, S., Borgas, P., Christie, S., Pereira, F., Browne, S., Yiu, J., Dworkin, A., Brayley, J., Palmer, A., Charalambos, M., Jones, C. S., Toner, S., Cowden, R., Lee, L., Nicol, P., Holman, O., Imtiaz, M., Albert, V., Leung, S. P., Erotocritou, M., Stroud, R., Wilkin, R., Thomson, W., Mackee, L., Kler, A., Reynolds, L., Mohamed, S. H., Majeed, Y., Fakim, B., Jones, A., Liversedge, G., Carrington, Z., Windebank, J., Izzarina, A., Akbani, U., Craven, J., Aldarragi, A., Harding, S., Millward, A., Bedford, M., Gopalan, V., Midgen, A., Khadka, P., Cheng, O., Taneja, S., Manobharath, N., Kok, J. Y., Lim, D. W. E., Buick, T., Boland, M., Piya, S., Devlin, R., Fairfield, C. J., George, R. J., Rahi, M., Zaman, S., Hajiev, S., Ross, T., Crisp, E., Thompson, C., Charalambous, A., Hollywood, J. L., Hammond, R. F. L., Matthews, J., Mendonca, V., Spinty, J., Khan, K., Cheng, J., Glynn, N., Muhammad, U., Khan, M., Anderson, L., Mccormack, K., Mak, J., Patrawala, S., Milinkovic, N., Schofield, R., Chauhan, M., Hartley, L., Hind, J., Nelson, L., Ratnasingham, D., Whitehead, T., Dimitriadis, S., Marshall, K., Flint, E. J., Horner, C., Heybourne, A., Morgan, H., Wickstone, C., Panagiotou, D., O'Connell, E., Dean, K., Iqbal, R., Walsh, L., Yu, N., Rana, N., Massie, E., Ng, J., Jung, M., Lee, Y. D., Harris, M., White, S., Boev, B., Tonchev, P., Prochazka, V., Risko, J., Skalicky, A., Ravn, S., Ojakaar, A., Dorr-Harim, C., Koutserimpas, C., Giraudo, G., Armellini, A., Ruzzenente, A., Mazzeo, C., De Padua, C., Luc, A. R., Maroli, A., Vitali, M., Gusai, G. P., Quattromani, R., Virgilio, E., Berti, S., Di Mola, F. F., Papagni, V., Tuminello, F., Vittori, L., Longheu, A., Loche, G. A., Braccio, B., De Luca, E., Resta, G., Ancans, G., Tamosiunas, A., Petrulionis, M., Abdulrahman, N., van de Pas, K. G. H., Thomas, G., Brandsma, A. M., Davids, J., Rottier, S. J., de Roy van Zuidewijn, D., Hawkins, R., Ong, H. I., Li, Y., Desmond, B., Winstanley, J., Martins, M., Americano, M., Frade, S., Senhorinho, R., Peixoto, R., Alves-Vale, C., Lamas, M., O'Connor, D. B., Hoo, M., Gopaul, A., Scanlon, K., O'Dwyer, N., Jovanovic, M., Panyko, A., Van Vuuren, S., Centeno, A., Bernado, I. R., Senorans, M. P. G., Amor, L. G., Ramirez, A. C., Abrisqueta, J., Gomez, M. E., Arroyo, A., Cerdan, C., Romeu, N. G., Enriquez-Navascues, J. M., Collado-Roura, F., Curchod, P., Gaspar, S., Imadalou, L., Mutlu, D., Akyol, C., Uygur, F. A., Eray, I. C., Biyiklioglu, O., Cetin, M. F., Isik, A. E., Karip, B., Dogan, H., Sarigul, L., Tunc, E., Aydin, T., Bodur, S., Karabulut, K., Francis, A. A., Al-hadithi, A., Lau, I. S. F., Smith, E., Mahapatra, S., Mcauliffe, O., Imam, L., Akram, B., Hossaini, S., Davies, R., Ko, M., Collins, J., Pandya, A., Reilly, S., Archer, J., Livie, J., Chaudhry, F. A., Ntakomyti, E., Diallo, R., Bylinski, T., Wright, J., Masiha, E., Tung, J., Shirazi, B., Neilson, A., Epton, S., Patel, N., Trussell, S., Couldrey, A., and Donnelly, C.
Subjects: operative, Male, postoperative discharge, Postoperative Complications, 0302 clinical medicine, Colostomy, CRITERIA, Prospective Studies, Bowel function, Colectomy, IMAGINE, stoma, intestines, Proctectomy, Ileostomy, digestive, oral, and skin physiology, patient discharge, colorectal surgery, hospital discharge, bowel function, RECOVERY, Middle Aged, adult, colostomy, elective surgical procedures, female, follow-up studies, humans, ileostomy, ileus, male, middle aged, multivariate analysis, patient readmission, patient safety, postoperative complications, prospective studies, recovery of function, colectomy, proctectomy, Patient Discharge, Colorectal surgery, ileus - - discharge - bowel function - elective - colorectal surgery, Elective Surgical Procedures, 030220 oncology & carcinogenesis, Female, 030211 gastroenterology & hepatology, Patient Safety, Cohort study, safety, Adult, medicine.medical_specialty, Ileus, Patient Readmission, defecation, 03 medical and health sciences, medicine, Hospital discharge, Humans, colorectal surgery, colorectal resection, Colorectal resection, defecation, postoperative complications, colorectal surgery, intestines, patient discharge, patient readmission, safety, surgical procedures, operative, colorectal resection, ileus, business.industry, Recovery of Function, Odds ratio, medicine.disease, digestive system diseases, surgical procedures, Surgery, Multivariate Analysis, Defecation, business, Follow-Up Studies
Abstract: Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function.A prospective, multicentre cohort study was undertaken across an international collaborative network. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The main outcome of interest was readmission to hospital within 30 days of surgery. The impact of discharge timing according to the return of bowel function was explored using multivariable regression analysis. Other outcomes were postoperative complications within 30 days of surgery, measured using the Clavien-Dindo classification system.A total of 3288 patients were included in the analysis, of whom 301 (9·2 per cent) were discharged before the return of bowel function. The median duration of hospital stay for patients discharged before and after return of bowel function was 5 (i.q.r. 4-7) and 7 (6-8) days respectively (P 0·001). There were no significant differences in rates of readmission between these groups (6·6 versus 8·0 per cent; P = 0·499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0·90, 95 per cent c.i. 0·55 to 1·46; P = 0·659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34·7 versus 39·5 per cent; major 3·3 versus 3·4 per cent; P = 0·110).Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients.El íleo es frecuente tras la cirugía colorrectal y se asocia con un aumento del riesgo de las complicaciones postoperatorias. Identificar las características de una recuperación normal del tránsito y la idoneidad para el alta hospitalaria es una tarea difícil. Este estudio examinó la seguridad del alta hospitalaria antes del restablecimiento de la función intestinal. MÉTODOS: Se llevó a cabo un estudio de cohortes prospectivo y multicéntrico a través de una red de colaboración internacional. Se incluyeron pacientes adultos sometidos a resección electiva colorrectal entre enero y abril 2018. El objetivo principal fue el reingreso hospitalario durante los 30 primeros días tras la intervención. Se utilizó un análisis de regresión multivariable para evaluar el impacto del momento del alta en función del restablecimiento de la función intestinal. El objetivo secundario fue las complicaciones postoperatorias en los primeros 30 días después de la cirugía, valoradas mediante el sistema de clasificación de Clavien-Dindo.Se incluyeron en el análisis 3.288 pacientes, de los cuales 301 (9,2%) fueron dados de alta antes del restablecimiento de la función intestinal. La mediana de la estancia hospitalaria de los pacientes dados de alta antes y después del restablecimiento de la función intestinal fue 5 (rango intercuartílico: 4-7) y 7 (6-8) días, respectivamente (P 0,001). No hubo diferencias significativas en las tasas de reingreso entre estos grupos (6,6% versus 8,0%; P = 0,499), y este resultado se mantuvo en el análisis multivariable tras el ajuste por diferencias basales (razón de opotunidades, odds ratio, OR 0,90; i.c. del 95% 0,55-1,46, P = 0,659). Las tasas de complicaciones postoperarorias fueron similares en aquellos dados de alta antes o después del restablecimiento de la función intestinal (complicaciones menores: 34,7% versus 39,5%; complicaciones mayores 3,3% versus 3,4%; P = 0,110). CONCLUSIÓN: Dar de alta antes del restablecimiento de la función intestinal tras cirugía colorrectal electiva parece ser seguro en pacientes debidamente seleccionados.
Published: 2020

13. Prognostic Value of CDX2 and Villin Expression in Advanced Stage Colorectal Carcinoma

Author: Yasemin Altintas, Suleyman Altintas, and Mehmet Bayrak
Subjects: Adult, Male, 0301 basic medicine, medicine.medical_specialty, Turkey, Colorectal cancer, Perineural invasion, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Biomarkers, Tumor, Humans, Medicine, CDX2 Transcription Factor, Neoplasm Invasiveness, Stage (cooking), Survival rate, Survival analysis, Aged, Aged, 80 and over, biology, business.industry, Microfilament Proteins, Cancer, General Medicine, Middle Aged, Prognosis, medicine.disease, Survival Rate, 030104 developmental biology, Lymphatic Metastasis, 030220 oncology & carcinogenesis, biology.protein, Immunohistochemistry, Female, Colorectal Neoplasms, business, Villin
Abstract: OBJECTIVE To determine the frequency of expression of CDX2 and Villin in a subsection of advanced stage primary colorectal cancers and detect its association with tumour differentiation, lymph node metastasis, invasion and survival. STUDY DESIGN A descriptive study. PLACE AND DURATION OF STUDY Ortadogu Private Hospital, Adana, Turkey, from January 2012 to March 2017. METHODOLOGY Formalin-fixed, paraffin-embedded tissue specimens were obtained from 70 patients who underwent surgery for colorectal carcinoma. Inclusion criteria were patients who underwent surgery with stage 3 and stage 4 colorectal cancer. The exclusion criteria were patients who had recurrent colorectal cancer and/or accompanying cancer in another region. Immunohistochemical technique was used for the localisation of CDX2 and Villin in colorectal cancer tissues. The catagorical variables between the groups was analysed by using the Chi-square test or Fisher Exc. test. Overall survival time was defined as the years elapsed between date of after operation and death as a result of disease (or the last follow-up date). Overall survival was analysed using the Wald test, and the log-rank test was used to examine their relationship when different parameters were applied. The survival curve was plotted using the standard Kaplan-Meier methodology. Values of p
Published: 2019

14. A qualitative and quantitative assessment of simultaneous strain, shear wave, and point shear wave elastography to distinguish malignant and benign breast lesions

Author: Medih Çeliktaş, Ömer Alabaz, Yasemin Altintas, and Mehmet Bayrak
Subjects: Adult, medicine.medical_specialty, Adolescent, Breast Neoplasms, Strain (injury), Sensitivity and Specificity, 030218 nuclear medicine & medical imaging, Diagnosis, Differential, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Consistency (statistics), Elastic Modulus, medicine, Quantitative assessment, Humans, Radiology, Nuclear Medicine and imaging, Breast, Prospective Studies, Aged, Aged, 80 and over, Shear wave elastography, Radiological and Ultrasound Technology, medicine.diagnostic_test, business.industry, Reproducibility of Results, General Medicine, Middle Aged, medicine.disease, Shear (geology), Evaluation Studies as Topic, 030220 oncology & carcinogenesis, Elasticity Imaging Techniques, Female, Ultrasonography, Mammary, Radiology, Elastography, business
Abstract: Background Ultrasound (US) elastography has become a routine instrument in ultrasonographic diagnosis that measures the consistency and stiffness of tissues. Purpose To distinguish benign and malignant breast masses using a single US system by comparing the diagnostic parameters of three kinds of breast elastography simultaneously added to B-mode ultrasonography. Material and Methods A total of 163 breast lesions in 159 consecutive women who underwent US-guided core needle biopsy were included in this prospective study. Before the biopsy, the lesions were examined with B-mode ultrasonography and strain (SE), shear wave (SWE), and point shear wave (STQ) elastography. The strain ratio was computed and the Tsukuba score determined. The mean elasticity values using SWE and STQ were computed and converted to Young’s modulus E (kPa). Results All SE, SWE, and STQ parameters showed similar diagnostic performance. The SE score, SE ratio, SWEmean, SWEmax, STQmean, and STQmax yielded higher specificity than B-mode US alone to differentiate benign and malignant masses. The sensitivity of B-mode US, SWE, and STQ was slightly higher than that of the SE score and SE ratio. The SE score, SE ratio, SWEmean, SWEmax, STQmean, and STQmax had significantly higher positive predictive value and diagnostic accuracy than B-mode US alone. The area under the curve for each of these elastography methods in differentiating benign and malignant breast lesions was 0.93, 0.93, 0.98, 0.97, 0.98, and 0.96, respectively; PConclusion SE (ratio and score), SWE, and STQ had higher diagnostic performance individually than B-mode US alone in distinguishing between malignant and benign breast masses.
Published: 2020

15. Determination of cerebral blood flow velocity and microembolic signals in essential thrombocytosis by transcranial doppler ultrasonography

Author: Ahmet Cinar, Seda Turgut, Güven Çetin, Ozge Altintas Kadirhan, Iskender Ekinci, Talip Asil, and ÇETİN, GÜVEN
Subjects: Adult, Male, 0301 basic medicine, medicine.medical_specialty, Ultrasonography, Doppler, Transcranial, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, Cinar A., ÇETİN G., Altintas Kadirhan O., Turgut S., Ekinci I., Asil T., -Determination of cerebral blood flow velocity and microembolic signals in essential thrombocytosis by transcranial doppler ultrasonography-, NEUROLOGICAL RESEARCH, 2020, Prospective Studies, Thrombocytosis, business.industry, General Medicine, Middle Aged, medicine.disease, Thrombosis, Transcranial Doppler ultrasonography, 030104 developmental biology, Intracranial Embolism, Neurology, Cerebral blood flow, Case-Control Studies, Cerebrovascular Circulation, cardiovascular system, Cardiology, Female, Neurology (clinical), Intracranial Thrombosis, business, Blood Flow Velocity, 030217 neurology & neurosurgery
Abstract: Objectives The goal of treatment in essential thrombocytosis (ET) is to prevent vascular complications such as thrombosis and hemorrhage. This study aimed to evaluate the risk of cerebrovascular microembolism in ET patients due to detection of microembolic signals (MES) and measure cerebral blood flow velocity (CBFV) by Transcranial Doppler (TCD) ultrasonography. Material and Methods In this prospective case-control study, forty patients with diagnosed ET and age and sex-matched forty healthy controls were examined by the TCD sonography. Results The ET group had a higher rate of MES (8/40) in the right MCA than that in the control group (none), as measured by TCD. Five patients had MES at the left MCA compared to that in no subjects in the control group. The comparison of the ET and control groups in terms of CBFV parameters showed significantly lower end-diastolic FV at the right MCA in the ET group compared to that in the control group (p < 0.05). On the other hand; both pulsatility and resistance indices in the right and left MCA and the ratios of systolic to diastolic blood flow rates in the right and left MCA were significantly higher in the ET group than that in the control group. Discussion This study revealed that MES seems to be more common in patients with ET despite treatment. We could suggest that ET patients should be monitored more closely to address the potential risk of developing a cerebrovascular disease, which can be estimated by detection MES and raised CBFV, combine antiplatelet therapies to standard treatments. Bezmiâlem Vakıf Üniversitesi
Published: 2020

16. Open Versus Arthroscopic Latarjet Procedure for the Treatment of Chronic Anterior Glenohumeral Instability With Glenoid Bone Loss

Author: Direnç Özlem Aksoy, Burak Altintas, Jotyar Ali, Kerem Bilsel, Robert E. Boykin, Anil Pulatkan, and AKSOY, DİRENÇ ÖZLEM
Subjects: Adult, Joint Instability, Male, medicine.medical_specialty, Adolescent, Visual Analog Scale, Visual analogue scale, Radiography, Coracoid, Cohort Studies, Arthroscopy, Young Adult, 03 medical and health sciences, ALİ J., Altintas B., Pulatkan A., Boykin R. E. , AKSOY D. Ö. , Bilsel K., -Open Versus Arthroscopic Latarjet Procedure for the Treatment of Chronic Anterior Glenohumeral Instability With Glenoid Bone Loss-, ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY, cilt.36, ss.940-949, 2020, 0302 clinical medicine, medicine, Humans, Orthopedic Procedures, Orthopedics and Sports Medicine, Retrospective Studies, 030222 orthopedics, Shoulder Joint, Glenohumeral instability, business.industry, Retrospective cohort study, 030229 sport sciences, Anterior shoulder, Middle Aged, Latarjet procedure, Surgery, Scapula, Female, Range of motion, business, Follow-Up Studies
Abstract: Purpose The purpose of this study was to compare the clinical, functional, and radiographic outcomes of open versus arthroscopic Latarjet procedures. Methods Between December 2009 to January 2015, all patients older than 18 years of age who were treated with a Latarjet procedure for chronic osseous anterior instability by a single surgeon were included in this retrospective cohort study. Range of motion, strength, Rowe, Western Ontario Shoulder Instability Index (WOSI) scores, and pain level according to the Visual Analog Scale (VAS) were evaluated. In addition, postoperative computed tomography scans were used to evaluate the position of the transferred coracoid, screw orientation, and degree of graft resorption. Results Forty-eight patients with a mean age of 29.5 years (range 19-59 years) who underwent open (n = 15; group OL) and arthroscopic (n = 33; group AL) Latarjet procedures were included in the study. The mean follow-up was 30.5 months (range 24-50 months). At final follow-up there were significant differences in the mean internal rotation loss (mean of 9° vs 14°, P = .044) favoring open surgery and WOSI (P = .017) scores favoring arthroscopic. No significant differences were detected in mean forward flexion loss (P = .918), external rotation loss (P = .883), Rowe (P = .429), and Visual Analog Scale (P = .208) scores. Mean superoinferior position of the coracoid bone graft was found between the 1:55 and 4:49 o’clock positions (2:05-4:55 for group OL; 1:51-4:47 for group AL) in en-face views. The grafts were placed laterally in 13% (group OL) and 9% (group AL) of patients. The mean α angles of the screws were 11° and 19.2°, respectively (P = .004). The mean graft resorption rates were 21% and 34% (P = .087), respectively. Conclusion Good functional results were obtained after both open and arthroscopic Latarjet procedures for the treatment of chronic osseous anterior shoulder instability. Comparative analysis showed small but statistically significant differences in internal rotation loss favoring open and in WOSI favoring arthroscopic techniques. All measured radiographic parameters were similar with the exception of a significant difference in alpha angle with improved screw position in open surgery. OL and AL techniques provide similar clinical and radiographic outcomes. Level of Evidence III; Retrospective cohort study with comparison group.
Published: 2020

17. A Case With New-Onset Neuromyelitis Optica Spectrum Disorder Following COVID-19 mRNA BNT162b2 Vaccination

Author: Ilay Caliskan, Eser Bulus, Nazire Afsar, Ayse Altintas, and Acibadem University Dspace
Subjects: Adult, mRNA vaccine, NMOSD, Neuromyelitis Optica, Vaccination, COVID-19, Humans, BNT162b2, Female, BNT162 Vaccine
Abstract: Introduction: In the midst of the coronavirus disease of 2019 pandemic, active immunization by effective vaccination gained utmost importance in terms of global health. The messenger RNA (mRNA) vaccines are novel strategies requiring clinical surveillance for adverse events. Case Report: We report a 43-year-old previously healthy female with an optic neuritis attack 24 hours following immunization with the second dose of coronavirus disease of 2019 mRNA BNT162b2 vaccine. A second transverse myelitis attack together with an elevated anti-AQP-4 antibody titer confirmed the diagnosis of neuromyelitis optica spectrum disorder. Conclusion: Our case identifies the BNT162b2 vaccine as a possible trigger for neuromyelitis optica spectrum disorder. This rare and potentially coincidental event has no implications for vaccine administration practices. However, further research is needed to elucidate the effects of mRNA vaccines on humoral and cell-mediated immunity.
Published: 2022

18. Fanconi anaemia: A syndrome with distinct subgroups

Author: Blanche P. Alter, Neelam Giri, Lisa J. McReynolds, and Burak Altintas
Subjects: Adult, Fanconi Anemia, Leukemia, Head and Neck Neoplasms, Squamous Cell Carcinoma of Head and Neck, Hematopoietic Stem Cell Transplantation, Congenital Bone Marrow Failure Syndromes, Humans, Female, Hematology, Bone Marrow Failure Disorders, Child
Abstract: Fanconi anaemia (FA) is an inherited bone marrow failure syndrome (IBMFS) with a high cancer predisposition rate. Traditional diagnoses are made before age 10 years due to bone marrow failure (BMF) and characteristic birth defects. Up to 10% of published cases were adults at diagnosis. We hypothesized that FA subgroups diagnosed in childhood are distinct from those diagnosed as adults. We classified patients by age at diagnosis of FA as FA-PED (18 years) or FA-ADULT (≥18 years). The National Cancer Institute IBMFS cohort included 178 FA-PED and 26 FA-ADULT cases. We compared various features; the cumulative incidences of first adverse events (severe BMF leading to haematopoietic cell transplant or death, leukaemia, or solid tumours) were compared using competing-risk analyses. FA-ADULT lacked the 'typical' FA features (birth defects and early-onset BMF or leukaemia), were mainly female, had more patients with FANCA genotype, and had or developed more head and neck squamous-cell carcinoma (HNSCC) and/or gynaecological cancers compared with FA-PED, albeit at similar ages in both subgroups. FA-ADULT is a distinct subgroup that remained unrecognized during childhood. Centres for adult haematology-oncology should consider FA diagnosis in patients with early-onset HNSCC or gynaecological cancer with or without haematologic problems.
Published: 2022

19. A New Risk-Scoring System for Colorectal Cancer and Polyp Screening by Turkish Colorectal Cancer and Polyp Study Group

Author: Erdem, Levent, Akbal, Erdem, Kocak, Erdem, Tucer, Dilek, Ucbilek, Enver, Uyanikoglu, Ahmet, Dolapcioglu, Can, Erim, Emel Ahisali, Sirin, Goktug, Alkim, Huseyin, Soylu, Aliye, Doganay, Levent, Kurbuz, Ahmet Kemal, Ozdil, Kamil, Alagozlu, Hakan, Ozturk, Tuba Erurker, Sezikli, Mesut, Adali, Gupse, Coban, Mehmet, Hulagu, Saadettin, Degertekin, Halil, Atasoy, Alp, Akyuz, Filiz, Gaffarli, Ilham, Saruc, Murat, Altintas, Engin, Sezgin, Orhan, Tozun, Nurdan, Acibadem University Dspace, Ahıshalı Erim, Emel, Erdem, L., Akbal, E., Koçak, E., Tucer, D., Üçbilek, E., Uyanıkoğlu, A., Dolapçıoğlu, C., Şirin, G., Alkım, H., Soylu, A., Doğanay, L., Kürbüz, A.K., Özdil, K., Alagözlü, H., Erürker Öztürk, T., Sezikli, M., Adalı, G., Çoban, M., Hülagü, S., Değertekin, H., Atasoy, A., Akyüz, F., Gaffarlı, İ., Saruç, M., Altıntaş, E., Sezgin, O., Tözün N., and School of Medicine
Subjects: Adult, Male, screening method, Colonic Polyps, Colonoscopy, Middle Aged, Colon cancer, Adenomatous Polyps, Risk Factors, polyp, Humans, Medicine, Polyp, Screening method, Original Article, Prospective Studies, Colorectal Neoplasms, Early Detection of Cancer
Abstract: Background: colorectal cancer is one of the most commonly diagnosed types of cancer worldwide. An early diagnosis and detection of colon cancer and polyp can reduce mortality and morbidity from colorectal cancer. Even though there are a variety of options in screening tests, the question remains on which test is the most effective for the early detection of colorectal cancer. In this prospective study, we aimed to develop a simple, useful, effective, and reliable scoring system to detect colon polyp and colorectal cancer. Methods: we enrolled 6508 subjects over the age of 18 from 16 centers, with colonoscopy screening. The age, smoking status, alcohol consumption, body mass index, polyp incidence, polyp size, number and localization, and pathologic findings were recorded. Results: the age, male gender, obesity, smoking, and family history were found as independent risk factors for adenomatous polyp. We have developed a new scoring system which can be used for these factors. With a score of 4 or above, we found the following: sensitivity 81%, specificity 40%, positive predictive value 25.68%, and negative predictive value 89.84%, for adenomatous polyp detection; and sensitivity 96%, specificity 39%, positive predictive value 3.35%, negative predictive value 99.29%, for colorectal cancer detection. Conclusion: even though the first colorectal cancer screening worldwide is generally performed for individuals over 50 years of age, we recommend that screening for colorectal cancer might begin for those under 50 years of age as well. Individuals with a score ? 4 must be included in the screening tests for colorectal cancer., NA
Published: 2022

20. Predictive Factors Affecting Recurrence of Anal Fistula after LIFT Procedure

Author: Mehmet, Bayrak and Yasemin, Altintas
Subjects: Male, Adult, Treatment Outcome, Recurrence, Humans, Anal Canal, Rectal Fistula, Female, Middle Aged, Neoplasm Recurrence, Local, Ligation, Retrospective Studies
Abstract: To determine the predictive factors affecting the recurrence or persistence of anal fistula of demographic and technical variables.Descriptive study.Department of General Surgery and Radiology, Private Ortadogu Hospital General, Turkey, between 2014 and 2020.The recurrence, persistence, and complication rates of 176 patients who underwent LIFT were compared with demographic and technical data by multivariate logistic regression analysis. Inclusion criteria were patients with anal fistula cryptoglandular origin. Exclusion criteria included patients with intersphincteric fistula, rectovaginal fistula, abscess, pilonidal sinus fistula, and inflammatory bowel disease. Recurrence was defined as the opening of a fistula that persisted after 3 months.The mean age was 38.6±9.0 years. The mean BMI was 31.9±5.7 Kg/m2. There were no statistically significant differences between the two groups concerning, age, the complexity of fistula tract(s), the surgical technique of suture versus ligation, operation time, and seton placement duration. Twenty-three patients had previous fistula surgery. Twenty-One patients had previously required seton drainage. Higher BMI, being male, having a prior fistula surgery, and having a height IFO15 were independent risk factors for recurrence (OR =1.28, 5.69, 23.39, and 15.38 respectively).Higher BMI, male gender, having a prior fistula surgery, and having a height IFO15 were independent risk factors for recurrence.LIFT, Anal fistula, Recurrence, Wexner incontinence score (WIS), Male, Prior fistula surgery, height 1FO.
Published: 2021

21. Is there a relationship between heart rate recovery and blood pressure in white coat hypertension?

Author: Ferhat Eyyupkoca, Ajar Kocak, Onur Yildirim, Mehmet Sait Altintas, Karabekir Ercan, Cengiz Sabanoglu, and Sercan Okutucu
Subjects: Adult, Cross-Sectional Studies, Heart Rate, Hypertension, Humans, Blood Pressure, Blood Pressure Monitoring, Ambulatory, Middle Aged, Cardiology and Cardiovascular Medicine, White Coat Hypertension, Circadian Rhythm
Abstract: Aim Increasing evidence suggests that autonomic dysfunction may be involved in the etiology of white coat hypertension (WCH). The aim of this study was to evaluate cardiac autonomic function by using heart rate recovery (HRR) indices in patients with WCH classified according to their circadian rhythm type of blood pressure (BP).Material and methods This cross-sectional study included 120 participants over the age of 18 yrs, including 50 patients diagnosed with WCH and 70 healthy controls with normal in- and out-of-office BP and without any known disease. Circadian rhythm types, i.e., dippers and non-dippers, were identified using ambulatory BP monitoring. The HRR indices were calculated by subtracting the 1st-minute (HRR1), 2nd-minute (HRR2), and 3rd-minute (HRR3) heart rates from the maximal heart rate recorded during stress testing.Results The lesser decline in nighttime BP (6.4±2.14 and 13.3±2.2 mmHg, respectively; pConclusion Delayed recovery of heart rate after an exercise stress test is associated with non-dipper type of circadian rhythm of BP. This was more pronounced in WCH patients, and these patients are at risk of autonomic dysfunction.
Published: 2021

22. Safety and efficacy of non-steroidal anti-inflammatory drugs to reduce ileus after colorectal surgery

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Stainer, B, Thavayogan, R, Jones, D, Onafowokan, Oo, Gharooni, A, Dabab, N, Carlton‐carew, S, Kungwengwe, G, Gabriel, M, Sewart, E, Shortland, Tc, Lawday, S, Pockney, P, Dawson, A, Brumfitt, Cd, Stewart, P, Ng, B, Luong, Jk, Ivanov, V, Borisova, A, Neykov, V, Kunčarová, K, Kološová, B, Antonova, T, Farkašová, M, Harbjerg, Jl, Brandsborg, S, Brinck, S, Kjaer, Md, Mark‐christensen, A, Unbehaun, Kp, Dalsgaard, P, Lycke, Kd, Lenaoures, P, Brigand, C, Dumange, E, Gout, M, Moehwald, C, Prem, M, Alhalabi, O, Sliwinski, S, Krupp, J, Gablenz, E, Schmitzer, L, Kopp, A, Steinle, J, Gsenger, J, Pohl, Lj, Riccardi, M, Christodoulou, Im, Konstantinidis, M, Machairas, N, Zoikas, A, Balalis, D, Manatakis, Dk, Aguilera, Ml, Marano, L, Fleres, F, Lovisetto, F, Sasia, D, Segalini, E, Pata, G, Lucchi, A, Sagnotta, A, Campagnaro, T, Petrelli, F, Gallo, G, Papandrea, M, Testa, V, Sinibaldi, G, Di Candido, F, Colombo, F, Perrone, G, Aresu, S, Biancafarina, A, Canonico, G, Pagnanelli, M, Curletti, G, Bini, R, 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al-Ausi M., Jovaisaite A., Shah S.M., Khalid N., Gutmann D., Davison S., Alame Y.J., Syed L., Owen W.J., Ahsan S.D., Anthony-Uzoeto U., Macleod Hall C., Zheng S., Wynter K., James C., Sapre D., Ghosh R., Baird J., Cockburn L., Blackwood O., Simpson W., Jeong S., Bishop S., Bate R., Hobson C., Adam A.H., Redclift C., Do J., Adeleye O., Poli F., Batterham A., Brown S., Parekh J.N., Clay W., Pieri K., Jackson A., Saxena A., Gurung B., Oyebola T., O'Brien F., Djeugam B., Gardezi S., Ul-Hasan S., Martin-Hernandez M.P., Sisley M., Modi S., Antakia R., Elbayouk A., Soh Y.J., Mather J., Yusuf Z., Al-Sarraf Z., Naja M., Rassool S.B., Convill J., Nikookam Y., Warsame A., Pace C., Kiandee M., Ridwan R., Carey C., Hirri F., McMillan M.J.A., Ling J.J., Pendelbury L., Kerimzade K., Tang A., Howard E.O., Humayun S., Wadsworth O.J., Tan K., Abdelhameed F., Haglund C., Radnaeva I., Hu N., Rambhatla S., Waldron D., Madahar P., Malik S., Meney L.C., Ibrahim I., Kang C.K., Chiu J.Z.J., Livie V., Ibrahim 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Craven J., Aldarragi A., Harding S., Millward A., Bedford M., Gopalan V., Midgen A., Khadka P., Cheng O., Taneja S., Manobharath N., Kok J.Y., Lim D.W.E., Buick T., Boland M., Piya S., Devlin R., Fairfield C.J., George R.J., Rahi M., Zaman S., Hajiev S., Ross T., Crisp E., Thompson C., Charalambous A., Hollywood J.L., Hammond R.F.L., Matthews J., Mendonca V., Spinty J., Khan K., Cheng J., Glynn N., Muhammad U., Khan M., Anderson L., Mccormack K., Mak J., Patrawala S., Milinkovic N., Schofield R., Chauhan M., Hartley L., Hind J., Nelson L., Ratnasingham D., Whitehead T., Dimitriadis S., Marshall K., Flint E.J., Horner C., Heybourne A., Morgan H., Wickstone C., Panagiotou D., O'Connell E., Dean K., Iqbal R., Walsh L., Yu N., Rana N., Massie E., Ng J., Jung M., Lee Y.D., Harris M., White S., Boev B., Tonchev P., Prochazka V., Skalicky A., Ravn S., Ojakaar A., Dorr-Harim C., Koutserimpas C., Giraudo G., Armellini A., Ruzzenente A., Mazzeo C., De Padua C., Realis Luc A., Maroli A., Giani 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L., Matthews, J., Mendonca, V., Spinty, J., Khan, K., Cheng, J., Glynn, N., Muhammad, U., Khan, M., Anderson, L., Mccormack, K., Mak, J., Patrawala, S., Milinkovic, N., Schofield, R., Chauhan, M., Hartley, L., Hind, J., Nelson, L., Ratnasingham, D., Whitehead, T., Dimitriadis, S., Marshall, K., Flint, E. J., Horner, C., Heybourne, A., Morgan, H., Wickstone, C., Panagiotou, D., O'Connell, E., Dean, K., Iqbal, R., Walsh, L., Yu, N., Rana, N., Massie, E., Ng, J., Jung, M., Lee, Y. D., Harris, M., White, S., Boev, B., Tonchev, P., Prochazka, V., Skalicky, A., Ravn, S., Ojakaar, A., Dorr-Harim, C., Koutserimpas, C., Giraudo, G., Armellini, A., Ruzzenente, A., Mazzeo, C., De Padua, C., Realis Luc, A., Maroli, A., Giani, I., Cufari, M. E., Vitali, M., Gusai, G. P., Quattromani, R., Virgilio, E., Berti, S., Di Mola, F. F., Papagni, V., Tuminello, F., Vittori, L., Longheu, A., Loche, G. A., Braccio, B., De Luca, E., Resta, G., Ancans, G., Tamosiunas, A., Petrulionis, M., Andrejevic, P., Stellingwerf, M. E., Abdulrahman, N., van de Pas, K. G. H., Thomas, G., Brandsma, A. M., Davids, J., Rottier, S. J., de Roy van Zuidewijn, D., Hawkins, R., Ong, H. I., Li, Y., Desmond, B., Winstanley, J., Martins, M., Americano, M., Frade, S., Senhorinho, R., Peixoto, R., Alves-Vale, C., Lamas, M., O'Connor, D. B., Hoo, M., Gopaul, A., Scanlon, K., O'Dwyer, N., Jovanovic, M., Panyko, A., Van Vuuren, S., Curchod, P., Gaspar, S., Imadalou, L., Mutlu, D., Akyol, C., Uygur, F. A., Eray, I. C., Biyiklioglu, O., Cetin, M. F., Isik, A. E., Karip, B., Dogan, H., Sarigul, L., Tunc, E., Aydin, T., Bodur, S., Karabulut, K., Al-hadithi, A., To, N., Lau, I. S. F., Smith, E., Mahapatra, S., Mcauliffe, O., Imam, L., Akram, B., Hossaini, S., Davies, R., Ko, M., Collins, J., Pandya, A., Reilly, S., Archer, J., Auty, C., Roche, C. D., Livie, J., Chaudhry, F. A., Ntakomyti, E., Diallo, R., Bylinski, T., Wright, J., Masiha, E., Tung, J., Shirazi, B., Neilson, A., Epton, S., Patel, N., Trussell, S., Couldrey, A., Donnelly, C., Eftychiou, S., Surgery, AGEM - Digestive immunity, AGEM - Re-generation and cancer of the digestive system, Graduate School, APH - Methodology, ACS - Heart failure & arrhythmias, Eurosurg, Collaborative, Ajmera A., Chapman, Sj, Blanco‐colino, R, Žebrák, R, Glasbey, Jc, Sgrò, A, Elst, T, Knowles, Ch, Bath, Mf, Yasin, Ih, Larsen, Hm, Rädeker, L, Frey, Pe, Elst, Tr, Fagan, Pvb, Wells, Ci, Alagoa João, A, Ozkan, Bb, Yagız Sen, A, Aktas, Mk, Baki, Be, Yüksek, B, Khaw, Ra, Ablett, Ad, Khan, Sm, Manley, Lr, Tan, Hl, Norman, Jg, Baker, Dm, Brandao, Bd, Onafowokan, Oo, Carlton‐carew, S, Shortland, Tc, Brumfitt, Cd, Luong, Jk, Kunčarová, K, Kološová, B, Farkašová, M, Harbjerg, Jl, Kjaer, Md, Mark‐christensen, A, Unbehaun, Kp, Lycke, Kd, Pohl, Lj, Christodoulou, Im, Manatakis, Dk, Aguilera, Ml, Manzoni Garberini, A, Tilocca, Pl, Piozzi, Gn, Wijnbergen, Jwm, Dinger, Tl, Doesschate, Sfh, Dalen, Ashm, Bos, Dd, Kuiper, Sz, Pruijssers, Sr, Elliott, Bm, Geneta, Vp, Peng, Sl, Lim, Yk, Neves‐marques, C, Correia, Jg, Vieira, Bn, Quintela, Ac, Serra, Ml, Aparício, Dj, Eiró, F, Almeida, Mr, Machado, Nd, Ćuk, Vv, Mészárosová, K, Ozmen, Bb, Kocer, Md, Cinar, En, Uslu, Ö, Farhan‐alanie, Mmh, Finch, Bj, Suchett‐kay, I, Liu, Fy, Nadama, Hh, Al‐saraff, Z, Tam, Jph, Powell‐chandler, A, Gorgievska, Rebecca, Gan, Fw, Makin‐taylor, R, Hey, Cy, Findlay, Jm, Örhalmi, J, Skalický, P, Skalický, T, Worsøe, J, Emmertsen, Kj, Mihaljevic, Al, Konstantinidis, Km, Bisagni, Pag, Altomare, Df, Sivinš, A, Bemelman, Wa, Graat, Lj, Wijnhoven, Bpl, Ven, Ahw, Stassen, Lp, Acherman, Yiz, Gerhards, Mf, Stommel, Mwj, Hazebroek, Ej, Geloven, Aaw, Schasfoort, Ra, Leeuwen, Bl, Tuynman, Jb, Tilburg, Mwa, Boerma, Eg, Bissett, Ip, Francisco, V, Ourô, S, Caratão, M, Silva‐vaz, P, Ridgway, Pf, Mcnamara, Da, O'Connell, Pr, Ćuk, Vm, Hübner, M, Sauvain, Mo, Geçim, Ie, Disçi, E, Haksal, Mc, Agarwal, T, Maxwell‐armstrong, C, Moug, Sj, Lund, Jn, Smart, Nj, Smith, Fm, Lee, Yj, Lai, Lt, Jun, Hj, Mendis, Dm, Robb, Pm, Lee, Hj, Wyche, Aab, Davis, Lt, Jayalath, Jmsn, Blefari, Nda, Goh, Yk, Beh, Yz, Dudi‐venkata, Nn, Borrow, Jl, Chua, Th, Tan, Rr, Ng, Sy, Britten‐jones, P, Pham, Hdv, Coulter‐nile, Smcj, Gosselink, Mp, Wang, Yl, Pös, M, Bartoš, M, Malý, O, Hanušová, M, Hurný, M, Riško, J, Treskoň, R, Pospíšil, M, Hlaváčová, L, Tomanová, D, Novický, R, Sobotková, K, šuta Kimle, K, Paclík, A, Jürgens‐lahnstein, J, Kristensen, Fp, Bønnerup, K, Højgaard Pedersen, J, Jepsen, Bn, Hillgaard, Tk, Erichsen, Sb, Nielsen, Cv, Madsen, Cp, Skejø, Cd, Aabling, Rr, Sørensen, J, Schöning, L, Simon, S CS, Thäwel, T, Seckler, Am, Athanasopoulos, Pg, Giuffrida, Mc, Billo, Me, Marrosu, Ag, Ruggiu, Mw, Antona, Ad, Bitonti, Mf, Romano, Fm, Pellicanò, Ga, Murru, Ml, Angelucci, Gp, Tenconi, Sm, Mura, Fa, Ruggiu, Gv, Mura, Ga, Perrone, Ba, Esposito, Lm, Marcianò, M, Aru, Ac, Figà, F, Truškovs, A, Machatschek, Mj, Wiemann, Am, Müller, Nl, Samalavicius, Ne, Poškus, E, Kryžauskas, M, Poškus, T, Looyen, R, Becker, Maj, Molder, L, Tissen, Ym, Vries, H, Smaalen, Tc, Veen, Oc, Dingemans, Sa, Brink, Lc, Vijgen, Ghej, Voort, Emf, Pool, A, Rest, Klc, Sluijpers, Nrf, Molenaar, Cjl, Gordinou de Gouberville, Mc, Mens, Ma, Hoeks, Em, Praag, Em, Smit, Mpcm, Lely, Sj, Stijns, Rch, Leow, Ty, Ruiter, A, Aarts, Cam, Jonge, J, Alqethami, Hj, Elst, Pc, Tissink, Mw, Grüter, A, Voeten, Dm, Boon, Cl, Franssen, Rjm, Jense, Mtf, Lau, Wk, Adams, Sib, Chen, Sy, Kim, Dh, Mclaughlin, Sjp, Chapman, Da, Mcintosh, Nd, Tewhaiti‐smith, J, Yam, St, Tomé, M, Santos, Tc, Lages, Rr, Sá, Tc, Bernardes, Fm, Cunha, Mf, Veiga, Dn, Loureiro, Ar, Torre, Ap, Paixão, I, Rocha, Af, Jervis, Mj, Paixão, V, Silva, Ag, Galvão, D, Mónica, I, Guimarães, N, Martins, Sf, Rocha‐melo, M, Patrício, J, Cinza, Am, Simões, J, Gonçalves, Jp, Guimarães, J, Martins, Ar, Lérias, R, Bártolo, J, Correia, Am, Martins, Pc, Jardim, Jam, Domingos, Sp, Baião, Jm, Lopes, Nmro, Jordão, Dm, Ângelo, Md, Caroço, T, Gomes, Jr, Monteiro, Rg, Colon, Lf, Dockry, É, Aly, Ak, Kang, Sj, Pentony, Ar, Piong, Cl, Eow, Sy, Kamath, Pj, Soh, Tbw, Dyer, Ah, Chee, Sy, Tan, Ixh, Jones, Mr, Al‐salihi, A, Ciubotaru, Ci, Radulović, R, Miloševic, K, Bojičić, J, Genčić, M, Janković, U, Sucháň, Pk, Dubovský, M, Sautter, Sc, Mcduling, Cr, Haller, Ml, Piotet, Lm, Kurtoglu, Gk, Sel, Ek, Isler, Vc, Demirkaya, Hc, Korkmaz, Hk, Pektas, Am, Güner, B, İşlek, Ec, Tombul, Hb, Boztuğ, Cy, Tınaz, A, Yılmaz, M, Akın, Fa, Başçavuş, M, Seker, Mc, Koçak, Zb, Karapinar, Ye, Köseoglu, E, Agca, Mh, Alim, Ye, Kürklü, Ö, Çalar, Sn, Kavar, Rc, Cevlik, Ad, Turk, Eg, Erdönmez, H, Gürsoy, F, Önsal, U, Özbek, M, Kasar, Pa, Özen, D, Ölmez, M, Sariçiçek, T, Tipi, Ou, Benli, Ge, Bilgili, Ac, Kiraz, In, Aksoy, Ab, Karagöz, E, Tümer, S, Abdulrahman, Smf, Kuyumcu, Of, Afsar, Hb, Guler, Se, Gul, Eb, Dossa, Saa, Mizan, Sr, Sahin, Az, Kilinç, A, Yumurtaci, Ö, Girit, Çagri, Yildirak, Mk, Güldag, A, Söyleyici, B, Aytin, Ye, Akay, Fe, Iskan, Ng, Sunay, Ao, Tie‐gill, T, Delaugere, Lp, Yeo, Yq, Aly, Mh, Dwyer‐hemmings, L, Bin Amran, Am, Kyaw, Ha, Clements, Jm, Wong, Hl, Armitage, Mn, Hassan Serry, My, Tam, Lyc, Sookramanien, Sr, Ward, Kl, Pherwani, Sa, Drury, Dj, James, Sj, Teasdale, Ab, Richardson, Etj, Thomas, Da, Williams, Rl, Najabat‐lattif, Hf, Zhu, Ly, Suchett‐kaye, I, Mihailidis, Th, Pedersen, Ac, Robinson, Av, Cheong, Cm, Ike, Si, Chu, Tsm, Mogg, Jaw, Claireaux, Ha, Vaughan‐burleigh, S, Al‐ausi, M, Shah, Sm, Alame, Yj, Owen, Wj, Ahsan, Sd, Anthony‐uzoeto, U, Adam, Ah, Parekh, Jn, Ul‐hasan, S, Martin‐hernandez, Mp, Soh, Yj, Al‐sarraf, Z, Rassool, Sb, Mcmillan, Mja, Ling, Jj, Howard, Eo, Wadsworth, Oj, Meney, Lc, Kang, Ck, Chiu, Jzj, Tan, Qj, Cross, Gwv, Shah, Dr, Ng, Mpe, Wong, Rtw, Rojoa, Dm, Ruddy, Cm, Hall, Jd, Hassane, Asi, Azhar, Aw, Tan, Tk, Kwak, Sy, Ong, Eh, Goolam‐mahomed, Z, Kirnon‐jackman, O, Lim, Qx, Yong, Sq, Chen, Jy, Sam, Zh, Goh, Yn, Muthukumar, Mg, Johnson, Ta, Williams, Ri, Honeyman, Si, Malcolm, Fl, Wilkerson, Ht, Chatterjee‐woolman, S, Ahmed, Wur, Kwan, Kwl, Sanders‐crook, L, Boh, Zy, English, Wj, Novotny, Sa, Chong, Jt, Lee, De, Embury‐young, Y, Clavé Llavall, A, Pang, Yl, Dellen, J, Al‐azzawi, A, Alawode, Dot, Wynell‐mayow, W, Christodoulou, T, Jones, Cj, Leung, Sp, Mohamed, Sh, Kok, Jy, Lim, Dwe, Fairfield, Cj, George, Rj, Hollywood, Jl, Hammond, Rfl, Flint, Ej, Lee, Yd, Skalický, A, Ojakäär, A, Dörr‐harim, C, Cufari, Me, Gusai, Gp, Di Mola, Ff, Loche, Ga, Stellingwerf, Me, Pas, Kgh, Brandsma, Am, Rottier, Sj, Roy van Zuidewijn, D, Ong, Hi, Alves‐vale, C, O'Connor, Db, Jovanović, M, Uygur, Fa, Eray, Ic, Çetin, Mf, Isik, Ae, Sarıgül, L, Francis, Aa, Al‐hadithi, A, Lau, Isf, Roche, Cd, and Chaudhry, Fa
Subjects: Male, renal failure, Time Factors, medicine.medical_treatment, Adult, Aged, Anti-Inflammatory Agents, Non-Steroidal, Elective Surgical Procedures, Female, Humans, Ileus, Kaplan-Meier Estimate, Middle Aged, Patient Safety, Postoperative Care, Postoperative Complications, Proportional Hazards Models, Prospective Studies, Recovery of Function, Treatment Outcome, Colectomy, Proctectomy, Anti-Inflammatory Agents, colorectal surgery, ileus, non-steroidal anti-inflammatory drugs, NSAIDS, 030230 surgery, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], 0302 clinical medicine, Prospective cohort study, Colorectal, RISK, Hazard ratio, Acute kidney injury, Colorectal surgery, NSAID, 030220 oncology & carcinogenesis, Non-Steroidal, Cohort study, colorectal Surgery, ileus, non-steroidal anti-inflammatory drugs, medicine.medical_specialty, Non‐steroidal anti‐inflammatory drugs. NSAIDs. Postoperative ileus. Colorectal surgery, ACUTE KIDNEY INJURY, anti-inflammatory agents, 03 medical and health sciences, Internal medicine, medicine, Adverse effect, non-steroidal anti-inflammatory drugs - ileus - colorectal surgery, business.industry, medicine.disease, Settore MED/18 - Chirurgia Generale, colorectal cancer, Surgery, business
Abstract: Ileus is common after elective colorectal surgery, and is associated with increased adverse events and prolonged hospital stay. The aim was to assess the role of non-steroidal anti-inflammatory drugs (NSAIDs) for reducing ileus after surgery.A prospective multicentre cohort study was delivered by an international, student- and trainee-led collaborative group. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The primary outcome was time to gastrointestinal recovery, measured using a composite measure of bowel function and tolerance to oral intake. The impact of NSAIDs was explored using Cox regression analyses, including the results of a centre-specific survey of compliance to enhanced recovery principles. Secondary safety outcomes included anastomotic leak rate and acute kidney injury.A total of 4164 patients were included, with a median age of 68 (i.q.r. 57-75) years (54·9 per cent men). Some 1153 (27·7 per cent) received NSAIDs on postoperative days 1-3, of whom 1061 (92·0 per cent) received non-selective cyclo-oxygenase inhibitors. After adjustment for baseline differences, the mean time to gastrointestinal recovery did not differ significantly between patients who received NSAIDs and those who did not (4·6 versus 4·8 days; hazard ratio 1·04, 95 per cent c.i. 0·96 to 1·12; P = 0·360). There were no significant differences in anastomotic leak rate (5·4 versus 4·6 per cent; P = 0·349) or acute kidney injury (14·3 versus 13·8 per cent; P = 0·666) between the groups. Significantly fewer patients receiving NSAIDs required strong opioid analgesia (35·3 versus 56·7 per cent; P 0·001).NSAIDs did not reduce the time for gastrointestinal recovery after colorectal surgery, but they were safe and associated with reduced postoperative opioid requirement.El ileo es frecuente tras cirugía colorrectal electiva y se asocia con un incremento de los eventos adversos y de la duración de la estancia hospitalaria. El objetivo fue evaluar el papel de los fármacos antiinflamatorios no esteroideos (non-steroidal anti-inflammatory drugs, NSAIDs) para reducir el ileo tras la cirugía. MÉTODOS: Estudio de cohortes prospectivo y multicéntrico efecuado por un grupo colaborativo dirigido por estudiantes y cirujanos en formación. Se incluyeron pacientes adultos sometidos a cirugía colorectal electiva entre enero y abril 2018. El resultado primario fue el tiempo hasta la recuperaciòn gastrointestinal, medido por una variable compuesta de función intestinal y tolerancia a la alimentación oral. El impacto de los NSAIDs se exploró utilizando un análisis de regresión de Cox, que incluía los resultados de una encuesta específica dirigida a los centros sobre la adherencia a los principios de la recuperación intensificada. Los resultados secundarios de seguridad incluyeron la dehiscencia anastomótica y la insuficiencia renal aguda.Se incluyeron 4.164 pacientes con una mediana de edad de 68 años (rango intercuartílico: 57-75; 54,9% varones). Un total de 1.153 (27,7%) pacientes fueron tratados con NSAIDs en los días postoperarorios 1-3, de los cuales 1.061 (92,0%) recibieron inhibidores no selectivos de la ciclooxigenasa. Tras los ajustes por las diferencias basales, el tiempo medio hasta la recuperación gastrointestinal no difería significativamente entre pacientes que recibieron o no recibieron NSAIDs (4,6 versus 4,8 días; cociente de riesgos instantáneos, hazard ratio, HR 1,04, i.c. del 95%: 0,96-1,12, P = 0,360). No hubo diferencias significativas en la tasa de dehiscencias anastomóticas (5,4% versus 4,6%; P = 0,349) o insuficiencia renal aguda (14,3% versus 13,8%; P = 0,666) entre los grupos. Sin embargo, significativamente menos pacientes de los que recibieron NSAIDs precisaron una analgesia intensa con opioides (35,3% versus 56,7%; P 0,001). CONCLUSIÓN: La administración de NSAIDs no redujo el tiempo hasta la recuperación gastrointestinal tras cirugía colorrectal, pero fueron seguros y se asociaron con una reducción en la necesidad de opioides postoperarorios.
Published: 2019

23. Early clinical markers of aggressive multiple sclerosis

Author: Tomas Kalincik, Marc Girard, Guillermo Izquierdo, Cristina Ramo-Tello, Francois Grand'Maison, Ali Manouchehrinia, Youssef Sidhom, Charles B Malpas, Alexandre Prat, Maria Trojano, Franco Granella, Pamela A. McCombe, Rana Karabudak, Murat Terzi, Eugenio Pucci, Raymond Hupperts, Vincent Van Pesch, Pierre Grammond, Sifat Sharmin, Richard A L Macdonell, Ayse Altintas, Riadh Gouider, Recai Turkoglu, Diana Ferraro, Alessandra Lugaresi, Pierre Duquette, Helmut Butzkueven, Serkan Ozakbas, Sara Eichau, Izanne Roos, Daniele Spitaleri, Yara Dadalti Fragoso, Mark Slee, Roberto Bergamaschi, Jan Hillert, Edgardo Cristiano, Thor Petersen, Eva Havrdova, Javier Olascoaga, Cavit Boz, Patrizia Sola, Freek Verheul, Aysun Soysal, Tomas Olsson, Dana Horakova, Ondokuz Mayıs Üniversitesi, Malpas C.B., Manouchehrinia A., Sharmin S., Roos I., Horakova D., Havrdova E.K., Trojano M., Izquierdo G., Eichau S., Bergamaschi R., Sola P., Ferraro D., Lugaresi A., Prat A., Girard M., Duquette P., Grammond P., Grand'Maison F., Ozakbas S., van Pesch V., Granella F., Hupperts R., Pucci E., Boz C., Sidhom Y., Gouider R., Spitaleri D., Soysal A., Petersen T., Verheul F., Karabudak R., Turkoglu R., Ramo-Tello C., Terzi M., Cristiano E., Slee M., McCombe P., Macdonell R., Fragoso Y., Olascoaga J., Altintas A., Olsson T., Butzkueven H., Hillert J., Kalincik T., Altıntaş, Ayşe (ORCID 0000-0002-8524-5087 & YÖK ID 11611), School of Medicine, UCL - SSS/IONS/CEMO - Pôle Cellulaire et moléculaire, and UCL - (SLuc) Service de neurologie
Subjects: Male, PROGRESSION, Disease, multiple sclerosis, 01 natural sciences, THERAPY, Severity of Illness Index, Aggressive disease, 010104 statistics & probability, Disability Evaluation, 0302 clinical medicine, PROGNOSTIC-FACTORS, Multiple Sclerosi, Disability, Multiple sclerosis, Precision medicine, Prediction, R PACKAGE, Age of Onset, AcademicSubjects/SCI01870, Neurosciences and neurology, IMPAIRMENT, Cohort, Disease Progression, RELAPSE RATE, Female, Cohort study, Human, Adult, medicine.medical_specialty, Multiple Sclerosis, precision medicine, BRAIN MRI, Sensitivity and Specificity, 03 medical and health sciences, Internal medicine, Severity of illness, medicine, Humans, 0101 mathematics, Letters to the Editor, Expanded Disability Status Scale, business.industry, NATURAL-HISTORY, prediction, medicine.disease, PREDICTIVE-VALUE, Confidence interval, disability, AcademicSubjects/MED00310, Neurology (clinical), Age of onset, business, aggressive disease, 030217 neurology & neurosurgery, LONG-TERM DISABILITY
Abstract: Patients with the 'aggressive' form of multiple sclerosis accrue disability at an accelerated rate, typically reaching Expanded Disability Status Score (EDSS) ≥ 6 within 10 years of symptom onset. Several clinicodemographic factors have been associated with aggressive multiple sclerosis, but less research has focused on clinical markers that are present in the first year of disease. The development of early predictive models of aggressive multiple sclerosis is essential to optimize treatment in this multiple sclerosis subtype. We evaluated whether patients who will develop aggressive multiple sclerosis can be identified based on early clinical markers. We then replicated this analysis in an independent cohort. Patient data were obtained from the MSBase observational study. Inclusion criteria were (i) first recorded disability score (EDSS) within 12 months of symptom onset; (ii) at least two recorded EDSS scores; and (iii) at least 10 years of observation time, based on time of last recorded EDSS score. Patients were classified as having 'aggressive multiple sclerosis' if all of the following criteria were met: (i) EDSS ≥ 6 reached within 10 years of symptom onset; (ii) EDSS ≥ 6 confirmed and sustained over ≥6 months; and (iii) EDSS ≥ 6 sustained until the end of follow-up. Clinical predictors included patient variables (sex, age at onset, baseline EDSS, disease duration at first visit) and recorded relapses in the first 12 months since disease onset (count, pyramidal signs, bowel-bladder symptoms, cerebellar signs, incomplete relapse recovery, steroid administration, hospitalization). Predictors were evaluated using Bayesian model averaging. Independent validation was performed using data from the Swedish Multiple Sclerosis Registry. Of the 2403 patients identified, 145 were classified as having aggressive multiple sclerosis (6%). Bayesian model averaging identified three statistical predictors: age > 35 at symptom onset, EDSS ≥ 3 in the first year, and the presence of pyramidal signs in the first year. This model significantly predicted aggressive multiple sclerosis [area under the curve (AUC) = 0.80, 95% confidence intervals (CIs): 0.75, 0.84, positive predictive value = 0.15, negative predictive value = 0.98]. The presence of all three signs was strongly predictive, with 32% of such patients meeting aggressive disease criteria. The absence of all three signs was associated with a 1.4% risk. Of the 556 eligible patients in the Swedish Multiple Sclerosis Registry cohort, 34 (6%) met criteria for aggressive multiple sclerosis. The combination of all three signs was also predictive in this cohort (AUC = 0.75, 95% CIs: 0.66, 0.84, positive predictive value = 0.15, negative predictive value = 0.97). Taken together, these findings suggest that older age at symptom onset, greater disability during the first year, and pyramidal signs in the first year are early indicators of aggressive multiple sclerosis., National Health and Medical Research Council of Australia; Roche; Merck; Biogen; Novartis; Bayer Schering; Sanofi Genzyme; Teva
Published: 2020

24. Clinical and therapeutic predictors of disease outcomes in AQP4-IgG+ neuromyelitis optica spectrum disorder

Author: Guillermo Izquierdo, Ayse Altintas, Tomas Kalincik, Petra Nytrova, Charles B Malpas, Roberto Bergamaschi, Ilya Kister, Diana Ferraro, Aysun Soysal, Helmut Butzkueven, Sara Eichau, Francois Grand'Maison, Guy Laureys, Jeannette Lechner-Scott, Jyh Yung Hor, Pamela A. McCombe, Yara Dadalti Fragoso, Steve Vucic, Rana Karabudak, Raed Alroughani, Cavit Boz, Celia Oreja-Guevara, Eugenio Pucci, Tünde Csépány, Patrizia Sola, Serkan Ozakbas, Bhim Singhal, Francesco Patti, Maria Trojano, Franco Granella, Marco Onofrj, Alessandra Lugaresi, Recai Turkoglu, Mark Marriott, Murat Terzi, Amy Kunchok, Talal Al-Harbi, Magdolna Simó, Javier Olascoaga, Eva Havrdova, Bassem Yamout, Kunchok A., Malpas C., Nytrova P., Havrdova E.K., Alroughani R., Terzi M., Yamout B., Hor J.Y., Karabudak R., Boz C., Ozakbas S., Olascoaga J., Simo M., Granella F., Patti F., McCombe P., Csepany T., Singhal B., Bergamaschi R., Fragoso Y., Al-Harbi T., Turkoglu R., Lechner-Scott J., Laureys G., Oreja-Guevara C., Pucci E., Sola P., Ferraro D., Altintas A., Soysal A., Vucic S., Grand'Maison F., Izquierdo G., Eichau S., Lugaresi A., Onofrj M., Trojano M., Marriott M., Butzkueven H., Kister I., Kalincik T., and Ondokuz Mayıs Üniversitesi
Subjects: Male, Time Factors, Azathioprine, Severity of Illness Index, 0302 clinical medicine, Natalizumab, Recurrence, Outcome Assessment, Health Care, Disability, Immunosuppression, Neuromyelitis optica spectrum disorder, Predictors, Relapses, Therapy, 030212 general & internal medicine, Registries, Relapse, Hazard ratio, Neuromyelitis Optica, Age Factors, General Medicine, Middle Aged, Neurology, Cohort, Disease Progression, Female, Rituximab, medicine.drug, Cohort study, Adult, medicine.medical_specialty, 03 medical and health sciences, Internal medicine, medicine, Humans, Immunologic Factors, Aquaporin 4, Neuromyelitis optica, Expanded Disability Status Scale, Proportional hazards model, business.industry, Mycophenolic Acid, medicine.disease, Immunoglobulin G, Neurology (clinical), business, 030217 neurology & neurosurgery, Follow-Up Studies, Predictor
Abstract: Altintas, Ayse/0000-0002-8524-5087; Laureys, Guy/0000-0002-1708-4373; Vucic, Steve/0000-0002-8323-873X; patti, francesco/0000-0002-6923-0846; Kister, Ilya/0000-0003-3549-949X; Lugaresi, Alessandra/0000-0003-2902-5589 WOS: 000521648000049 PubMed: 31877445 Background: Aquaporin-4-IgG positive (AQP4-IgG(+)) Neuromyelitis Optica Spectrum Disorder (NMOSD) is an uncommon central nervous system autoimmune disorder. Disease outcomes in AQP4-IgG + NMOSD are typically measured by relapse rate and disability. Using the MSBase, a multi-centre international registry, we aimed to examine the impact immunosuppressive therapies and patient characteristics as predictors of disease outcome measures in AQP4-IgG + NMOSD. Method: This MSBase cohort study of AQP4-IgG + NMOSD patients examined modifiers of relapse in a multivariable proportional hazards model and expanded disability status score (EDSS) using a mixed effects model. Results: 206 AQP4-IgG + patients were included (median follow-up 3.7 years). Age (hazard ratio [HR] = 0.82 per decade, p = 0.001), brainstem onset (HR = 0.45, p = 0.009), azathioprine (HR = 0.46, p < 0.001) and mycophenolate mofetil (HR = 0.09, p = 0.012) were associated with a reduced risk of relapse. A greater EDSS was associated with age (beta = 0.45 (per decade), p < 0.001) and disease duration (beta = 0.07 per year, p < 0.001). A slower increase in EDSS was associated with azathioprine (beta = -0.48, p < 0.001), mycophenolate mofetil (beta = -0.69, p = 0.04) and rituximab (beta = -0.35, p = 0.024). Interpretation: This study has demonstrated that azathioprine and mycophenolate mofetil reduce the risk of relapses and disability progression is modified by azathioprine, mycophenolate mofetil and rituximab. Age and disease duration were the only patient characteristics that modified the risk of relapse and disability in our cohort. National Health and Medical Research Council of AustraliaNational Health and Medical Research Council of Australia [1083539, 1129189, 1140766, 1080518]; MerckMerck & Company; BiogenBiogen; NovartisNovartis; Bayer-ScheringBayer AG; Sanofi-Genzyme; Teva This study was financially supported by National Health and Medical Research Council of Australia [project grants 1083539 and 1129189, and fellowships 1140766 and 1080518]. The MSBase Foundation is a not-for-profit organization that receives support from Merck, Biogen, Novartis, Bayer-Schering, Sanofi-Genzyme and Teva. The study was conducted separately and apart from the guidance of the sponsors.
Published: 2020

25. Risk of secondary progressive multiple sclerosis: A longitudinal study

Author: Michael Barnett, Bhim Singhal, Maria Trojano, Franco Granella, Neil Shuey, Guillermo Izquierdo, Dana Horakova, Helmut Butzkueven, Talal Al-Harbi, Maria Laura Saladino, Cameron Shaw, Adam Fambiatos, Bart Van Wijmeersch, Serkan Ozakbas, Tünde Csépány, Freek Verheul, Cavit Boz, Tim Spelman, Pierre Duquette, Jeannette Lechner-Scott, Bassem Yamout, Roberto Bergamaschi, Vincent Van Pesch, Claudio Solaro, Edgardo Cristiano, Patrizia Sola, Vilija Jokubaitis, Jae Kwan Jun, Alessandra Lugaresi, Javier Olascoaga, Aysun Soysal, Thor Petersen, Mark Slee, Raed Alroughani, Francois Grand'Maison, Orla Gray, Tomas Kalincik, Marc Girard, Gerardo Iuliano, Anneke van der Walt, Eva Havrdova, Jose Luis Sanchez-Menoyo, Radek Ampapa, Julie Prevost, Steve Vucic, Pamela A. McCombe, Recai Turkoglu, Yara Dadalti Fragoso, Jordana Hughes, Olga Skibina, Murat Terzi, Eugenio Pucci, Diana Ferraro, Pierre Grammond, Fraser Moore, Ayse Altintas, Suzanne Hodgkinson, Youssef Sidhom, Norma Deri, Alexandre Prat, Raymond Hupperts, Daniele Spitaleri, Bruce V. Taylor, Fambiatos A., Jokubaitis V., Horakova D., Kubala Havrdova E., Trojano M., Prat A., Girard M., Duquette P., Lugaresi A., Izquierdo G., Grand'Maison F., Grammond P., Sola P., Ferraro D., Alroughani R., Terzi M., Hupperts R., Boz C., Lechner-Scott J., Pucci E., Bergamaschi R., Van Pesch V., Ozakbas S., Granella F., Turkoglu R., Iuliano G., Spitaleri D., McCombe P., Solaro C., Slee M., Ampapa R., Soysal A., Petersen T., Sanchez-Menoyo J.L., Verheul F., Prevost J., Sidhom Y., Van Wijmeersch B., Vucic S., Cristiano E., Saladino M.L., Deri N., Barnett M., Olascoaga J., Moore F., Skibina O., Gray O., Fragoso Y., Yamout B., Shaw C., Singhal B., Shuey N., Hodgkinson S., Altintas A., Al-Harbi T., Csepany T., Taylor B., Hughes J., Jun J.-K., van der Walt A., Spelman T., Butzkueven H., Kalincik T., Ondokuz Mayıs Üniversitesi, UCL - SSS/IONS/CEMO - Pôle Cellulaire et moléculaire, and UCL - (SLuc) Service de neurologie
Subjects: Adult, Male, Risk, medicine.medical_specialty, Longitudinal study, Immunologic Factors, multiple sclerosis, Severity of Illness Index, 03 medical and health sciences, 0302 clinical medicine, Multiple Sclerosis, Relapsing-Remitting, disease modifying therapies, prognostics, Internal medicine, Severity of illness, Medicine, Humans, Longitudinal Studies, 030304 developmental biology, 0303 health sciences, business.industry, Multiple sclerosis, Disease progression, prediction, Multiple Sclerosis, Chronic Progressive, medicine.disease, SPMS, Clinical neurology, Natural history, Neurology, multiple sclerosi, disease modifying therapie, Disease Progression, Secondary progressive multiple sclerosis, Female, Neurology (clinical), business, prognostic, 030217 neurology & neurosurgery
Abstract: Turkoglu, Recai/0000-0001-9724-851X; Ferraro, Diana/0000-0003-4818-3806; McCombe, Pamela/0000-0003-2704-8517; Altintas, Ayse/0000-0002-8524-5087; Jokubaitis, Vilija G./0000-0002-3942-4340; Slee, Mark/0000-0003-4323-2453; Lugaresi, Alessandra/0000-0003-2902-5589; van Pesch, Vincent/0000-0003-2885-9004; Vucic, Steve/0000-0002-8323-873X WOS: 000481049900001 PubMed: 31397221 Background: The risk factors for conversion from relapsing-remitting to secondary progressive multiple sclerosis remain highly contested. Objective: The aim of this study was to determine the demographic, clinical and paraclinical features that influence the risk of conversion to secondary progressive multiple sclerosis. Methods: Patients with adult-onset relapsing-remitting multiple sclerosis and at least four recorded disability scores were selected from MSBase, a global observational cohort. The risk of conversion to objectively defined secondary progressive multiple sclerosis was evaluated at multiple time points per patient using multivariable marginal Cox regression models. Sensitivity analyses were performed. Results: A total of 15,717 patients were included in the primary analysis. Older age (hazard ratio (HR) = 1.02, p < 0.001), longer disease duration (HR = 1.01, p = 0.038), a higher Expanded Disability Status Scale score (HR = 1.30, p < 0.001), more rapid disability trajectory (HR = 2.82, p < 0.001) and greater number of relapses in the previous year (HR = 1.07, p = 0.010) were independently associated with an increased risk of secondary progressive multiple sclerosis. Improving disability (HR = 0.62, p = 0.039) and disease-modifying therapy exposure (HR = 0.71, p = 0.007) were associated with a lower risk. Recent cerebral magnetic resonance imaging activity, evidence of spinal cord lesions and oligoclonal bands in the cerebrospinal fluid were not associated with the risk of conversion. Conclusion: Risk of secondary progressive multiple sclerosis increases with age, duration of illness and worsening disability and decreases with improving disability. Therapy may delay the onset of secondary progression. National Health and Medical Research Council of AustraliaNational Health and Medical Research Council of Australia [1083539, 1129189, 1140766]; BiogenBiogen; RocheRoche Holding; Bayer ScheringBayer AG; Sanofi Genzyme; Teva; MerckMerck & Company; NovartisNovartis The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was financially supported by National Health and Medical Research Council of Australia (project grants 1083539 and 1129189 and fellowship 1140766). The MSBase Foundation is a not-for-profit organisation that receives support from Merck, Biogen, Roche, Novartis, Bayer Schering, Sanofi Genzyme and Teva. The study was conducted separately and apart from the guidance of the sponsors.
Published: 2020

26. Prevalence of COVID-19 in 10,000 samples from 7853 patients in Eastern Turkey by positive real-time PCR

Author: Murat Karamese, Ayşegül Tuna, Emin E Tutuncu, Didem Ozgur, Abdullah Gumus, Saliha Kazci, Onur Coruh, Gozde Apaydin, Mursel Karadavut, Okan Caliskan, Necati Mumcu, Ceyda Tarhan, and Susamber D Altintas
Subjects: 0301 basic medicine, Microbiology (medical), Adult, Male, 2019-20 coronavirus outbreak, Veterinary medicine, Coronavirus disease 2019 (COVID-19), Screening test, Adolescent, Fever, Turkey, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Short Communication, prevalence, Real-Time Polymerase Chain Reaction, Microbiology, 03 medical and health sciences, Young Adult, 0302 clinical medicine, COVID-19 Testing, Medicine, Humans, 030212 general & internal medicine, Child, Aged, business.industry, SARS-CoV-2, Infant, Newborn, COVID-19, Infant, Middle Aged, positivity rate, Positive patient, Infant newborn, 030104 developmental biology, Real-time polymerase chain reaction, Cough, Child, Preschool, Population study, Female, business, real-time PCR
Abstract: Aim: COVID-19, caused by SARS-CoV-2, started in December 2019 and has spread across the world. Materials & methods: We analyzed real-time PCR results of 10,000 samples from 2 April to 30 May 2020 in three neighbor cities located in the East of Turkey. The final study population was 7853 cases, after excluding screening tests. Results: Real-time PCR was performed to detect the SARS-CoV-2-specific RNA-dependent-RNA-polymerase gene fragment. The number of total positive samples out of 7853 were 487; however, the number of nonrepeating positive patient was 373 (4.8%). Cough and fever were the most common symptoms in positive cases. Conclusion: Epidemiologic studies should be performed about the prevalence of SARS-CoV-2 infection to better understand the effect of the virus across the world.
Published: 2021

27. Can Early ‘Shallow’ Needle-knife Papillotomy be the First Choice in ERCP?

Author: Tansu Altintas and Mustafa Uygar Kalayci
Subjects: Adult, Male, medicine.medical_specialty, Perforation (oil well), Sphincterotomy, Endoscopic, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, medicine, Humans, Needle knife, Duodenoscopy, Aged, Retrospective Studies, Cholangiopancreatography, Endoscopic Retrograde, Endoscopic retrograde cholangiopancreatography, medicine.diagnostic_test, Common bile duct, business.industry, Pancreatic Diseases, Postoperative complication, Retrospective cohort study, Middle Aged, Standard technique, Surgery, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Female, 030211 gastroenterology & hepatology, Complication, business
Abstract: Purpose Needle-knife sphincterotomy, known as 'precut' is recommended as the second option in the case of difficult cannulation due to its potential higher complication (bleeding and perforation) rates. The aim of this study was to present our experience on early shallow needle-knife papillotomy (eSNKP) as the first-line choice independently of standard technique with or without difficult cannulation. Materials and methods A total of 70 patients underwent therapeutic endoscopic retrograde cholangiopancreatography. A standard eSNKP and guidewire cannulation technique was routinely preferred as a first-line intervention. Deep biliary cannulation rate and timing were recorded, as well as intraoperative and postoperative complication rates. Results Successful deep biliary cannulation was performed in 66 (94.3%) patients during the first procedure. In 4 patients (5.7%), the procedure was terminated due to failed cannulation and repeated successfully after 72 hours. Minor complications were observed in 3 (4.3%) patients. No mortality was seen. Conclusion eSNKP is a safe, time-saving, and effective technique as the first-line of endoscopic retrograde cholangiopancreatography for common bile duct cannulation.
Published: 2020

28. Retinal Optical Coherence Tomography in Neuromyelitis Optica

Author: Denis Bernardi Bichuetti, Letizia Leocani, Claudia Chien, Maria Isabel Leite, Anitha D'Cunha, Ayse Altintas, Sasitorn Siritho, Alvaro Cobo Calvo, Jacqueline Palace, Michael R. Yeaman, Ibis Soto de Castillo, Seyedamirhosein Motamedi, Frederike C. Oertel, Alireza Dehghani, Rengin Yildirim, Marco Aurélio Lana Peixoto, Rahele Kafieh, Joachim Havla, Friedemann Paul, Uygur Tanriverdi, Jérôme De Seze, Adriana Roca-Fernandez, Zoe Rimler, Charlotte Bereuter, Svenja Specovius, Marco Pisa, Eugene May, Anu Jacob, Ivan Maynart Tavares, Fereshteh Ashtari, Hadas Stiebel-Kalish, Romain Marignier, Alexander U. Brandt, Orhan Aktas, Ho Jin Kim, Mariana Andrade Fontanelle, Ari J. Green, Nasrin Asgari, Yang Mao-Draayer, Lawrence Cook, Hanna Zimmermann, Kerstin Soelberg, Srilakshmi M Sharma, Axel Petzold, Thomas Senger, Terry J. Smith, Jae-Won Hyun, Saif Huda, Allyson Reid, Mohsen Pourazizi, Marius Ringelstein, Elena H. Martinez-Lapiscina, Caryl Tongco, Lekha Pandit, M. Radaelli, Philipp Albrecht, Institut Català de la Salut, [Oertel FC] Experimental and Clinical Research Center, Max Delbruck Center for Molecular Medicine and Charité- Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany. NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Germany. Department of Neurology, University of California San Francisco, CA. [Specovius S, Zimmermann HG, Chien C, Motamedi S, Bereuter C] Experimental and Clinical Research Center, Max Delbruck Center for Molecular Medicine and Charité- Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany. NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Germany. [Cobo-Calvo A] Biomedical Center and University Hospital, Ludwig-Maximilians Universitaet Muenchen, Munich, Germany. Neurology, Multiple Sclerosis, Myelin Disorders and Neuroinflammation, Pierre Wertheimer Neurological Hospital, Hospices Civils de Lyon, France. Centre d’Esclerosi Múltiple de Catalunya (CEMCAT), Barcelona, Spain. Servei de Neurologia-Neuroimmunologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain, and Vall d'Hebron Barcelona Hospital Campus
Subjects: Male, Visual acuity, Ulls - Tomografia, genetic structures, Nervous System Diseases::Autoimmune Diseases of the Nervous System::Demyelinating Autoimmune Diseases, CNS::Myelitis, Transverse::Neuromyelitis Optica [DISEASES], Nerve fiber layer, Layer Segmentation, chemistry.chemical_compound, diagnóstico::técnicas y procedimientos diagnósticos::diagnóstico por imagen::imágenes ópticas::tomografía óptica::tomografía de coherencia óptica [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], medicine.diagnostic_test, Neuromyelitis Optica, Neuromyelitis Optica/diagnostic imaging, Trastorns de la visió - Imatgeria, Aquaporin 4/immunology, Middle Aged, Ganglion, medicine.anatomical_structure, Neurology, Optic nerve, Female, medicine.symptom, Function and Dysfunction of the Nervous System, Tomography, Optical Coherence, Retinal Neurons, Adult, medicine.medical_specialty, Optic Neuritis, enfermedades del sistema nervioso::enfermedades autoinmunitarias del sistema nervioso::enfermedades autoinmunes desmielinizantes del SNC::mielitis transversa::neuromielitis óptica [ENFERMEDADES], Fellow Eyes, Article, Spectrum Disorder, Young Adult, Optical coherence tomography, Ophthalmology, medicine, Humans, Other subheadings::Other subheadings::/diagnostic imaging [Other subheadings], Retrospective Studies, Aquaporin 4, Neuromyelitis optica, Sistema nerviós - Malalties, business.industry, Volume, Correction, Retinal, Retrospective cohort study, Otros calificadores::Otros calificadores::/diagnóstico por imagen [Otros calificadores], medicine.disease, eye diseases, Multiple-Sclerosis, Cross-Sectional Studies, chemistry, Oct, Optic Neuritis/diagnostic imaging, Diagnosis::Diagnostic Techniques and Procedures::Diagnostic Imaging::Optical Imaging::Tomography, Optical::Tomography, Optical Coherence [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], Neurology (clinical), sense organs, business, Retinal Neurons/pathology
Abstract: Background and ObjectivesTo determine optic nerve and retinal damage in aquaporin-4 antibody (AQP4-IgG)-seropositive neuromyelitis optica spectrum disorders (NMOSD) in a large international cohort after previous studies have been limited by small and heterogeneous cohorts.MethodsThe cross-sectional Collaborative Retrospective Study on retinal optical coherence tomography (OCT) in neuromyelitis optica collected retrospective data from 22 centers. Of 653 screened participants, we included 283 AQP4-IgG–seropositive patients with NMOSD and 72 healthy controls (HCs). Participants underwent OCT with central reading including quality control and intraretinal segmentation. The primary outcome was thickness of combined ganglion cell and inner plexiform (GCIP) layer; secondary outcomes were thickness of peripapillary retinal nerve fiber layer (pRNFL) and visual acuity (VA).ResultsEyes with ON (NMOSD-ON, N = 260) or without ON (NMOSD-NON, N = 241) were assessed compared with HCs (N = 136). In NMOSD-ON, GCIP layer (57.4 ± 12.2 μm) was reduced compared with HC (GCIP layer: 81.4 ± 5.7 μm, p < 0.001). GCIP layer loss (−22.7 μm) after the first ON was higher than after the next (−3.5 μm) and subsequent episodes. pRNFL observations were similar. NMOSD-NON exhibited reduced GCIP layer but not pRNFL compared with HC. VA was greatly reduced in NMOSD-ON compared with HC eyes, but did not differ between NMOSD-NON and HC.DiscussionOur results emphasize that attack prevention is key to avoid severe neuroaxonal damage and vision loss caused by ON in NMOSD. Therapies ameliorating attack-related damage, especially during a first attack, are an unmet clinical need. Mild signs of neuroaxonal changes without apparent vision loss in ON-unaffected eyes might be solely due to contralateral ON attacks and do not suggest clinically relevant progression but need further investigation.
Published: 2021

29. Metabolic Changes in Peripheral Blood Mononuclear Cells Isolated From Patients With End Stage Renal Disease

Author: Haimanot Wasse, Salvatore DiBartolo, Mehmet M. Altintas, Lana Tadros, and Beata Samelko
Subjects: Adult, Male, AMPK, 0301 basic medicine, medicine.medical_specialty, Bioenergetics, Endocrinology, Diabetes and Metabolism, Cell Respiration, Cell Separation, Oxidative phosphorylation, Mitochondrion, bioenergetics, lcsh:Diseases of the endocrine glands. Clinical endocrinology, Peripheral blood mononuclear cell, End stage renal disease, 03 medical and health sciences, Oxygen Consumption, Endocrinology, 0302 clinical medicine, Internal medicine, medicine, Humans, Glycolysis, Lactic Acid, Aged, Original Research, Whole blood, Aged, 80 and over, ESKD, lcsh:RC648-665, business.industry, Carbon Dioxide, Middle Aged, Metabolic Flux Analysis, mitochondria, 030104 developmental biology, Case-Control Studies, PBMCs, Leukocytes, Mononuclear, Kidney Failure, Chronic, Female, Mitochondrial fission, Energy Metabolism, business, 030217 neurology & neurosurgery
Abstract: As numerous complex pathologies stem from cellular energy dysfunction, we aimed to elucidate mitochondrial function and associated stress pathologies in kidney disease in a cohort of hemodialysis patients with end-stage kidney disease (ESKD). The bioenergetics study was conducted using peripheral blood mononuclear cells (PBMCs) of ESKD patients (n = 29) and healthy controls (no ESKD, n = 10). PBMCs were isolated from whole blood and seeded into assay plates to detect changes in oxidative phosphorylation and glycolysis. The bioenergetics analysis (i.e., mitochondrial stress test) was performed using Seahorse XFe24 flux analyzer. We observed significant reduction in mitochondrial respiration in patient PBMCs in terms of fundamental bioenergetics parameters such as basal respiration, ATP turnover, maximal respiration and spare respiratory capacity. These findings were correlated with the expression levels of proteins coordinating cellular energy status and regulating mitochondrial dynamics. Our data demonstrates an association between mitochondrial oxygen consumption of PBMCs and ESKD. AMPK activity, its downstream effector PGC-1α and mitochondrial fission/fusion proteins are partially responsible for the decrease in oxidative phosphorylation of PBMCs isolated from ESKD patients. We propose a link between mitochondrial dysfunction and ESKD and a role for mitochondria as a potential site for therapeutic interventions.
Published: 2021

30. Astrocytic outer retinal layer thinning is not a feature in AQP4-IgG seropositive neuromyelitis optica spectrum disorders

Author: Maria Isabel Leite, Letizia Leocani, Jérôme De Seze, Denis Bernardi Bichuetti, Ibis Soto de Castillo, Sasitorn Siritho, Alvaro Cobo-Calvo, Elena H. Martinez-Lapiscina, Anitha D'Cunha, Adriana Roca-Fernandez, Jacqueline Palace, Orhan Aktas, Marco Aurélio Lana-Peixoto, Marco Pisa, Michael R. Yeaman, Anu Jacob, Mariana Andrade Fontenelle, Friedemann Paul, Ari J. Green, Yang Mao-Draayer, Eugene F May, Claudia Chien, Alireza Dehghani, Ivan Maynart Tavares, Lawrence J. Cook, Angelo Lu, Su-Kyung Jung, Rengin Yildirim, Ayse Altintas, Mohsen Pourazizi, Ho Jin Kim, Rahele Kafieh, Caryl Tongco, Lekha Pandit, Hadas Stiebel-Kalish, Romain Marignier, Fereshteh Ashtari, Hanna Zimmermann, Joachim Havla, M. Radaelli, Svenja Specovius, Frederike C. Oertel, Kerstin Soelberg, Srilakshmi M Sharma, Axel Petzold, Seyedamirhosein Motamedi, Zoe Rimler, Saif Huda, Philipp Albrecht, Alexander U. Brandt, Jae-Won Hyun, Allyson Reid, Marius Ringelstein, Uygur Tanriverdi, Terry J. Smith, Thomas Senger, Nasrin Asgari, Charlotte Bereuter, Altıntaş, Ayşe (ORCID 0000-0002-8524-5087 & YÖK ID 11611), Lu, A., Zimmermann, HG., Specovius, S., Motamedi, S., Chien, C., Bereuter, C., Lana-Peixoto, MA., Fontenelle, MA., Ashtari, F., Kafieh, R., Dehghani, A., Pourazizi, M., Pandit, L., D Cunha, A., Kim, HJ., Hyun, JW., Jung, SK., Leocani, L., Pisa, M., Radaelli, M., Siritho, S., May, E.F., Tongco, C., De Sèze, J., Senger, T., Palace, J., Roca-Fernández, A., Leite, MI., Sharma, SM., Stiebel-Kalish, H., Asgari, N., Soelberg, K.K., Martinez-Lapiscina, EH., Havla, J., Mao-Draayer, Y., Rimler, Z., Reid, A., Marignier, R., Cobo-Calvo, A., Tanriverdi, U., Yildirim, R., Aktas, O., Ringelstein, M., Albrecht, P., Tavares, IM., Bichuetti, DB., Jacob, A., Huda, S., Soto de Castillo, I., Petzold, A., Green, AJ., Yeaman, MR., Smith, TJ., Cook, L., Paul, F., Brandt, AU., Oertel, FC., GJCF International Clinical Consortium for NMOSD., Koç University Research Center for Translational Medicine (KUTTAM) / Koç Üniversitesi Translasyonel Tıp Araştırma Merkezi (KUTTAM), School of Medicine, Neurology, Ophthalmology, APH - Mental Health, APH - Methodology, and Amsterdam Neuroscience - Neuroinfection & -inflammation
Subjects: Adult, Male, medicine.medical_specialty, genetic structures, Vision, Clinical neurology, Ophthalmology, Outer plexiform layer, Retina, chemistry.chemical_compound, medicine, Humans, In patient, Optic neuritis, Outer nuclear layer, Autoantibodies, Aquaporin 4, business.industry, Neuromyelitis Optica, Retinal, Middle Aged, medicine.disease, eye diseases, Neurosciences and neurology, Psychiatry, Surgery, Psychiatry and Mental health, medicine.anatomical_structure, Retinal dysfunction, Cross-Sectional Studies, chemistry, Neuromyelitis Optica Spectrum Disorders, Astrocytes, Female, Neurology (clinical), sense organs, business, Function and Dysfunction of the Nervous System, Axonal degeneration, Tomography, Optical Coherence
Abstract: Background: patients with anti-aquaporin-4 antibody seropositive (AQP4-IgG+) neuromyelitis optica spectrum disorders (NMOSDs) frequently suffer from optic neuritis (ON) leading to severe retinal neuroaxonal damage. Further, the relationship of this retinal damage to a primary astrocytopathy in NMOSD is uncertain. Primary astrocytopathy has been suggested to cause ON-independent retinal damage and contribute to changes particularly in the outer plexiform layer (OPL) and outer nuclear layer (ONL), as reported in some earlier studies. However, these were limited in their sample size and contradictory as to the localisation. This study assesses outer retinal layer changes using optical coherence tomography (OCT) in a multicentre cross-sectional cohort. Method: 197 patients who were AQP4-IgG+ and 32 myelin-oligodendrocyte-glycoprotein antibody seropositive (MOG-IgG+) patients were enrolled in this study along with 75 healthy controls. Participants underwent neurological examination and OCT with central postprocessing conducted at a single site. Results: no significant thinning of OPL (25.02 +/- 2.03 mu m) or ONL (61.63 +/- 7.04 mu m) were observed in patients who were AQP4-IgG+ compared with patients who were MOG-IgG+ with comparable neuroaxonal damage (OPL: 25.10 +/- 2.00 mu m; ONL: 64.71 +/- 7.87 mu m) or healthy controls (OPL: 24.58 +/- 1.64 mu m; ONL: 63.59 +/- 5.78 mu m). Eyes of patients who were AQP4-IgG+ (19.84 +/- 5.09 mu m, p=0.027) and MOG-IgG+ (19.82 +/- 4.78 mu m, p=0.004) with a history of ON showed parafoveal OPL thinning compared with healthy controls (20.99 +/- 5.14 mu m); this was not observed elsewhere. Conclusion: the results suggest that outer retinal layer loss is not a consistent component of retinal astrocytic damage in AQP4-IgG+ NMOSD. Longitudinal studies are necessary to determine if OPL and ONL are damaged in late disease due to retrograde trans-synaptic axonal degeneration and whether outer retinal dysfunction occurs despite any measurable structural correlates., Guthy Jackson Charitable Foundation (GJCF); German Research Foundation (DFG)
Published: 2021

31. Outcome of patients admitted to intensive care units due to influenza-related severe acute respiratory illness in 2017-2018 flu season: A multicenter study from Turkey

Author: Aykan Gulleroglu, Defne Altintas, Hülya Sungurtekin, Gülbin Aygencel, Serdar Akpinar, Arzu Topeli, Burcu Arpinar, Ebru Ortaç Ersoy, Kazim Rollas, Fatma Ciftci, Feza Bacakoglu, Berrin Er, Bilgin Comert, Sema Turan, Kezban Özmen Süner, and Ege Üniversitesi
Subjects: Male, Turkey, medicine.medical_treatment, retrospective study, very elderly, hematologic disease, mortality rate, Respiratory failure, intensive care unit, Turkey (republic), law.invention, law, Risk Factors, middle aged, Hospital Mortality, Aged, 80 and over, Respiratory Distress Syndrome, Acute respiratory distress syndrome, Mortality rate, adult, Acute kidney injury, artificial ventilation, clinical trial, Acute Kidney Injury, Intensive care unit, hospital bed capacity, nasopharyngeal swab, Hospitalization, aged, Intensive Care Units, female, priority journal, risk factor, Hematologic Neoplasms, Mortality, young adult, epidemiology, influenza, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Critically ill, Influenza viruses, complication, severe acute respiratory syndrome, Article, acute kidney failure, invasive ventilation, turkey (bird), Intensive care, Influenza, Human, medicine, Flu season, Humans, human, Retrospective Studies, Mechanical ventilation, business.industry, aging, disease association, Outbreak, medicine.disease, major clinical study, Respiration, Artificial, hospital admission, multicenter study, Emergency medicine, treatment outcome, hematologic malignancy, business
Abstract: Background: Influenza can cause severe acute respiratory illness (SARI), which occurs as local outbreaks or seasonal epidemics with high intensive care unit (ICU) admission and mortality rates. Mortality is mainly due to SARI. Objective: The aim of this study was to evaluate the outcome of patients admitted to ICU due to influenza-related SARI in 2017–2018 flu season in Turkey. Methods: A retrospective multicenter study was conducted in 13 ICUs with a total of 216 beds from 6 cities in Turkey. All adult patients (over 18 years) admitted to the ICUs in 2017–2018 flu season (between September 1, 2017, and April 30, 2018) because of SARI and with a positive nasopharyngeal swab for influenza were included in the study. Results: A total of 123 cases were included in the study. The mean age of patients was 64.5 ± 17.5 years, and 66 (53.7%) patients were older than 65 years. The ICU mortality was 33.9%, and hospital mortality was 35.6%. Invasive mechanical ventilation (IMV), acute kidney injury (AKI), hematologic malignancy, and >65 years of age were the factors affecting mortality in influenza. Conclusion: SARI due to influenza carries a high mortality rate, and IMV, AKI, presence of hematologic malignancy, and older age are independent risk factors for mortality.
Published: 2021

32. The Turkish experience of COVID-19 infection in people with NMOSD and MOGAD: a milder course?

Author: Sibel Canbaz Kabay, Murat Kürtüncü, Sedat Sen, Pinar Acar, Haluk Gümüş, Murat Terzi, Dilcan Kotan, Özden Kamışlı, Ipek Gungor Dogan, Aksel Siva, Sami Omerhoca, Yusuf Tamam, Serkan Demir, Gokhan Arslan, Destan Bunul, Ahmet Kasim Kilic, Semra Mungan, Tuncay Gündüz, Belgin Petek Balci, Husnu Efendi, Melih Tutuncu, Ugur Uygunoglu, Yeşim Beckmann, Sibel Güler, Levent Sinan Bir, Serhan Sevim, Ömer Faruk Turan, Özgül Ekmekci, Mesrure Koseoglu, Rana Karabudak, Nur Yüceyar, Meltem Demirkiran, Cavid Baba, Serkan Ozakbas, Ayse Altintas, Cihat Uzunköprü, Aslı Tuncer, Altıntaş, Ayşe (ORCID 0000-0002-8524-5087 & YÖK ID 11611), Şen, S., Tuncer, A., Özakbaş, S., Uzunköprü, C., Baba, C., Demir, S., Beckmann, Y., Gümüş, H., Arslan, G., Kılıç, A.K., Yüceyar, N., Turan, O.F., Tütüncü, M., Terzi, M., Acar, P., Bünül, S.D., Balcı, B.P., Bir, L.S., Köseoğlu, M., Mungan, S., Gündüz, T., Doğan, I.G., Kotan, D., Uygunoğlu, U., Ekmekçi, O., Demirkiran, M., Kamışlı O., Kabay, S.C., Tamam, Y., Ömerhoca, S., Sevim, S., Güler, S., Kürtüncü, M., Efendi, H., Karabudak, R., Şiva A., and School of Medicine
Subjects: clinical outcome, serology, Disease, myelin oligodendrocyte glycoprotein, myelooptic neuropathy, rituximab, experience, Medicine, azathioprine, biology, Medicine, general and internal, adult, Neuromyelitis Optica, General Medicine, cohort analysis, comorbidity, female, risk factor, Neurology, Comorbid disease, Myelin oligodendrocyte glycoprotein antibody-associated disorders, disease severity, hospitalization, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Coronavirus, Disease modifying treatment, Neuromyelitis optica spectrum disorders, SARS-CoV-2, complication, protein deficiency, Article, Myelin oligodendrocyte glycoprotein, coronavirus disease 2019, male, Disease severity, death, myelin oligodendrocyte glycoprotein antibody associated disorder, Internal medicine, Humans, controlled study, human, Autoantibodies, Aquaporin 4, business.industry, Multiple sclerosis, disease association, COVID-19, medical information, medicine.disease, major clinical study, clinical feature, age, exposure, Neuromyelitis Optica Spectrum Disorders, biology.protein, Myelin-Oligodendrocyte Glycoprotein, Neurology (clinical), disease duration, business, autoantibody
Abstract: Background: COVID-19 is a multisystemic infection with variables consequences depending on individual and comorbid conditions. The course and outcomes of COVID-19 during neuromyelitis optica spectrum disorders (NMOSD) and myelin oligodendrocyte glycoprotein antibody-associated disorders (MOGAD) are not clearly known. Objective methods: the aim of this study was to examine the features and outcomes of COVID-19 infection in NMOSD and MOGAD patients. The patients' demographic and clinical factors, disease modifying treatment (DMT) used and disease information of COVID-19 infection were recorded. Conditions leading to hospitalization and severe exposure to COVID-19 infection were also analyzed. Results: the study included 63 patients from 25 centers. Thirty-two patients (50.8%) belong to AQP-4 seropositive group, 13 (20.6%) and 18 (28.6%) were in MOG-positive and double-seronegative groups, respectively. Risk factors for severe COVID-19 infection and hospitalization were advanced age, high disability level and the presence of comorbid disease. Disease severity was found to be high in double-seronegative NMOSD and low in MOGAD patients. No statistically significant effect of DMTs on disease severity and hospitalization was found. Conclusion: in NMOSD and MOGAD patients, advanced age, high disability and presence of comorbid disease pose risks for severe COVID-19 infection. There was no direct significant effect of DMTs for COVID-19 infection., NA
Published: 2021

33. Predictors of survival in turkish patients with primary glioblastoma

Author: Suleyman Altintas, Yurdal Gezercan, Emre Bilgin, Berna Bozkurt Duman, Timuçin Çil, and Ali İhsan Ökten
Subjects: Adult, Male, Oncology, Turkish population, medicine.medical_specialty, Methyltransferase, Multivariate analysis, Turkey, Young Adult, Internal medicine, Antineoplastic Combined Chemotherapy Protocols, medicine, Humans, Progression-free survival, DNA Modification Methylases, neoplasms, Pathological, Survival analysis, Aged, Retrospective Studies, Aged, 80 and over, Brain Neoplasms, business.industry, Tumor Suppressor Proteins, DNA Methylation, Middle Aged, Prognosis, Survival Analysis, Isocitrate Dehydrogenase, DNA Repair Enzymes, Treatment Outcome, Isocitrate dehydrogenase, Mutation, Immunohistochemistry, Female, Surgery, Neurology (clinical), Glioblastoma, business
Abstract: Aim An increasing number of biomarkers of primary glioblastoma (GBM) have recently been described. We aimed to investigate the biological and clinical factors that affect survival in Turkish patients with primary GBM. Material and methods The clinical and demographic data of all patients with primary GBM diagnosed between 2007 and 2016 were evaluated. In all the patients' pathological specimens, O6 methylguanine-DNA methyltransferase (MGMT) methylation and isocitrate dehydrogenase (IDH) 1 mutation were detected retrospectively by immunohistochemistry. Kaplan-Meier survival analysis, log-rank test, and multivariate analyses of the Cox hazard proportional model for all the variables were performed using the SPSS statistical package. The treatment details and other patient-related factors were identified, and their correlations were analyzed. Results We enrolled 137 primary GBM patients to the study. Median progression free survival (PFS) was 8.57 months (95% CI: 6.8-9.5) and median overall survival (OS) was 12 months (95 % CI: 10.8-13.3). IDH-1 mutations were detected in 21 primary GBMs (15.3%). PFS was 15.43 ± 1.95 months. Survival rates were higher, but no statistically significant difference (p: 0.074). MGMT methylation was detected in 40 primary GBMs (29.2%). OS and PFS of MGMT (+) cases were higher than MGMT(-)cases (p: 0.001; p: 0.001 respectively). Ki67 (%) measurement (10%-90%) average is 32.64 ± 16.56.No statistically significant between higher and lower ki67 levels (p : 0.510, p: 0.505 respectively). KPS(%) more than 70 at the time of diagnosis statistically significant longer median OS and PFS (p: 0.001) .PFS and OS were higher in all treatment modalities. Conclusion The most important factors that affected survival were performance score, MGMT methylation status, systemic oncologic therapy, and IDH mutation in the Turkish population with primary GBM. We demonstrated that MGMT methylation and higher KPS levels were associated with significiantly longer OS and PFS.
Published: 2021

34. Clinical Outcomes and Independent Risk Factors for 90-Day Mortality in Critically Ill Patients with Respiratory Failure Infected with SARS-CoV-2: A Multicenter Study in Turkish Intensive Care Units

Author: Deniz Aral Ozbek, Pervin Hancı, Recep Civan Yüksel, Seda Yilmaz, Begüm Ergan, Gulseren Elay, Asli Acikgoz, Avşar Zerman, Mehmet Çağatay Gürkök, Yeliz Bilir, Ebru Ortaç Ersoy, Taha Koray Sahin, Arzu Topeli, Kamil Inci, Murat Sungur, Sema Sarı, Ezgi Ozyilmaz, Emre Aydin, Tugce Mengi, Meltem Simsek, Irem Akin Sen, Burcu Acar Cinleti, Jülide Ergil, Göksel Güven, Ibrahim Hakki Tor, Ramazan Ulu, Kursat Gundogan, Müge Aydoğdu, Ayca Gumus, Jale Bengi Celik, Ali Ümit Esbah, Zuhal Gullu, Nazire Ates Ayhan, Neriman Defne Altintas, Burcin Halacli, Ferhan Demirer Aydemir, Cenk Kıraklı, Leyla Talan, Iskender Kara, Ummu Gulsum Yuksel, Melda Turkoglu, Ahmet Firat, Fatma Yıldırım, Bilgin Comert, Türkay Akbaş, Nuri Tutar, Kemal Tolga Saracoglu, Esma Eren, Emre Karakoc, Serpil Öcal, Şahin Temel, Ismail Hakki Akbudak, Firdevs Tugba Bozkurt, Canan Balci, [Belirlenecek], Tıp Fakültesi, Avşar Zerman / 0000-0003-0957-0766, and Ayça Gümüş / 0000-0002-4429-0949
Subjects: Adult, Male, medicine.medical_specialty, Critical Care, Turkey, Critical Illness, medicine.medical_treatment, Risk Factors, Intensive care, Internal medicine, Fluid Balance, Humans, Medicine, Survival analysis, Aged, Retrospective Studies, Aged, 80 and over, Mechanical ventilation, business.industry, Mortality rate, Cardiac arrhythmia, Retrospective cohort study, Middle Aged, Prognosis, Survival Analysis, New-York-City, Intensive Care Units, Respiratory failure, Cohort, Female, Respiratory Insufficiency, business, Covid-19, Follow-Up Studies
Abstract: Background: There are limited data on the long-term outcomes of COVID-19 from different parts of the world. Aims: To determine risk factors of 90-day mortality in critically ill patients in Turkish intensive care units (ICUs), with respiratory failure. Study design: Retrospective, observational cohort. Methods: Patients with laboratory-confirmed COVID-19 and who had been followed up in the ICUs with respiratory failure for more than 24 hours were included in the study. Their demographics, clinical characteristics, laboratory variables, treatment protocols, and survival data were recorded. Results: A total of 421 patients were included. The median age was 67 (IQR: 57-76) years, and 251 patients (59.6%) were men. The 90-day mortality rate was 55.1%. The factors independently associated with 90-day mortality were invasive mechanical ventilation (IMV) (HR 4.09 [95% CI: [2.20-7.63], P2 mmol/L (2.78 [1.93-4.01], P= 60 years (2.45 [1.48-4.06)], P= 600 mL/day (1.68 [1.21-2.34], P=.002), PaO2/FiO(2) ratio of = 1 (1.42 [1.00-2.02], P=.050). Conclusion: Long-term mortality was high in critically ill patients with COVID-19 hospitalized in intensive care units in Turkey. Invasive mechanical ventilation, lactate level, age, cardiac arrhythmia, vasopressor therapy, positive fluid balance, severe hypoxemia and ECOG score were the independent risk factors for 90-day mortality. WOS:000700853600007 2-s2.0-85115428262 PubMed: 34558415
Published: 2021

35. Abatacept as a Long-Term Targeted Therapy for LRBA Deficiency

Author: Manolya Kara, Murat Cansever, Esra Dursun, Derya Ufuk Altintas, Ahmad Al-Shaibi, Şükrü Nail Güner, Ayse Metin, Louis-Marie Charbonnier, Talal A. Chatila, Necil Kutukculer, Alisan Yildiran, Ismail Ogulur, Ercan Nain, Ayper Somer, Ayla Güven, Mustafa Yilmaz, Turkan Patiroglu, Guzide Aksu, Nourhen Agrebi, Nurhan Kasap, Hasan Kapakli, Dilek Dogruel, Metin Aydogan, Aysen Uncuoglu, Cigdem Aydogmus, Nuray Aktay Ayaz, Mujde Tuba Cogurlu, Ahmet Ozen, Ismail Reisli, Ozlem Arman Bilir, Elif Karakoc-Aydiner, Neslihan Edeer Karaca, Safa Baris, Dilek Baser, Şeyhan Kutluğ, Bernice Lo, Ayca Kiykim, Sara Sebnem Kilic, Şükrü Çekiç, Sevgi Keles, Ege Üniversitesi, Ondokuz Mayıs Üniversitesi, Kiykim, Ayca, Ogulur, Ismail, Dursun, Esra, Charbonnier, Louis Marie, Nain, Ercan, Cekic, Sukru, Dogruel, Dilek, Karaca, Neslihan Edeer, Cogurlu, Mujde Tuba, Bilir, Ozlem Arman, Cansever, Murat, Kapakli, Hasan, Baser, Dilek, Kasap, Nurhan, Kutlug, Seyhan, Altintas, Derya Ufuk, Al-Shaibi, Ahmad, Agrebi, Nourhen, Kara, Manolya, Guven, Ayla, Somer, Ayper, Aydogmus, Cigdem, Ayaz, Nuray Aktay, Metin, Ayse, Aydogan, Metin, Uncuoglu, Aysen, Patiroglu, Turkan, Yildiran, Alisan, Guner, Sukru Nail, Keles, Sevgi, Reisli, Ismail, Aksu, Guzide, Kutukculer, Necil, Kilic, Sara S., Yilmaz, Mustafa, Karakoc-Aydiner, Elif, Lo, Bernice, Ozen, Ahmet, Chatila, Talal A., Baris, Safa, Uludağ Üniversitesi/Tıp Fakültesi/Dahili Bilimler/Çocuk Sağlığı ve Hastalıkları, Çekiç, Şükrü, Kılıç, Sara Şebnem, L-1933-2017, and Çukurova Üniversitesi
Subjects: ENTEROPATHY, LPS-responsive beige-like anchor, Male, Allergy, Unclassified drug, Cytotoxicity, medicine.medical_treatment, Immune deficiency, CTLA-4 CHECKPOINT, Autoimmunity, Lipopolysaccharide responsive beige like anchor protein, Hematopoietic stem cell transplantation, medicine.disease_cause, DISEASE, Targeted therapy, 0302 clinical medicine, Lymphocyte proliferation, Controlled clinical trial, T lymphocyte, Immunology and Allergy, Disease activity, Flow cytometry, 030212 general & internal medicine, Molecular Targeted Therapy, Long term care, POLYENDOCRINOPATHY, Child, Recurrent infection, Phenotype, Treatment Outcome, Immune dysregulatıon, Immunosuppressive agent, Molecularly targeted therapy, Child, Preschool, Female, Immunosuppressive Agents, Human, medicine.drug, musculoskeletal diseases, Adult, Adolescent, Clinical article, Immunology, Drug response, Immunopathology, Tfh cell, Article, Lymphocyte subpopulation, LRBA, Abatacept, 03 medical and health sciences, Young Adult, Signal transducing adaptor protein, Immune system, Antigen, Ctla-4 checpoint, Genetics, medicine, Humans, Immune response, Child preschool, Chronic diarrhea, Disease severity, Infection sensitivity, Adaptor Proteins, Signal Transducing, MUTATIONS, business.industry, Protein deficiency, Immunologic Deficiency Syndromes, Follow up, Carrier proteins and binding proteins, Immune dysregulation, Therapy effect, Biological marker, Drug efficacy, Clinical feature, Preschool child, 030228 respiratory system, Common Variable Immunodeficiency, Immunoglobulin Deficiency, Immunosuppression, Cytopenia, Protein expression, T follicular helper cells, School child, Lrba protein, business, Controlled study
Abstract: kiykim, ayca/0000-0001-5821-3963; Baris, Safa/0000-0002-4730-9422; AGREBI, Nourhen/0000-0001-5703-9668; Ayaz, Nuray Aktay/0000-0003-3594-7387; Cekic, Sukru/0000-0002-9574-1842; Karaca, Neslihan/0000-0002-2202-7082; Kara, Emine Manolya/0000-0001-6234-7024; /0000-0002-9065-1901; Lo, Bernice/0000-0002-1087-6845, WOS: 000495746100038, PubMed: 31238161, BACKGROUND: LPS-responsive beige-like anchor (LRBA) deficiency presents with susceptibility to infections, autoimmunity, and lymphoproliferation. the long-term efficacy of cytotoxic T-lymphocyte-associated antigen 4-immunoglobulin (abatacept) as targeted therapy for its immune dysregulatory features remains to be established. OBJECTIVE: To determine the clinical and immunologic features of LRBA deficiency and long-term efficacy of abatacept treatment in controlling the different disease manifestations. METHODS: Twenty-two LRBA-deficient patients were recruited from different immunology centers and followed prospectively. Eighteen patients on abatacept were evaluated every 3 months for long-term clinical and immunologic responses. LRBA expression, lymphocyte subpopulations, and circulating T follicular helper cells were determined by flow cytometry. RESULTS: the mean age of the patients was 13.4 +/- 7.9 years, and the follow-up period was 3.4 +/- 2.3 years. Recurrent infections (n = 19 [86.4%]), immune dysregulation (n = 18 [81.8%]), and lymphoproliferation (n = 16 [72.7%]) were common clinical features. the long-term benefits of abatacept in 16 patients were demonstrated by complete control of lymphoproliferation and chronic diarrhea followed by immune dysregulation, most notably autoimmune cytopenias. Weekly or every other week administration of abatacept gave better disease control compared with every 4 weeks. There were no serious side effects related to the abatacept therapy. Circulating T follicular helper cell frequencies were found to be a reliable biomarker of disease activity, which decreased on abatacept therapy in most subjects. However, high circulating T follicular helper cell frequencies persisted in 2 patients who had a more severe disease phenotype that was relatively resistant to abatacept therapy. CONCLUSIONS: Long-term abatacept therapy is effective in most patients with LRBA deficiency. (C) 2019 American Academy of Allergy, Asthma & Immunology, Scientific and Technological Research Council of TurkeyTurkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) [217S847]; National Institutes of HealthUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USA [5R01AI085090]; NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASESUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute of Allergy & Infectious Diseases (NIAID) [R01AI085090, R01AI085090, R01AI065617, R01AI065617, R01AI085090, R01AI085090, R01AI065617, R01AI065617] Funding Source: NIH RePORTER, This work was supported by grants from the Scientific and Technological Research Council of Turkey (grant no. 217S847 to S.B.) and the National Institutes of Health (grant no. 5R01AI085090 to T.A.C.).
Published: 2019

36. Extracranial Metastasis of IDH-1 Wild Type Glioblastomas

Author: Gökhan Çavuş, Berna Bozkurt Duman, Ismail Istemen, Suleyman Altintas, Ali İhsan Ökten, Emre Bilgin, and Vedat Acik
Subjects: Oncology, Adult, Male, medicine.medical_specialty, Adolescent, medicine.medical_treatment, Brain tumor, Young Adult, Internal medicine, medicine, Humans, Stage (cooking), Child, Survival rate, Aged, Retrospective Studies, Aged, 80 and over, Spinal Neoplasms, business.industry, Brain Neoplasms, Incidence (epidemiology), Not Otherwise Specified, Middle Aged, medicine.disease, Prognosis, Isocitrate Dehydrogenase, Radiation therapy, Isocitrate dehydrogenase, Child, Preschool, Mutation, Immunohistochemistry, Surgery, Female, Neurology (clinical), business, Glioblastoma
Abstract: Aim Glioblastomas are the most common malignant brain tumors. Although they are highly infiltrative tumors, they rarely metastasize extracranially. Therefore, this study aimed to identify effects of different immunohistochemical features of glioblastoma seldom observed in spinal metastases based on the metastatic spread and survival rate. Material and methods A total of 214 patients who were diagnosed with and operated for brain tumor in our clinic between 2007 and 2018 and pathologically diagnosed with glioblastoma were retrospectively evaluated. Among them, 141 medical records were reviewed, and 23 of them underwent spinal magnetic rezonance imaging postoperatively due to various complaints. Results All patients with glioblastoma with spinal metastases had negative isocitrate dehydrogenase 1 in the immunohistochemical examination. The incidence of spinal metastasis is 1.91%. The median KI-67 index is 30 (range, 4-90; median KI-67 index: 30+/-18.5). Isocitrate dehydrogenase mutation is wild in 55%, mutant in 33%, and not otherwise specified in 12%. Four patients with spinal metastasis has wild-type IDH with mean KI-67 index of 60, and one of them was a woman (25%) and the remaining three were men (%75), with mean age of 32 years. Conclusion Gliomas with high immunohistochemical proliferation indexes and wild-type isocitrate dehydrogenase with poor prognostic features based on the new classification tended to metastasize to the spine in the early disease stage; therefore, early spinal scanning and radiation therapy might extend the life expectancy. High KI-67 index and the presence of wild-type isocitrate dehydrogenase may be the predictive factors for spinal screening.
Published: 2020

37. Benefits of eculizumab in AQP4+ neuromyelitis optica spectrum disorder: Subgroup analyses of the randomized controlled phase 3 PREVENT trial

Author: Jacqueline Palace, Dean M. Wingerchuk, Kazuo Fujihara, Achim Berthele, Celia Oreja-Guevara, Ho Jin Kim, Ichiro Nakashima, Michael Levy, Murat Terzi, Natalia Totolyan, Shanthi Viswanathan, Kai-Chen Wang, Amy Pace, Marcus Yountz, Larisa Miller, Róisín Armstrong, Sean Pittock, Daniel Julio Muñoz, Jorge David Amor, Carolina Bocchiardo, Julieta Iourno Danielle, Alfredo Laffue, Carolina Daniela Diaz Obregon, Maria Fernanda Paez, Roberto Martin Perez, Viviana Ana Maria Rocchi, Loreley Deborah Teijeiro, Jesica Gómez, Andres Maria Villa, Florencia Aguirre, Victoria Carla Fernández, Ramon F. Goicoechea, Luciana Melamud, Ana Stillman, Mariana de Virgiliis, Fatima Pagani Cassara, Marta Cordoba, Maria Teresa Gutierrez, Mariana Ingolotti, Natalia Larripa, Anahi Lupinacci, Josefina Arroyo, Alejandra Romano, Mariana Foa Torres, Carlos Héctor Ballario, Ana Elisa Chiesa, Hernán Gustavo Gómez, Hernán Gabriel Lattini, Carolina Natalia Mainella, Gisel Edith Bolner, María Soledad Eschoyez, Simon Andrew Broadley, Saman Heshmat, Arman Sabet, Andrew Swayne, Susan Freeman, Sofia Jimenez Sanchez, Neil Shuey, Linda Dalic, Ann French, Guru Kuma, Joshua Laing, Lai Yin Law, Jennifer MacIntyre, Andrew Neal, Christopher Plummer, Prashanth Ramachandran, Leslie Sedal, Ian Wilson, Antony Winkel, Wenwen Zhang, Tina Chen, Rani Watts, Michael Barnett, Joshua Barton, Heidi Beadnall, Justin Garber, Todd Andrew Hardy, Benjamin Trewin, Marinda Taha, Deleni Walters, Federico Arturo Silva Sieger, Nhora Patricia Ruiz Alfonso, Anna Maria Pinzon Camacho, Alexander Pabón Moreno, Jorge Armando Castellanos Prad, Adriana Paola Duarte Rueda, Tatiana Castillo, Karol Melissa Castillo Gonzalez, Martha Yolanda Moreno Pico, Judith Castill, Mario Habek, Ivan Adamec, Barbara Barun, Luka Crnosija, Tereza Gabelic, Petra Nytrova, Eva Krasulova, Jana Pavlickova, Michaela Tyblova, Jana Zubkova, Thor Petersen, Gro Helen Dale, Peter Vestergaard Rasmussen, Morten Stilund, Kristina Bacher Svendsen, Vivi Brandt, Nicolas Collongues, Marie-Celine Fleury, Laurent Kremer, Sandrine Bendele, Valérie Neff, Ricarda Diem, Michael Platten, Anne Berberich, Jonabelle Jansen, Hannah Jaschoneck, Brigitte Wildemann, Ursula Aures, Tanja Brandenburger, Tanja Haut, Maria-Lourdes Treceno Fernández, Lilian Aly, Kirsten Brinkhoff, Dorothea Buck, Daniel Golkowski, Mirjam Hermisson, Muna-Miriam Hoshi, Miriam Kaminski, Markus Christian Kowarik, Helena Kronsbein, Klaus Lehmann-Horn, Viola Maria Pongratz, Andreas Schweiker, Lisa-Ann Leddy, Silvia Mueller, Kim Obergfell, Marion Wanka, Uwe Klaus Zettl, Jan Klinke, Micha Loebermann, Stefanie Meister, Florian Rimmele, Alexander Winkelmann, Ina Schroeder, Alexander Yuk-Lun Lau, Lisa Wing-Chi Au, Florence Sin-Ying Fan, Vincent Hing-Lung Ip, Karen Ka-Yan Ma, Sze-Ho Ma, Vincent Chung-Tong Mok, Cheryl Chung-Kwan Au, Pauline Wing-Lam Kwan, Francesco Patti, Andrea Salvatore Caramma, Clara Grazia Chisari, Salvatore Lo Fermo, Silvia Messina, Maria Projetto, Cinzia Caserta, Alessandro Filla, Teresa Costabile, Chiara Pane, Francesco Sacca, Angela Marsili, Giorgia Puorro, Roberto Bergamaschi, Eliana Berra, Giulia Mallucci, Cinzia Fattore, Claudio Gasperini, Simonetta Galgani, Shalom Haggiag, Serena Ruggieri, Claudio Vento, Esmeralda Maria Quartuccio, Carlo Pozzilli, Valeria Teresa Barletta, Giovanna Borriello, Laura De Giglio, Fabiana Marinelli, Miriam Tasillo, Alessandra Amadori, Mariano Fischetti, Flavia Gurreri, Masahiro Mori, Hiroki Masuda, Ryohei Ohtani, Yukari Sekiguchi, Tomohiko Uchida, Akiyuki Uzawa, Hiromi Ito, Emi Kabasawa, Yoko Kaneko, Takuya Matsushita, Dai Matsuse, Hiroyuki Murai, Shintaro Hayashi, Katsuhisa Masak, Hidenori Ogata, Koji Shinoda, Taira Uehara, Mitsuru Watanabe, Hiroo Yamaguchi, Ryo Yamasaki, Tomomi Yonekawa, Maki Jingu, Makiko Nagano, Yumiko Nakamura, Yoshiko Sano, Manabu Araki, Youwei Lin, Madoka Mori, Yohei Mukai, Terunori Sano, Wakiro Sato, Naoya Gogun, Yuriko Maeda, Asami Nishimoto, Sachiko Tsukamoto, Ritsuko Yanagi, Takahiko Saida, Shinichi Nakamura, Tetsuya Nasu, Kyoko Saida, Yuko Shikata, Yoshimi Kodani, Megumi Saeki, Yukako Sawada, Hiroo Yoshikawa, Takashi Kimura, Masamitsu Nishi, Shun Sakamoto, Shinichiro Ukon, Shohei Watanabe, Saori Ebisuya, Nami Kimura, Manami Matsuura, Yukie Morisaki, Yoshiko Muroi, Kuniko Onishi, Ikuko Oshima, Yuki Washino, Tomomi Yamashita, Tatsuro Misu, Kimihiko Kaneko, Masaaki Kato, Hiroshi Kuroda, Kazuhiro Kurosawa, Shuhei Nishiyama, Hirohiko Ono, Yoshiki Takai, Keiko Abe, Hitomi Hoshi, Mari Jinushi, Azusa Oyama, Motonari Sakuma, Yuko Sawada, Satoru Ishibashi, Takanori Yokota, Yoichiro Nishida, Kokoro Ozaki, Nobuo Sanjo, Nozomu Sato, Fuki Denno, Haruko Hiraki, Yumi Matsubara, Takashi Kanda, Masaaki Abe, Masaya Honda, Motoharu Kawai, Michiaki Koga, Toshihiko Maeda, Junichi Ogasawara, Masatoshi Omoto, Yasuteru Sano, Ryota Sato, Fumitaka Shimizu, Hideki Arima, Sachie Fukui, Yoshiko Ishikawa, Tomoko Koyama, Shigemi Shimose, Hirokazu Shinozaki, Masanori Watanabe, Sachi Yasuda, Chieko Yoshiwaka, Suffian Adenan, Mohd Azman M Aris, Ahmad Shahir bin Mawardi, Muhammad Al Hafiz Adnan, Nanthini Munusamy, Siti Nur Omaira Razali, Punitha Somasundram, Jae Won Hyun, In Hye Jeong, Su-Hyun Kim, Hyun-June Shin, Ji Sung Yoo, HyunMin Jang, AeRan Joung, Byung-Jo Kim, Seol-Hee Baek, Jung Bin Kim, Yoo Hwan Kim, Yong Seo Koo, Chan Nyoung Lee, Hung Youl Seok, Jinhee Hwang, Sung Min Kim, So Hyun Ahn, Kyomin Choi, Seok-Jin Choi, Jun-Soon Kim, Young Nam Kwon, Je-Young Shin, Hyeonju Kwon, Byoung Joon Kim, Eun Bin Cho, Hye-Jin Cho, Misong Choi, DongSun Kim, Ju Hyeon Kim, SeungJu Ki, Hye Lim Lee, Kwang-Ho Lee, Ju-Hong Min, Ji-Hyung Park, Jinmyoung Seok, Eunhwa Choi, Sang Ae Park, Seung Min Kim, Ha-Neul Jeong, Bong Jeongbin, Jin Woo Jung, Seung Woo Kim, Yool-hee Kim, Hyung Seok Lee, Ha Young Shin, Yeon Jung, Min Jung Kim, Nou Ri Lee, MiJu Shin, Farit A Khabirov, Lyudmila Averyanova, Natalya Babicheva, Eugenii Granatov, Sergey Kazarov, Timur Khaybullin, Alexander Rogozhin, Dmitry V Pokhabov, Vladislav Abramov, Anastasia Amelina, Yulia Nesteroca, Tatyana Bozhenkina, Aleksey N Boyko, Elena G Demyan, Inessa Khoroshilova, Mikhail Melnikov, Ekaterina V Popova, Svetlana N Sharanova, Sergey G Shchur, Denis V Sazonov, Larisa Babenko, Elena Bayandina, Asya Yarmoschuk, Victor A Baliazin, Elena Baliazina, Elena Budaeva, Irina Chernikova, Zoya Goncharova, Vladimir Krasnov, Marina Myatleva, Olga V. Rodionova, Iuliana Samulyzhko, Alla A. Timofeeva, Sabas Boyero Duran, Maria Mar Mendibe Bilbao, Irene Diaz Cuervo, Jose Maria Losada Domingo, Amaia Gonzalez Eizaguirre, Jose Eulalio Barcena Llona, Roberto Valverde Moyano, Carmen Bahamonde, Fernando Sanchez Lopez, Raquel Pinar Morales, Eduardo Agüera Morales, Carmen Bahamonde Roman, Juan Jose Ochoa Sepulveda, Maria del Carmen Blanco Valero, Nazaret Pelaez Viña, Cristina Conde Gavilan, Ana Maria Jover Sanchez, Sara Vila Bedmar, Nuria Gonzalez Garcia, Aida Orviz Garcia, Ines Gonzalez-Suarez, Elena Miñano Guillamon, Miguel Kawiorski, Elena Guerra Schulz, Alba Garcia Alonso, Francisco Jesus Lopez Perez, Marta Palacios Sarmiento, Guillermo Izquierdo Ayuso, Guillermo Navarro Mascarell, Cristina Paramo Camino, Asuncion Varas Garcia, Yaiza Montserrat Mendoza, Veronica Ines Vargas Muñoz, Patricia Torres Tonda, Ching-Piao Tsai, Jiu-Haw Yin, Mei-Jung Chen, Shan-Ni Li, Fei-Ti Wang, Suwat Srisuwannanukorn, Thanatat Boonmongkol, Duangporn Borisutbuathip, Duangkamol Singwicha, Krittika Siritanan, Chidchanoke Thearapati, Kwanmuang Sornda, Metha Apiwattanakul, Saharat Aungsumart, Narupat Suanprasert, Kaona Suksuchano, Nittaya Parkinsee, Kongkiat Kulkantrakorn, Praween Lolekha, Artit Potigumjon, Puchit Sukphulloprat, Dararat Suksasunee, Chankawee Komaratat, Sunattana Luangtong, Arkhom Arayawichanont, Phanpaphon Konpan, Nathapol Riablershirun, Thaddao Wiroteurairuang, Panadda Jantaweesirirat, Aslı Kurne, Irem Erkent, Ebru Bekircan Kurt, Ezgi Saylam, Yagmur Caliskan, Gulsah Orsel, Yahya Celik, Canan Celebi, Aslan Tekatas, Tugce Banbal, Gulsen Akman Demir, Burcu Altunrende, Zeliha Matur, Baris Topcular, Tules Elmas, Aysenur Gulo, Selin Ozdemir, Cansu Ozkoklesen, Mahinur Ozturk, Mertkan Yanik, Elif Yildirim, Melih Tutuncu, Ayse Altintas, Abdulsamet Cam, Ayse Deniz Elmali, Sabahattin Saip, Aksel Siva, Uygur Tanrıverdi, Ugur Uygunoglu, Sinem Caliskan, Pinar Gulo, Esra Kozig, Sakine Sakiz, Ihsan Sukru Sengun, Egemen Idiman, Rahmi Tumay Ala, Duygu Arslan, Utku Bulut, Yasemin Karakaptan, Derya Kaya, Zaur Mehdiyev, Bengu Balkan, Berfu Kuku, Mujgan Ozhun, Celal Tuga, Muzeyyen Ugur, Husnu Efendi, Sena Destan Bunul, Hakan Cavus, Yunus Emre Gorke, Ayse Kutlu, Seda Ozturk, Cansu Egilmez Sarikaya, Gulsah Becerikli, Cansu Semiz, Ozlem Tun, Sehriban Ayer, Musa Kazim Onar, Mehlika Berra Ozberk, Sedat Sen, Tugce Kirbas Cavdar, Adife Veske, Cavit Boz, Didem Altiparmak, Cigdem Ozen Aydin, Sibel Gazioglu, Duygu Bekircan, Anu Jacob, Heike Arndt, Liene Elsone, Shahd Hassan Mahmoud Hamid, Daniel Hugh Whittam, Martin Wilson, Imelda O'Brien, Maria Isabel da Silva Leite, Pedro Maria Rodriguez Cruz, Damian Robert Jenkins, George Tackley, Ana Cavey, Rosie Everett, Joy Hodder, Abigail Koelewyn, Ellen Mowry, Walter Royal, Robert Shin, Christopher Bever, Daniel Harrison, Horea Rus, Wei Zheng, Karen Callison, Kerry Naunton, Benjamin M Frishberg, Andrew M Blumenfeld, Andrew Inocelda, Kalyani Korabathina, Michael Lobatz, Melissa M Mortin, Irene J Oh, Jay H Rosenberg, Mark Sadoff, Gregory A Sahagian, Anchi Wang, Yasmin Camberos, Guadalupe Sanchez, Estela Soto, Jacqueline A Nicholas, Aaron Boster, Geoffrey Eubank, Katy Groezinger, Meghan Lauf, Annette F Okai, Rashedul Hasan, Chaouki Khoury, Victoria Stokes, Stacey Clardy, Melissa Cortez, John Greenlee, John Rose, Mateo Paz Soldan, Amanda Emett, Lawanda Esquibel, Lilly Fagatele, Ka-Ho Wong, James C Stevens, Thomas M Banas, Marlene C Bultemeyer, Andrea Haller, Natalie Manalo, Keri Aeschliman, Debi Kocks, Michael Racke, Aaron Lee Boster, Michelle Bowman, Jaime Imitola, Yasushi Kisanuki, Misty Green, Stephanie Scarberry, Sharon G Lynch, Heather S Anderson, Gary S Gronseth, Nancy E Hammond, Yasir N Jassam, Manoj K Mittal, Muhammed M Nashatizadeh, Nicholas Levine, Lisa Schmidt, Jill Sibley, Vonda Whitley, James Winkley, Timothy Coleman, Gregory Cooper, Stephanie Sheffield, Keri Turner, Dana Galloway, Robert S Tillett, Geeta A Ganesh, Brian M Plato, Tad D Seifert, Diana Godwin, Deborah Lockridge, Kottil W Rammohan, William A Sheremata, Silvia Delgado, Jose Gonzalez, Alexis Lizarraga, Janice Maldonado, Melissa Ortega, Leticia Tornes, Yanet Babcock, Osmara Cailam, Yesica Campos, Irlisse Couvertier, Bettina Daneri, Jeremy Deni, Jeffrey Hernandez, Tatiana Jaramillo, Tenita Morris, Daniel Nobel, Anjelis Oliveira, Reshma Richardson, Gloria Rodriguez, Ana Romero, Carlos Sandova, Ruta Sawant, Lissett Tueros, Eric S Zetka, Chao Zheng, Daniel H Jacobs, Constance Easterling, Jennifer Fairbank, Revathi Iyengar, Mark Klafter, Justin Lindquist, Ahmed H Sadek, Elizabeth Carmona Toro, Navin Verma, Brigith Patino Castro, Nadia Sukhraj-Singh, Joseph Berger, Eric Williamson, Salim Chahin, Dina Jacobs, Clyde Markowitz, Jessica Dobbins, Lauren Mace, Maria Martin, Ashley Pinckney, Amber Roberts, Islam Zaydan, Galen W Mitchell, Rock A Heyman, Ryan L Orie, Valerie R Suski, Kerry Oddis, Darlene Punjack, Eoin Flanagan, Avi Gadoth, Andrew McKeon, W Oliver Tobin, Anastasia Zekeridou, Katie Dunlay, Jessica Sagen, Jonathan L Carter, Bachir Estephan, Brent P Goodman, Charlene R Hoffman Snyder, Andrea Francone, Irene Galasky, Martha Thomas, Pavle Repovic, James Bowen, Angeli Mayadev, Peiqing Qian, Yuriko Courtney, Lauren Lennox, Robert Thomas Naismith, Anne Haney Cross, Emily Evans, Erin E Longbrake, Megan E Orchard, Gregory F Wu, Linda Heinrich, Susan Sommers, Faria Amjad, Erika Mitchell, Carlos Mora, Bethany Schreiber, Carlo Tornatore, Alexis Carlson, Sacha McCarthy, and Alexandria Oliver
Subjects: Adult, medicine.medical_specialty, Population, Placebo, Antibodies, Monoclonal, Humanized, 03 medical and health sciences, Complement inhibitor, 0302 clinical medicine, Internal medicine, medicine, Humans, 030212 general & internal medicine, education, Aquaporin 4, education.field_of_study, Neuromyelitis optica, business.industry, Neuromyelitis Optica, General Medicine, Eculizumab, medicine.disease, Comorbidity, ddc, Neurology, Concomitant, Rituximab, Neurology (clinical), business, 030217 neurology & neurosurgery, medicine.drug
Abstract: Background Antibodies to the aquaporin-4 (AQP4) water channel in neuromyelitis optica spectrum disorder (NMOSD) are reported to trigger the complement cascade, which is implicated in astrocyte damage and subsequent neuronal injury. The PREVENT study demonstrated that the terminal complement inhibitor eculizumab reduces adjudicated relapse risk in patients with anti-AQP4 immunoglobulin G-positive (AQP4+) NMOSD. The objective of this analysis was to evaluate the efficacy of eculizumab in reducing relapse risk and its safety in AQP4+ NMOSD across clinically relevant subgroups in PREVENT. Methods In the randomized, double-blind, time-to-event, phase 3 PREVENT trial, 143 adults received eculizumab (maintenance dose, 1200 mg/2 weeks) or placebo (2:1), with stable-dose concomitant immunosuppressive therapy (IST) permitted (except rituximab and mitoxantrone). Post hoc analyses of relapses and adverse events were performed for prespecified and post hoc subgroups based on concomitant IST and prior rituximab use, demographic and disease characteristics, and autoimmune comorbidity. Results The significant reduction in relapse risk observed for eculizumab versus placebo in the overall PREVENT population was consistently maintained across subgroups based on concomitant IST and previous rituximab use, age, sex, region, race, time since clinical onset of NMOSD, historical annualized relapse rate, baseline Expanded Disability Status Scale score, and history of another autoimmune disorder. The serious infection rate was lower with eculizumab than placebo regardless of rituximab use in the previous year, concomitant IST use, or history of another autoimmune disorder. Conclusion Across a wide range of clinically relevant AQP4+ NMOSD patient subgroups in PREVENT, eculizumab therapy was consistently effective versus placebo in reducing relapse risk, with no apparent increase in serious infection rate. Trial registration NCT01892345 (ClinicalTrials.gov).
Published: 2020

38. Nutrition-Exercise Behaviors, Health Literacy Level, and Related Factors in Adolescents in Turkey

Author: Hulya Kulakci-Altintas and Sultan Ayaz-Alkaya
Subjects: Adult, Adolescent, Turkey, Health Behavior, Psychological intervention, Context (language use), Health literacy, Affect (psychology), Education, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, Intervention (counseling), Humans, 030212 general & internal medicine, Child, Exercise, Public Health, Environmental and Occupational Health, Health Literacy, Philosophy, Health promotion, Cross-Sectional Studies, Scale (social sciences), Psychology, Adolescent health, Clinical psychology
Abstract: BACKGROUND Health behaviors of adolescents affect their health and well-being into adulthood. This study was conducted to determine the nutrition-exercise behaviors, health literacy level, and related factors in adolescents. METHODS A cross-sectional design was used for this study. Overall, 810 students in grades 6-8 in a Turkish school completed the study. A personal information form, the Nutrition-Exercise Behaviors Scale, and the Health Literacy for School-Aged Children Scale were used for data collection. RESULTS According to the mean score of the Health Literacy Scale, 21% of the students had a low level of health literacy, 63.8% had a medium level, and 15.2% had a high level. A positive correlation was found between health literacy level and healthy nutrition-exercise behavior (r = 0.345, p < .001), and a positive correlation between health literacy level and meal pattern (r = 0.230, p < .001). A positive correlation (r = 0.385, p < .001) was found between meal pattern and healthy nutrition-exercise behavior. A moderate positive correlation (r = 0.510, p < .001) was found between unhealthy nutrition-exercise behavior and psychological/addicted eating behavior. CONCLUSION The present study revealed that nutrition-exercise behaviors and the health literacy of adolescents were at a moderate level and, there was a relationship between nutrition-exercise behaviors and health literacy levels in adolescents. Interventions should be planned and followed through with parents to help adolescents adopt healthy nutrition and exercise behaviors from an early age and to increase their health literacy level. In this context, it is recommended to implement training and intervention programs for adolescents and their families.
Published: 2020

39. Pericardial fat and its influence on cardiac diastolic function

Author: Casper Mihl, Sander M. J. van Kuijk, Romy J. M. Spee, Vera H. W. de Wit-Verheggen, Tineke van de Weijer, Joachim E. Wildberger, Vera B. Schrauwen-Hinderling, Bas L.J.H. Kietselaer, Sibel Altintas, Nutrition and Movement Sciences, RS: NUTRIM - R1 - Obesity, diabetes and cardiovascular health, RS: Carim - B06 Imaging, RS: Carim - H01 Clinical atrial fibrillation, MUMC+: MA Med Staf Artsass Cardiologie (9), MUMC+: MA Alg Ond Onderz Cardiologie (9), Beeldvorming, MUMC+: DA BV Medisch Specialisten Radiologie (9), MUMC+: KIO Kemta (9), Epidemiologie, RS: CAPHRI - R2 - Creating Value-Based Health Care, MUMC+: Diagnostiek en Advies (3), MUMC+: DA Beeldvorming (5), MUMC+: DA BV Research (9), MUMC+: DA BV Klinisch Fysicus (9), Cardiologie, MUMC+: MA Med Staf Spec Cardiologie (9), and MUMC+: DA BV Medisch Specialisten Nucleaire Geneesk (9)
Subjects: Male, lcsh:Diseases of the circulatory (Cardiovascular) system, Computed Tomography Angiography, Endocrinology, Diabetes and Metabolism, 030204 cardiovascular system & hematology, Chest pain, Coronary Angiography, Ventricular Function, Left, RECOMMENDATIONS, Ventricular Dysfunction, Left, Cardiac diastolic function, 0302 clinical medicine, Diastole, Risk Factors, Outpatient clinic, Original Investigation, Adiposity, Ejection fraction, ASSOCIATION, Middle Aged, Quartile, Adipose Tissue, Echocardiography, Cardiology, Female, medicine.symptom, Epicardial fat, Cardiology and Cardiovascular Medicine, Pericardium, EPICARDIAL ADIPOSE-TISSUE, Cardiac function curve, Adult, medicine.medical_specialty, 030209 endocrinology & metabolism, Risk Assessment, 03 medical and health sciences, Internal medicine, Diabetes mellitus, medicine, Humans, Angiology, Aged, Retrospective Studies, ACCUMULATION, business.industry, Pericardial fat, medicine.disease, DYSFUNCTION, Cross-Sectional Studies, lcsh:RC666-701, Asymptomatic Diseases, business
Abstract: Background Pericardial fat (PF) has been suggested to directly act on cardiomyocytes, leading to diastolic dysfunction. The aim of this study was to investigate whether a higher PF volume is associated with a lower diastolic function in healthy subjects. Methods 254 adults (40–70 years, BMI 18–35 kg/m2, normal left ventricular ejection fraction), with (a)typical chest pain (otherwise healthy) from the cardiology outpatient clinic were retrospectively included in this study. All patients underwent a coronary computed tomographic angiography for the measurement of pericardial fat volume, as well as a transthoracic echocardiography for the assessment of diastolic function parameters. To assess the independent association of PF and diastolic function parameters, multivariable linear regression analysis was performed. To maximize differences in PF volume, the group was divided in low (lowest quartile of both sexes) and high (highest quartile of both sexes) PF volume. Multivariable binary logistic analysis was used to study the associations within the groups between PF and diastolic function, adjusted for age, BMI, and sex. Results Significant associations for all four diastolic parameters with the PF volume were found after adjusting for BMI, age, and sex. In addition, subjects with high pericardial fat had a reduced left atrial volume index (p = 0.02), lower E/e (p Conclusion These findings confirm that pericardial fat volume, even in healthy subjects with normal cardiac function, is associated with diastolic function. Our results suggest that the mechanical effects of PF may limit the distensibility of the heart and thereby directly contribute to diastolic dysfunction. Trial registration NCT01671930
Published: 2020

40. Comparison of Two Different Bipolar Energy Resources in Transurethral Resection of Bladder Tumors

Author: Emre Altintas, Ali Furkan Batur, Murat Akand, Serdar Goktas, Murat Gul, Mehmet Kaynar, Zeliha Esin Celik, and Ozcan Kilic
Subjects: Adult, medicine.medical_specialty, Blood transfusion, Urology, medicine.medical_treatment, Electrosurgery, Hematocrit, Cystectomy, Resection, Electric Power Supplies, Urethra, medicine, Clinical endpoint, Humans, Single-Blind Method, Prospective Studies, Prospective cohort study, Saline, Aged, Aged, 80 and over, medicine.diagnostic_test, business.industry, Bladder Perforation, Perioperative, Middle Aged, Surgery, Treatment Outcome, Urinary Bladder Neoplasms, business
Abstract: Purpose: To determine whether the use of different bipolar resources is associated with different results on tissue and perioperative parameters in patients undergoing bipolar transurethral bladder tumor resection (bTURBT). Methods: In this single-center prospective study, patients diagnosed with bladder tumor randomized to undergo TURBT either with a Gyrus PlasmaKinetic system (n = 62) or Olympus TUR in saline (TURis) system (n = 51). Primary endpoint was to evaluate the alteration of patients’ perioperative parameters, while secondary aim was to assess the thermal effect of these 2 different bipolar devices on the resected tissue samples by a grading system determined by tissue characteristics. Results: One hundred thirteen patients were randomized in the study, and 43 were excluded from the analysis due to the exclusion criteria. There were no significant differences between the groups in terms of mean age, tumor site, number of tumors, operative time, alteration in hemoglobin or hematocrit, blood transfusion rate, catheterization time, and postoperative stay. On the other hand, the ratio of obturator jerk was significantly higher in the Olympus TURis group (p = 0.028). The histopathological analyses of both groups determined muscularis propria and cautery artifact presence without a statistically significant difference (χ2: 0.476, p = 0.788). Conclusion: Although the perioperative complications of bTURBT are low in nature, bladder perforation resulted from obturator jerk still poses a risk for extravesical tumor implantation. Urologists should be aware of this risk especially when they are using a TURis system.
Published: 2020

41. Kappa free light chains is a valid tool in the diagnostics of MS: A large multicenter study

Author: Leurs, CE, Twaalfhoven, HAM, Lissenberg-Witte, BI, van Pesch, V, Dujmovic, I, Drulovic, J, Castellazzi, M, Bellini, T, Pugliatti, M, Kuhle, J, Villar, LM, Alvarez-Cermeño, JC, Alvarez-Lafuente, R, Hegen, H, Deisenhammer, F, Walchhofer, LM, Thouvenot, E, Comabella, M, Montalban, X, Vécsei, L, Rajda, C, Galimberti, D, Scarpini, E, Altintas, A, Rejdak, K, Frederiksen, JL, Pihl-Jensen, G, Jensen, PEH, Khalil, M, Voortman, MM, Fazekas, F, Saiz, Albert, La Puma, D, Vercammen, M, Vanopdenbosch, L, Uitdehaag, BMJ, Killestein, J, Bridel, C, Teunissen, Charlotte E, Universitat Autònoma de Barcelona, UCL - SSS/IONS/CEMO - Pôle Cellulaire et moléculaire, UCL - (SLuc) Service de neurologie, Basic (bio-) Medical Sciences, Ayşe, Altıntaş, Leurs, C.E., Twaalfhoven, H.A.M., Lissenberg-Witte, B.I., van Pesch, V., Dujmovic, I., Drulovic, J., Castellazzi, M., Bellini, T., Pugliatti, M., Kuhle, J., Villar, L.M., Alvarez-Cermeño, J.C., Alvarez-Lafuente, R., Hegen, H., Deisenhammer, F., Walchhofer, L.M., Thouvenot, E., Comabella, M., Montalban, X., Vécsei, L., Rajda, C., Galimberti, D., Scarpini, E., Rejdak, K., Frederiksen, J.L., Pihl-Jensen, G., Jensen, P.E.H., Khalil, M., Voortman, M.M., Fazekas, F., Saiz, A., La Puma, D., Vercammen, M., Vanopdenbosch, L., Uitdehaag, B.M.J., Killestein, J., Bridel, C., Teunissen, C., School of Medicine, Department of Neurology, Neurology, Laboratory Medicine, Epidemiology and Data Science, APH - Methodology, Amsterdam Neuroscience - Neuroinfection & -inflammation, Academic Medical Center - Academisch Medisch Centrum [Amsterdam] (AMC), University of Amsterdam [Amsterdam] (UvA), Department of Anatomy and Neurosciences [Amsterdam, The Netherlands] (Amsterdam Neuroscience), Section Clinical Neuroanatomy [Amsterdam, The Netherlands], VU University Medical Center [Amsterdam]-VU University Medical Center [Amsterdam], Vrije Universiteit Medical Centre (VUMC), Vrije Universiteit Amsterdam [Amsterdam] (VU), Cliniques Universitaires Saint-Luc [Bruxelles], Clinical Centre of Serbia, Università degli Studi di Ferrara (UniFE), University Hospital Basel [Basel], Hospital Universitario Ramón y Cajal [Madrid], Universidad de Alcalá - University of Alcalá (UAH), Red Española de Esclerosis Múltiple (REEM), Instituto de Investigación Sanitaria del Hospital Clínico San Carlos [Madrid, Spain] (IdISSC), Department of Neurology, Medical University of Innsbruck, Service de Neurologie [CHU Nimes] (Pôle NIRR), Hôpital Universitaire Carémeau [Nîmes] (CHU Nîmes), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Centre d'Esclerosi Múltiple de Catalunya (CemCat), Vall d'Hebron University Hospital [Barcelona], Centre de résonance magnétique biologique et médicale (CRMBM), Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), University of Szeged [Szeged], Centro Dino Ferrari [Milano], Università degli Studi di Milano [Milano] (UNIMI)-Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Koç University, Medical University of Lublin, Rigshospitalet [Copenhagen], Copenhagen University Hospital, Danish Multiple Sclerosis Research Centre, Copenhagen University Hospital-Copenhagen University Hospital, Department of Neurology, Clinical Division of Neurogeriatrics, Medical University Graz, Graz 8010, Austria, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona (UB), Department of Neurology, AZ Sint Jan Brugge Oostende, Neuroscience Amsterdam, VU University Medical Centre, 1081HV 1117, Amsterdam, Amsterdam Neuroscience [Pays-Bas], and Vrije Universiteit Amsterdam [Amsterdam] (VU)-University of Amsterdam [Amsterdam] (UvA)-VU University Medical Center [Amsterdam]
Subjects: KFLC (kappa free light chain), Adult, Male, Multiple Sclerosis, Clinical Neurology, Esclerosi múltiple, CSF, CSF (cerebrospinal fluid), Immunoglobulin light chain, Sensitivity and Specificity, NO, Multiple sclerosis, Immunoglobulin kappa-Chains, 03 medical and health sciences, 0302 clinical medicine, Nuclear magnetic resonance, Immunoglobulin lambda-Chains, Humans, Medicine, Diagnostic biomarker, biomarkers, KFLC, OCB, 030304 developmental biology, 0303 health sciences, business.industry, Biochemical markers, Oligoclonal Bands, Reproducibility of Results, Middle Aged, OCB (oligoclonal IgG band), Free Light Chain, Biomarkers, Neurology, Multicenter study, Marcadors bioquímics, [SDV.IMM]Life Sciences [q-bio]/Immunology, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Female, Neurology (clinical), business, Original Research Papers, 030217 neurology & neurosurgery, Kappa
Abstract: Objective: to validate kappa free light chain (KFLC) and lambda free light chain (LFLC) indices as a diagnostic biomarker in multiple sclerosis (MS). Methods: we performed a multicenter study including 745 patients from 18 centers (219 controls and 526 clinically isolated syndrome (CIS)/MS patients) with a known oligoclonal IgG band (OCB) status. KFLC and LFLC were measured in paired cerebrospinal fluid (CSF) and serum samples. Gaussian mixture modeling was used to define a cut-off for KFLC and LFLC indexes. Results: the cut-off for the KFLC index was 6.6 (95% confidence interval (CI) = 5.2–138.1). The cut-off for the LFLC index was 6.9 (95% CI = 4.5–22.2). For CIS/MS patients, sensitivity of the KFLC index (0.88; 95% CI = 0.85–0.90) was higher than OCB (0.82; 95%CI = 0.79–0.85; p < 0.001), but specificity (0.83; 95% CI = 0.78–0.88) was lower (OCB = 0.92; 95% CI = 0.89–0.96; p < 0.001). Both sensitivity and specificity for the LFLC index were lower than OCB. Conclusion: compared with OCB, the KFLC index is more sensitive but less specific for diagnosing CIS/MS. Lacking an elevated KFLC index is more powerful for excluding MS compared with OCB but the latter is more important for ruling in a diagnosis of CIS/MS., NA
Published: 2020

42. Clinical features and accompanying findings of Pseudo-Bartter Syndrome in cystic fibrosis

Author: Sevgi Pekcan, Sevgi Bilgic Eltan, Melih Hangül, Hadice Selimoglu Sen, Ali Özdemir, Demet Can, Ozge Yilmaz, Zeynep Tamay, Mehmet Köse, Velat Şen, Haluk Cokugras, Hasan Yuksel, Ayşe Süleyman, Cem Murat Bal, Erdem Topal, Hakan Yazan, Abdurrahman Erdem Başaran, Ayse Tana Aslan, Ayşen Bingöl, Güzin Cinel, Ugur Ozcelik, Fazil Orhan, Nazan Cobanoglu, Derya Ufuk Altintas, Ebru Yalcin, Lina AlShadfan, Nural Kiper, Ayse Ayzit Kilinc, Zeynep Gökçe Gayretli Aydın, Gokcen Dilsa Tugcu, Ayşe Şenay Şaşihüseyinoğlu, Nagehan Emiralioglu, Şükrü Çekiç, Erkan Cakir, Tugba Sismanlar Eyuboglu, Ömür Ercan, Gönül Çaltepe, Deniz Dogru, Ozlem Keskin, Nihat Sapan, Tugba Ramasli Gursoy, Ondokuz Mayıs Üniversitesi, Department of Pediatric Pulmonology, Faculty of Medicine, Gazi University, Ankara, Turkey, Department of Pediatric Pulmonology, Faculty of Medicine, Hacettepe University, Ankara, Turkey, Department of Pediatric Pulmonology, Faculty of Medicine, Bezmialem Vakif University, İstanbul, Turkey, Department of Pediatric Pulmonology, Faculty of Medicine, Ankara University, Ankara, Turkey, Department of Pediatric Pulmonology, Meram Medicine Faculty, Necmettin Erbakan University, Konya, Turkey, Department of Pediatric Pulmonology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkey, Department of Pediatric Pulmonology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey, Department of Pulmonology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey, Department of Pediatric Allergy, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey, Department of Pediatric Allergy and Immunology, Faculty of Medicine, Çukurova University, Adana, Turkey, Department of Pediatric Allergy and Immunology, Faculty of Medicine, Uludag University, Bursa, Turkey, Department of Pediatric Allergy and Pulmonology, Cerrahpasa Medicine Faculty, İstanbul University, İstanbul, Turkey, Department of Pediatric Pulmonology, Allergy and Immunology, Faculty of Medicine, Akdeniz University, Antalya, Turkey, Department of Pediatric Pulmonology, Mersin City Research & Training Hospital, Mersin, Turkey, Department of Pediatric Pulmonology, Faculty of Medicine, Erciyes University, Kayseri, Turkey, Department of Pediatric Pulmonology, Ankara Children's Hematology Oncology Training and Research Hospital, Ankara, Turkey, Department of Pediatric Pulmonology, Allergy and Immunology, Faculty of Medicine, Celal Bayar University, Manisa, Turkey, Department of Pediatric Allergy, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey, Department of Pediatric Infectious Disease, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey, Department of Pediatric Allergy, Faculty of Medicine, İnonu University, Malatya, Turkey, Department of Pediatric Allergy and Immunology, İstanbul Facultyof Medicine, İstanbul University, İstanbul, Turkey, Department of Pediatric Pulmonology, Faculty of Medicine, Balıkesir University, Balıkesir, Turkey, Department of Pediatric Pulmonology, Doctor Lufti Kirdar Kartal Training and Research Hospital, ıstanbul, Turkey, Department of Pediatric Gastroenterology, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey, ÇAKIR, Erkan, Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı., Sapan, Nihat, Çekiç, Şükrü, and FUI-8766-2022
Subjects: Newborn screening, Male, Scoring system, Cystic Fibrosis, Turkey, Cystic Fibrosis Transmembrane Conductance Regulator, registry, Pediatrics, Cystic fibrosis, Turkey (republic), cystic fibrosis, Turkey (bird), Registries, Child, Priority journal, Diagnostic test, Register, Sismanlar E., Dogru D., Çakır E., Cobanoglu N., Pekcan S., Cinel G., Yalçın E., Kiper N., Sen V., Selimoglu S., et al., -Clinical features and accompanying findings of Pseudo-Bartter Syndrome in cystic fibrosis.-, Pediatric pulmonology, 2020, Bacterial colonization, Phenotype, Body mass, Child, Preschool, Female, Forced expiratory volume, Human, Adult, Pulmonary and Respiratory Medicine, Registry, medicine.medical_specialty, Current age, Adolescent, Pseudo Bartter Syndrome, Major clinical study, Bartter syndrome, Respiratory system, Article, Young Adult, Neonatal Screening, Internal medicine, Genetic screening, Genetics, medicine, Humans, In patient, Gene mutation, Disease registry, Pseudo-Bartter syndrome, business.industry, Body Weight, Infant, Newborn, Bartter Syndrome, Infant, Mean age, Alkalosis, Mutational analysis, Newborn, Nonhuman, Colonization status, medicine.disease, Body height, Clinical feature, Preschool child, Mutation, Pediatrics, Perinatology and Child Health, Pseudo-Bartter Syndrome, Comparative study, Complication, business, Controlled study
Abstract: Sismanlar Eyuboglu, Tugba/0000-0001-7284-4999; Dogru, Deniz/0000-0001-9931-9473; Aslan, Ayse Tana/0000-0002-5360-8517; COBANOGLU, NAZAN/0000-0002-3686-2927; ORHAN, FAZIL/0000-0002-4850-932X WOS: 000530442700001 PubMed: 32364312 Background Pseudo-Bartter syndrome (PBS) is a rare complication of cystic fibrosis (CF) and there are limited data in the literature about it. We aimed to compare clinical features and accompanying findings of patients with PBS in a large patient population. Methods The data were collected from the Cystic Fibrosis Registry of Turkey where 1170 CF patients were recorded in 2017. Clinical features, diagnostic test results, colonization status, complications, and genetic test results were compared in patients with and without PBS. Results Totally 1170 patients were recorded into the registry in 2017 and 120 (10%) of them had PBS. The mean age of diagnosis and current age of patients were significantly younger and newborn screening positivity was lower in patients with PBS (P < .001). There were no differences between the groups in terms of colonization status, mean z-scores of weight, height, BMI, and mean FEV1 percentage. Types of genetic mutations did not differ between the two groups. Accompanying complications were more frequent in patients without PBS. Conclusion PBS was detected as the most common complication in the registry. It could be due to warm weather conditions of our country. It is usually seen in younger ages regardless of mutation phenotype and it could be a clue for early diagnosis of CF.
Published: 2020

43. The use of Modified Rio score for determining treatment failure in patients with multiple sclerosis: retrospective descriptive case series study

Author: Bengi Gül Alpaslan, Ayse Altintas, Nilufer Kale Icen, Burcu V Dogan, Mesude Tutuncu, Eda Coban, Ayse Elmalı Karakaya, Aysun Sosyal, and Ugur Uygunoglu
Subjects: Adult, Male, medicine.medical_specialty, Neurology, Adolescent, Treatment failure, Lesion, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Multiple Sclerosis, Relapsing-Remitting, Adjuvants, Immunologic, Internal medicine, Positive predicative value, Medicine, Humans, 030212 general & internal medicine, Treatment Failure, Neuroradiology, Retrospective Studies, business.industry, Multiple sclerosis, Retrospective cohort study, General Medicine, Glatiramer Acetate, Middle Aged, medicine.disease, Disease Progression, Female, Neurology (clinical), medicine.symptom, business, 030217 neurology & neurosurgery, Immunosuppressive Agents, Interferon beta-1a, Case series
Abstract: Predicting treatment failure and switching effective treatment immediately in patients with multiple sclerosis (MS) is important. We aimed to evaluate the usefulness of Modified Rio score (MRS) in predicting treatment failure in MS patients. This is a retrospective study, which was conducted in two University Hospital. 129 MS patients treated with Interferon or glatiramer-acetate from 2 clinical sites, were retrospectively selected. MRS was calculated after the first year of therapy. Treatment failure was defined as the presence of a 1 point increase in EDSS, 2 clinical attacks, 1 clinical attack and progression, 1 clinical attack and new lesion on MRI except associated with an attack, or new lesion in 2 different MRI taken at least 3 months apart. The sensitivity, specificity, positive and negative predictive values of the MRS in predicting treatment failure were determined. 71 (55%) patients with score ‘0’, 41 (31.8%) patients with score ‘1’, 11 (8.5%) patients with score ‘2’, 6 (4.7%) patients with score ‘3’ were detected. 14 patients needed treatment switching during the first three years of the treatment. Sensitivity was 57%, specificity was 92%, positive predictive value was 95%, negative predictive value was 47% and accuracy was 89%. Modified Rio score (MRS) was found to be effective in determining the treatment failure as mentioned before. This study will be useful for clinicians who evaluate the treatment failure like us, and this study revealed that the MRS may also help predict treatment failure.
Published: 2020

44. Patients eligible for modulator drugs: Data from cystic fibrosis registry of Turkey

Author: Melih Hangül, Sebnem Ozdogan, Koray Harmanci, Mehmet Köse, Derya Ufuk Altintas, Sevgi Pekcan, Hakan Yazan, Demet Can, Ayşen Bingöl, Abdurrahman Erdem Başaran, Ayse Tana Aslan, Hasan Yuksel, Nihat Sapan, Velat Şen, Pervin Korkmaz Ekren, Zeynep Tamay, Deniz Dogru, Nazan Cobanoglu, Haluk Cokugras, Ugur Ozcelik, Ebru Celebioglu, Ebru Yalcin, Dilek Karagöz, Ayse Ayzit Kilinc, Ali Özdemir, Ozge Yilmaz, Hadice Selimoglu Sen, Erkan Cakir, Tugba Sismanlar Eyuboglu, Şükrü Çekiç, Ömür Ercan, Gönül Çaltepe, Gonca Kılıç Yıldırım, Nagehan Emiralioglu, Güzin Cinel, Mehmet Kilic, Esen Demir, Gizem Özcan, Tugba Ramasli Gursoy, Gokcen Dilsa Tugcu, Ayşe Süleyman, Nural Kiper, Erdem Topal, Lina Muhammed Al Shadfan, Gökçen Kartal Öztürk, ÇAKIR, Erkan, Ege Üniversitesi, Ondokuz Mayıs Üniversitesi, Division of Pediatric Pulmonology, Faculty of Medicine, Ankara University, Ankara, Turkey, Division of Pediatric Pulmonology, Faculty of Medicine, Hacettepe University, Ankara, Turkey, Division of Pediatric Pulmonology, Faculty of Medicine, Bezmialem University, İstanbul, Turkey, Division of Pediatric Pulmonology, Faculty of Medicine, Gazi University, Ankara, Turkey, Division of Pediatric Pulmonology, Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey, Division of Pediatric Pulmonology, Ankara Children's Hematology Oncology Training and Research Hospital, Ankara, Turkey, Division of Pediatric Pulmonology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey, Department of Pulmonology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey, Division of Pediatric Pulmonology, Cerrahpaşa Faculty of Medicine, İstanbul University, İstanbul, Turkey, Division of Pediatric Allergy and Immunology, Faculty of Medicine, Çukurova University, Adana, Turkey, Division of Pediatric Pulmonology, Faculty of Medicine, Ege University, İzmir, Turkey, Division of Pediatric Pulmonology, Allergy and Immunology, Faculty of Medicine Akdeniz University, Antalya, Turkey, Division of Pediatric Allergy and Immunology, Faculty of Medicine, Uludağ University, Bursa, Turkey, Department of Pulmonology, Faculty of Medicine, Hacettepe University, Ankara, Turkey, Division of Pediatric Pulmonology, Mersin City Training and Research Hospital, Mersin, Turkey, Division of Pediatric Allergy and Immunology, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey, Division of Pediatric Pulmonology, Faculty of Medicine, Erciyes University, Kayseri, Turkey, Division of Pediatric Allergy and Pulmonology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey, Division of Pediatric Pulmonology, Allergy and Immunology, Faculty of Medicine, Celal Bayar University, Manisa, Turkey, Division of Pediatric Allergy and Immunology, Faculty of Medicine, İnönü University, Malatya, Turkey, Division of Pediatric Pulmonology, Faculty of Medicine, Balıkesir University, Balıkesir, Turkey, Department of Pulmonology, Faculty of Medicine, Ege University, İzmir, Turkey, Division of Pediatric Gastroenterology, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey, Division of Pediatric Allergy and Immunology, Faculty of Medicine, Fırat University, Elazığ, Turkey, and Division of Pediatric Pulmonology, Sarıyer Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey
Subjects: Pulmonary and Respiratory Medicine, Adult, Male, medicine.medical_specialty, Indoles, Adolescent, Cystic Fibrosis, Turkey, Pyridines, Aminopyridines, Cystic Fibrosis Transmembrane Conductance Regulator, national registry, modulator drugs, Quinolones, Aminophenols, Cystic fibrosis, Ivacaftor, cystic fibrosis, Young Adult, Internal medicine, Medicine, Humans, Benzodioxoles, Registries, Child, Chloride Channel Agonists, biology, business.industry, Infant, medicine.disease, Cystic fibrosis transmembrane conductance regulator, Drug Combinations, Cross-Sectional Studies, Child, Preschool, Pediatrics, Perinatology and Child Health, Mutation, biology.protein, Quinolines, Pyrazoles, Female, National registry, business, medicine.drug
Abstract: Harmanci, Koray/0000-0002-8494-648X; Sismanlar Eyuboglu, Tugba/0000-0001-7284-4999; Aslan, Ayse Tana/0000-0002-5360-8517 WOS: 000535323700001 PubMed: 32453906 Background A better understanding of cystic fibrosis transmembrane conductance regulator biology has led to the development of modulator drugs such as ivacaftor, lumacaftor-ivacaftor, tezacaftor-ivacaftor, and elexacaftor-tezacaftor-ivacaftor. This cross-sectional study evaluated cystic fibrosis (CF) patients eligible for modulator drugs. Methods Data for age and genetic mutations from the Cystic Fibrosis Registry of Turkey collected in 2018 were used to find out the number of patients who are eligible for modulator therapy. Results Of registered 1488 CF patients, genetic analysis was done for 1351. The numbers and percentages of patients and names of the drugs, that the patients are eligible for, are as follows: 122 (9.03%) for ivacaftor, 156 (11.54%) for lumacaftor-ivacaftor, 163 (11.23%) for tezacaftor-ivacaftor, and 57 (4.21%) for elexacaftor-tezacaftor-ivacaftor. Among 1351 genotyped patients total of 313 (23.16%) patients are eligible for currently licensed modulator therapies (55 patients were shared by ivacaftor and tezacaftor-ivacaftor, 108 patients were shared by lumacaftor-ivacaftor and tezacaftor-ivacaftor, and 22 patients were shared by tezacaftor-ivacaftor and elexacaftor-tezacaftor-ivacaftor groups). Conclusions The present study shows that approximately one-fourth of the registered CF patients in Turkey are eligible for modulator drugs. As, frequent mutations that CF patients have in Turkey are different from North American and European CF patients, developing modulator drugs effective for those mutations is necessary. Furthermore, as modulator drugs are very expensive currently, financial support of the government in developing countries like Turkey is noteworthy.
Published: 2020

45. Cytokine expression profiles in Autism spectrum disorder: A multi-center study from Turkey

Author: Gulen Guler, Ahmet Buber, Ozgur Kutuk, Nurdan Coban, Ufuk Acikbas, Fatma Celik, Tuba Mutluer, Aslı Giray, Hasan Kandemir, Fethiye Kilicaslan, Yeliz Aka, Cem Gokcen, Zehra Topal, Seyma Coskun, Mehmet Karadag, Meryem Ozlem Kutuk, Evren Tufan, Çiğdem Yektaş, Ebru Altintas, ALKÜ, 0-belirlenecek, and [Belirlenecek]
Subjects: 0301 basic medicine, Pediatrics, interleukin 1beta, Turkey, peripheral blood mononuclear cell, Autism Spectrum Disorder, clinical evaluation, Interleukin-1beta, Biochemistry, Turkey (republic), 0302 clinical medicine, Neurodevelopmental disorder, Childhood Autism Rating Scale, Receptors, cytokine, Immunology and Allergy, Children, Cells, Cultured, developmental disorder, transforming growth factor beta, child, messenger RNA, Hematology, symptom, comorbidity, female, priority journal, Autism spectrum disorder, 030220 oncology & carcinogenesis, Cytokines, disease severity, Cns, Autistic symptoms, Adult, Risk, medicine.medical_specialty, tumor necrosis factor, Immunology, attention deficit disorder, interleukin 6, autism, behavioral disciplines and activities, interleukin 4, Article, 03 medical and health sciences, male, mental disorders, medicine, Humans, controlled study, human, Autistic Disorder, Molecular Biology, protein expression, Autoantibodies, Inflammation, Autoimmune-Diseases, business.industry, intellectual developmental disorder, Immunity, Cytokine expression, medicine.disease, major clinical study, clinical feature, Developmental disorder, immune system, Aberrations, 030104 developmental biology, Immune system, multicenter study, Multi center study, adolescent, Leukocytes, Mononuclear, Etiology, interleukin 1alpha, gene expression, Interleukin-4, business, interleukin 17
Abstract: Topal, Zehra/0000-0001-8397-5636; Kandemir, Hasan/0000-0002-1138-4973; Tufan, Evren/0000-0001-5207-6240; KUTUK, OZGUR/0000-0001-9854-7220 WOS: 000554002300029 PubMed: 32563959 Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder characterized by impairments in communication and social interaction as well as restricted interests and repetitive behaviors. The pathogenesis of ASD is not completely understood, but a growing body of research has demonstrated that the immune response may be a contributing factor in the etiology and/or ontogeny of ASD. The aim of this study was to determine the expression levels of IL-1 beta, IL-1 alpha, IL-4, IL-6, IL-17, TNF-alpha and TGF-beta in peripheral blood mononuclear cells of children with ASD and healthy controls in order to determine the contributions of cytokines to ASD. Within the study timeframe, 195 children with ASDs (80.5% male) and 162 controls (73.6% male) were enrolled. Most children with ASD had a comorbid disorder (n = 114, 58.5%), with the most common diagnoses as Intellectual Developmental Disorder (IDD, n = 64, 32.8%) and ADHD (n = 64, 32.8%). The majority of children with ASD had severe autistic symptoms as evaluated via Childhood Autism Rating Scale (CARS, n = 130, 64.6%). The mean CARS score in the ASD sample was 40.8 (S.D. = 7.6). The patients with ASD were found to have significantly higher levels of IL-6 (p < 0.001) and significantly lower levels of IL-17 (p < 0.05, all Bonferroni corrected). Treatment tended to affect IL-4 levels. Lastly, discriminant function analysis (DFA) revealed that a combination of IL-6, IL-17 and IL-1 alpha correctly classified 56.6% of cases. Despite extensive immunological evidence suggesting immune system aberrations, further research is required to clarify the relationship between immune profiles and ASD symptoms. Science Academy BAGEP program Ozgur Kutuk acknowledges support from Science Academy BAGEP program.
Published: 2020

46. Treatment of MOG antibody associated disorders: results of an international survey

Author: Romain Marignier, H. J. Kim, Georgina Arrambide, Brigitte Wildemann, Friedemann Paul, Tom Solomon, Kumaran Deiva, Shanthi Viswanathan, Mike Boggild, Russell C. Dale, Sudarshini Ramanathan, Saleel Chandratre, Ilya Kister, Marcelo Matiello, Gulsen Akman-Demir, Rachel Kneen, Olga Ciccarelli, Ingo Kleiter, Venkatraman Karthikeayan, Silvia Tenembaum, Peter Huppke, E Gibbons, Asya I. Wallach, Ichiro Nakashima, Kazuo Fujihara, J. Y. Hor, Marco Aurélio Lana-Peixoto, Marco Capobianco, Philippe Cabre, Maria Margherita Mancardi, Kevin Rostasy, Eric C. Klawiter, Margherita Nosadini, Mar Tintoré, Daniel Whittam, Brenda Banwell, Ayse Altintas, Jeffrey Bennett, Maria Isabel Leite, M. Apiwattankul, Anu Jacob, Brian G. Weinshenker, Wei Qiu, Simon Broadley, Zsolt Illes, Aksel Siva, Maria Pia Amato, Jacqueline Palace, J. de Seze, Douglas Kazutoshi Sato, Bernhard Hemmer, Ming K. Lim, Anne-Katrin Pröbstel, Saif Huda, Michael J. Levy, Benjamin Greenberg, Dean M. Wingerchuk, Yael Hacohen, Orhan Aktas, Lekha Pandit, Sven Jarius, Daniela Pohl, Rogier Q. Hintzen, Anthony Traboulsee, and Neurology
Subjects: Adult, medicine.medical_specialty, Neurology, MOG, treatment, survey, Azathioprine, Article, MOGAD, Myelin oligodendrocyte glycoprotein, 03 medical and health sciences, 0302 clinical medicine, Maintenance therapy, Surveys and Questionnaires, Internal medicine, Humans, Medicine, MOG, survey, 030212 general & internal medicine, Survey, Child, Autoantibodies, Response rate (survey), biology, treatment, business.industry, Immunoglobulins, Intravenous, Plasmapheresis, Clinical trial, biology.protein, Myelin-Oligodendrocyte Glycoprotein, Rituximab, Neurology (clinical), Antibody, business, 030217 neurology & neurosurgery, medicine.drug
Abstract: Introduction: While monophasic and relapsing forms of myelin oligodendrocyte glycoprotein antibody associated disorders (MOGAD) are increasingly diagnosed world-wide, consensus on management is yet to be developed. Objective: To survey the current global clinical practice of clinicians treating MOGAD. Method: Neurologists worldwide with expertise in treating MOGAD participated in an online survey (February–April 2019). Results: Fifty-two responses were received (response rate 60.5%) from 86 invited experts, comprising adult (78.8%, 41/52) and paediatric (21.2%, 11/52) neurologists in 22 countries. All treat acute attacks with high dose corticosteroids. If recovery is incomplete, 71.2% (37/52) proceed next to plasma exchange (PE). 45.5% (5/11) of paediatric neurologists use IV immunoglobulin (IVIg) in preference to PE. Following an acute attack, 55.8% (29/52) of respondents typically continue corticosteroids for ≥ 3 months; though less commonly when treating children. After an index event, 60% (31/51) usually start steroid-sparing maintenance therapy (MT); after ≥ 2 attacks 92.3% (48/52) would start MT. Repeat MOG antibody status is used by 52.9% (27/51) to help decide on MT initiation. Commonly used first line MTs in adults are azathioprine (30.8%, 16/52), mycophenolate mofetil (25.0%, 13/52) and rituximab (17.3%, 9/52). In children, IVIg is the preferred first line MT (54.5%; 6/11). Treatment response is monitored by MRI (53.8%; 28/52), optical coherence tomography (23.1%; 12/52) and MOG antibody titres (36.5%; 19/52). Regardless of monitoring results, 25.0% (13/52) would not stop MT. Conclusion: Current treatment of MOGAD is highly variable, indicating a need for consensus-based treatment guidelines, while awaiting definitive clinical trials.
Published: 2020

47. Value of prognostic scores in antineutrophil cytoplasmic antibody (ANCA) associated vasculitis patients in intensive care unit: a multicenter retrospective cohort study from Turkey

Author: Gülbin Aygencel, Muhammet Güven, Erhan Kaya, Neriman Defne Altintas, Recep Civan Yüksel, Murat Sungur, Melda Turkoglu, Uğur Özdemir, Arzu Topeli, and Ebru Ortaç Ersoy
Subjects: Adult, Male, medicine.medical_specialty, Turkey, viruses, Birmingham Vasculitis Activity Score, Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis, Sensitivity and Specificity, Article, vasculitis, law.invention, law, Internal medicine, Intensive care, medicine, Humans, Anti-neutrophil cytoplasmic antibody, Aged, Retrospective Studies, APACHE II, Antineutrophil cytoplasmic antibody, business.industry, Retrospective cohort study, General Medicine, Middle Aged, medicine.disease, Prognosis, Intensive care unit, mortality, critical care, Intensive Care Units, SAPS II, Female, business, Granulomatosis with polyangiitis, prognostic scores
Abstract: Background/aim There is a need for a scoring system for predicting ICU prognosis of patients with ANCA-associated vasculitis (AAV), but there are limited data on it in the literature. Therefore, we aimed to determine the scores that can estimate the prognosis of patients with AAV during intensive care follow up. Materials and methods All adult patients admitted to the medical ICUs of 4 reference university hospitals in Turkey due to AAV activation and/or disease/treatment complications in the last 10 years were included in this study. Demographic data, treatments before ICU, the Birmingham Vasculitis Activity Score (BVAS) score at the time of vasculitis diagnosis, and BVAS, APACHE II, SOFA, and SAPS II scores at the ICU admission, treatments, procedures, and complications during ICU stay were recorded for all AAV patients. Results Thirty-four patients were included in the study. The median age of the patients was 60 (42–70) years, and 64.7% were male. Twenty-five patients were diagnosed with Granulomatosis with polyangiitis, and 9 were diagnosed with Microscopic polyangiitis. The most common ICU admission causes were hemorrhage (85.3%) and sepsis/septic shock (67.6%). Twenty patients (58.8%) died in the ICU follow up. There were significant differences in APACHE II (P = 0.004) and SAPS II (P = 0.044) scores between survivors and nonsurvivors, while there were no significant differences in BVAS (during diagnosis P = 0.089 and ICU admission P = 0.539) and SOFA (P = 0.097) scores. APACHE II score was found to be an independent risk factor for ICU mortality (OR = 1.231, CI 95% = 1.011–1.498, P = 0.038) according to logistic regression analysis. An APACHE II score of greater than 20.5 predicted ICU mortality with 80% sensitivity and 70% specificity (AUC = 0.8, P = 0.004, Likelihood ratio = 2.6) according to the ROC curve analysis. Conclusion APACHE II score can be used for the prediction of ICU mortality in AAV patients.
Published: 2020

48. Midterm Results of the Bony Bankart Bridge Technique for the Treatment of Bony Bankart Lesions

Author: Zaamin B. Hussain, Peter J. Millett, Burak Altintas, Erik M. Fritz, Jonathan A. Godin, Marilee P. Horan, and Jonas Pogorzelski
Subjects: Adult, Joint Instability, Male, Physical Therapy, Sports Therapy and Rehabilitation, Bridge (interpersonal), Arthroscopy, Fracture Fixation, Internal, Young Adult, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Risk Factors, medicine, Humans, Orthopedics and Sports Medicine, Aged, Orthodontics, 030222 orthopedics, Shoulder Joint, business.industry, Middle Aged, medicine.disease, Return to Sport, Treatment Outcome, Bankart lesion, Patient Satisfaction, Athletic Injuries, Bankart Lesions, Anterior instability, Female, business
Abstract: Background: The arthroscopic “bony Bankart bridge” (BBB) repair technique was recently shown to successfully restore shoulder stability at short-term follow-up, but longer-term outcomes have not yet been described. Purpose: To report the outcomes at minimum 5-year follow-up after BBB repair for anterior shoulder instability with a bony Bankart lesion. Study Design: Case series; Level of evidence, 4. Methods: Patients were included if they sustained a bony Bankart lesion, were treated with a BBB technique, and were at least 5 years postoperative. Patients were excluded if they underwent concomitant rotator cuff repair or an open bone fragment reduction. All patients were assessed with the following measures preoperatively and at final evaluation: QuickDASH (Quick Disabilities of the Arm, Shoulder and Hand), American Shoulder and Elbow Surgeons, Single Assessment Numeric Evaluation, and 12-Item Short Form Health Survey (SF-12) Physical Component Summary. Results: From 2008 to 2012, 13 patients who underwent BBB met the inclusion criteria with a mean age of 39.6 years (range, 19.1-68.8 years) and a mean follow-up of 6.7 years (range, 5.1-9.0 years). Mean time from most recent injury to surgery was 6.3 months (range, 1 day–36 months). The mean glenoid bone loss was 22.5% (range, 9.1%-38.6%). Mean SF-12 scores demonstrated significant improvement from 45.8 (SD, 9.7) preoperatively to 55.1 (SD, 5.9) at a mean follow-up of 6.7 years. At final follow-up, the mean American Shoulder and Elbow Surgeons score was 93.1 (range, 68.3-100); the mean QuickDASH score, 6.2 (range, 0-25); and the mean Single Assessment Numeric Evaluation score, 92.8 (range, 69-99). None of the patients progressed to further shoulder surgery. Three of 13 patients (23%) reported subjective recurrent instability. At final follow-up, 9 of 12 (75%) patients indicated that their sports participation levels were equal to their preinjury levels. Median patient satisfaction at final follow-up was 10 of 10 points (range, 3-10). Conclusion: The arthroscopic BBB technique for patients with anterior bony Bankart lesions can restore shoulder stability, yield durable improvements in clinical outcomes, and provide a high return-to-sport rate at a minimum 5-year follow-up. Three of 13 patients experienced postoperative symptoms of instability but did not undergo further stabilization surgery.
Published: 2018

49. Migraine and associated comorbidities are three times more frequent in children with ADHD and their mothers

Author: Derya Uluduz, Gulen Guler, Harika Gozukara Bag, Ozgur Kutuk, Ebru Altintas, Ali Evren Tufan, Nurgul Aytan, Aynur Özge, Fevziye Toros, Meryem Ozlem Kutuk, and Osman Özgür Yalın
Subjects: Adult, Male, Proband, Pediatrics, medicine.medical_specialty, Adolescent, Turkey, Tension headache, Migraine Disorders, Mothers, Comorbidity, behavioral disciplines and activities, 03 medical and health sciences, Epilepsy, 0302 clinical medicine, Developmental Neuroscience, mental disorders, Humans, Medicine, 0501 psychology and cognitive sciences, Child, Headache diagnosis, business.industry, Tension-Type Headache, 05 social sciences, General Medicine, medicine.disease, Cross-Sectional Studies, Motion sickness, Migraine, Attention Deficit Disorder with Hyperactivity, Case-Control Studies, Pediatrics, Perinatology and Child Health, Attention deficit, Female, Neurology (clinical), business, 030217 neurology & neurosurgery, 050104 developmental & child psychology
Abstract: Objective Attention deficit and hyperactivity disorder (ADHD) is a neuro-developmental disorder related to internalizing and externalizing disorders as well as somatic complaints and disorders. This study was conducted to evaluate the prevalence of headache subtypes, epilepsy, atopic disorders, motion sickness and recurrent abdominal pain among children and adolescents with ADHD and their parents. Methods In a multi-center, cross-sectional, familial association study using case-control design, treatment naive children and adolescents between 6 and 18 years of age diagnosed with ADHD according to the DSM-5 criteria as well as age- and gender-matched healthy controls and their parents were evaluated by a neurologist and analyzed accordingly. Results 117 children and adolescents with ADHD and 111 controls were included. Headache disorder diagnosis was common for both patients and healthy controls (59.0% vs. 37.8%), with a significantly elevated rate in the ADHD group (p = 0.002). Migraine was found in 26.0% of ADHD patients and 9.9% of healthy controls. Tension headache was found in 32.4% of ADHD patients and 27.9% of healthy controls. Headache diagnosis was also found to be significantly more common in mothers of children with ADHD than control group mothers (90.5% vs. 36.6%, p Conclusion Headache diagnoses and specifically migraines were significantly more common among children with ADHD and their mothers, while recurrent abdominal pain was elevated in both parents and ADHD patients. Migraine is an important part of ADHD comorbidity, not only for children but also for mothers. Motion sickness may be reduced among families of ADHD probands.
Published: 2018

50. Treatment Response Score to Glatiramer Acetate or Interferon Beta-1a

Author: Francois Grand'Maison, Eva Havrdova, Serkan Ozakbas, Ayse Altintas, Gary Cutter, Cavit Boz, Cristina Ramo-Tello, Pierre Grammond, Marco Onofrj, Patrizia Sola, Francesca Bovis, Pierre Duquette, Diana Ferraro, Recai Turkoglu, Elisabetta Cartechini, Pamela A. McCombe, Roberto Bergamaschi, Aysun Soysal, Sara Eichau, Celia Oreja-Guevara, Alexandre Prat, Murat Terzi, Raymond Hupperts, Vincent Van Pesch, Guillermo Izquierdo, Dana Horakova, Charles B Malpas, Jerry S. Wolinsky, Helmut Butzkueven, Tomas Kalincik, Marc Girard, Claudio Solaro, Gerardo Iuliano, Alessandra Lugaresi, Francesco Patti, Fred D. Lublin, Maria Pia Sormani, Maria Trojano, Thor Petersen, DIPARTIMENTO DI SCIENZE BIOMEDICHE E NEUROMOTORIE, UCL - SSS/IONS/CEMO - Pôle Cellulaire et moléculaire, and UCL - (SLuc) Service de neurologie
Subjects: Adult, Male, medicine.medical_specialty, Multiple Sclerosis, Databases, Factual, Relapsing-Remitting, Injections, Intramuscular, Article, law.invention, Injections, Cohort Studies, 03 medical and health sciences, Databases, 0302 clinical medicine, Multiple Sclerosis, Relapsing-Remitting, Randomized controlled trial, Adjuvants, Immunologic, law, Immunologic, Internal medicine, medicine, Humans, 030212 general & internal medicine, Female, Glatiramer Acetate, Immunosuppressive Agents, Interferon beta-1a, Middle Aged, Treatment Outcome, Adjuvants, Glatiramer acetate, Factual, Intramuscular, Expanded Disability Status Scale, business.industry, Confidence interval, Quartile, Cohort, Neurology (clinical), business, 030217 neurology & neurosurgery, medicine.drug, Cohort study
Abstract: none 39 si OBJECTIVE: To compare the effectiveness of glatiramer acetate (GA) vs intramuscular interferon beta-1a (IFN-β-1a), we applied a previously published statistical method aimed at identifying patients' profiles associated with efficacy of treatments. METHODS: Data from 2 independent multiple sclerosis datasets, a randomized study (the Combination Therapy in Patients With Relapsing-Remitting Multiple Sclerosis [CombiRx] trial, evaluating GA vs IFN-β-1a) and an observational cohort extracted from MSBase, were used to build and validate a treatment response score, regressing annualized relapse rates (ARRs) on a set of baseline predictors. RESULTS: The overall ARR ratio of GA to IFN-β-1a in the CombiRx trial was 0.72. The response score (made up of a linear combination of age, sex, relapses in the previous year, disease duration, and Expanded Disability Status Scale score) detected differential response of GA vs IFN-β-1a: in the trial, patients with the largest benefit from GA vs IFN-β-1a (lower score quartile) had an ARR ratio of 0.40 (95% confidence interval [CI] 0.25-0.63), those in the 2 middle quartiles of 0.90 (95% CI 0.61-1.34), and those in the upper quartile of 1.14 (95% CI 0.59-2.18) (heterogeneity p = 0.012); this result was validated on MSBase, with the corresponding ARR ratios of 0.58 (95% CI 0.46-0.72), 0.92 (95% CI 0.77-1.09,) and 1.29 (95% CI 0.97-1.71); heterogeneity p < 0.0001). CONCLUSIONS: We demonstrate the possibility of a criterion, based on patients' characteristics, to choose whether to treat with GA or IFN-β-1a. This result, replicated on an independent real-life cohort, may have implications for clinical decisions in everyday clinical practice. open Bovis F.; Kalincik T.; Lublin F.; Cutter G.; Malpas C.; Horakova D.; Havrdova E.K.; Trojano M.; Prat A.; Girard M.; Duquette P.; Onofrj M.; Lugaresi A.; Izquierdo G.; Eichau S.; Patti F.; Terzi M.; Grammond P.; Bergamaschi R.; Sola P.; Ferraro D.; Ozakbas S.; Iuliano G.; Boz C.; Hupperts R.; Grand'Maison F.; Oreja-Guevara C.; van Pesch V.; Cartechini E.; Petersen T.; Altintas A.; Soysal A.; Ramo-Tello C.; McCombe P.; Turkoglu R.; Butzkueven H.; Wolinsky J.S.; Solaro C.; Sormani M.P. Bovis F.; Kalincik T.; Lublin F.; Cutter G.; Malpas C.; Horakova D.; Havrdova E.K.; Trojano M.; Prat A.; Girard M.; Duquette P.; Onofrj M.; Lugaresi A.; Izquierdo G.; Eichau S.; Patti F.; Terzi M.; Grammond P.; Bergamaschi R.; Sola P.; Ferraro D.; Ozakbas S.; Iuliano G.; Boz C.; Hupperts R.; Grand'Maison F.; Oreja-Guevara C.; van Pesch V.; Cartechini E.; Petersen T.; Altintas A.; Soysal A.; Ramo-Tello C.; McCombe P.; Turkoglu R.; Butzkueven H.; Wolinsky J.S.; Solaro C.; Sormani M.P.
Published: 2019

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