Medical Bulletin of Sisli Etfal Hospital最新文献

{"title":"Approaches to Mediastinal Staging in NSCLC Among Thoracic Surgeons: A Survey Study From Türkiye.","authors":"Melike Ulker, Volkan Erdogu, Ali Cevat Kutluk, Muzaffer Metin","doi":"10.14744/SEMB.2025.04903","DOIUrl":"10.14744/SEMB.2025.04903","url":null,"abstract":"<p><strong>Objectives: </strong>Mediastinal lymph node staging is a critical step in the treatment algorithm for non-small cell lung cancer (NSCLC). Current guidelines define the patient groups in which invasive or minimally invasive mediastinal lymph node sampling is required during preoperative staging. This study aimed to determine the extent to which thoracic surgeons actively practicing in Türkiye adhere to these guideline recommendations and to assess the concordance between their daily clinical practices and these recommendations.</p><p><strong>Methods: </strong>A guideline-based survey, including nine case scenarios, was emailed to 417 thoracic surgeons registered with the Turkish Thoracic Surgery Association. The survey collected data on participants' demographic characteristics, institutional profiles, and approaches to each clinical scenario. Responses were analyzed for concordance with guideline recommendations.</p><p><strong>Results: </strong>The survey response rate was 29.2% (n=122). A total of 48.3% of the participants possessed an academic title, and 77.8% were employed at training and research or university hospitals. In scenarios involving a radiologically positive, single, non-bulky N2 lymph node, 85.2% of respondents indicated that invasive mediastinal staging was required by guidelines. In contrast, among patients without radiologic evidence of N2 disease, the proportion of surgeons recommending mediastinal staging was 19.7% for squamous cell carcinoma >3 cm in size and 36.9% for adenocarcinoma. For centrally located tumors, 59% of participants recommended staging. Notably, there was substantial variation in opinions regarding the necessity of invasive sampling for suspicious aortopulmonary window lymph nodes.</p><p><strong>Conclusion: </strong>Thoracic surgeons in Türkiye generally exhibit approaches to mediastinal staging that align with guideline recommendations; however, variations exist in certain subgroups. Standardization is particularly needed in the definition of central tumors, the approach to sampling aortopulmonary lymph node stations, and staging strategies based on histologic tumor type. These findings highlight the importance of educational and awareness initiatives aimed at improving the integration of guideline recommendations into clinical practice.</p>","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":"60 1","pages":"71-78"},"PeriodicalIF":1.0,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147693004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interscalene Block versus Posterior Suprascapular Block for Postoperative Analgesia on Arthroscopic Shoulder Surgery: Randomized, Controlled, Prospective Study.","authors":"Sinem Ozler, Leyla Kilinc, Gamze Dilara Demir, Tugba Yucel, Pinar Sayin, Ayse Surhan Cinar","doi":"10.14744/SEMB.2026.65391","DOIUrl":"10.14744/SEMB.2026.65391","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to compare the effects of interscalene block and posterior suprascapular nerve block on postoperative analgesia in the first 24 hours after unilateral arthroscopic shoulder surgery.</p><p><strong>Methods: </strong>Ninety-eight adult patients aged between 18 and 65 years, with ASA (American Society of Anesthesiologists) physical status I-II, undergoing elective arthroscopic shoulder surgery were included in this prospective, randomized controlled study. All patients were randomized into two groups: the interscalene block group (Group ISB, n=48) and the suprascapular block group (Group SSB, n=50). Both groups received 10 mL of 0.5% bupivacaine. The duration of analgesia, total opioid consumption, complications, and Visual Analog Scale (VAS) scores were recorded at postoperative 0, 1, 4, 6, 12, and 24 hours.</p><p><strong>Results: </strong>Statistical data were analyzed in 87 patients after 7 patients from Group SSNB and 4 patients from Group ISB were excluded from the study. There was no significant difference between the two groups in analgesia duration, total opioid consumption, and patient satisfaction. While VAS values at 0 hours (p<0.01), 1 hour (p<0.05), 4 hours (p<0.01), and 6 hours (p<0.01) were lower in Group ISB, the VAS value at the 12th hour was similar between Group SSB and Group ISB (p>0.05). However, the VAS value at the 24th hour was lower in Group SSB (p<0.01). The complication rate was higher in Group ISB (p<0.01).</p><p><strong>Conclusion: </strong>It was concluded that ultrasound-guided posterior SSB for postoperative pain after arthroscopic shoulder surgery is not equivalent to ISB, especially in the early postoperative period, but it is an effective alternative technique with fewer side effects.</p>","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":"60 1","pages":"85-92"},"PeriodicalIF":1.0,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Author's Reply.","authors":"Barıs Acar, Ahmet Senel, Ahmet Sinan Kalyenci, Saltuk Bugra Tekin, Onur Gunday","doi":"10.14744/SEMB.2026.02058","DOIUrl":"10.14744/SEMB.2026.02058","url":null,"abstract":"","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":"60 1","pages":"132"},"PeriodicalIF":1.0,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comments on Kostek et al.: Deciding on Fine Needle Aspiration Biopsy in Thyroid Incidentalomas in FDG-PET/CT: Should Ultrasonographic Evaluation or FDG Uptake Be in the Foreground?","authors":"Betul Vatankulu, Sait Sager","doi":"10.14744/SEMB.2026.53486","DOIUrl":"10.14744/SEMB.2026.53486","url":null,"abstract":"","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":"60 1","pages":"136-137"},"PeriodicalIF":1.0,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the Turkish Version of the Quality of Recovery-15 Questionnaire.","authors":"Kaan Sunter, Kadir Yagiz Turker, Can Ates, Mehmet Ali Koc, Yusuf Sevim, Cemal Ensari, Onur Ilkay Dincer, Ismail Cem Eray, Burak Yavuz, Timucin Erol, Siyar Ersoz, Burak Kutlu, Mehmet Ayhan Kuzu","doi":"10.14744/SEMB.2026.70933","DOIUrl":"10.14744/SEMB.2026.70933","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to perform a cross-cultural adaptation and psychometric evaluation of the Quality of Recovery-15 (QoR-15) questionnaire in Türkiye.</p><p><strong>Methods: </strong>The QoR-15 was translated into Turkish through a rigorous process involving independent translations, consensus, forward-backward translation, and review. The questionnaire was administered to patients undergoing major abdominal surgery preoperatively and on postoperative days 1, 7, and 30. Reliability was assessed using Cronbach's α, McDonald's Omega, and the inter-item correlation coefficient. Construct validity was evaluated using confirmatory factor analysis (CFA), and responsiveness was analyzed using Cohen's effect size and the standardized response mean (SRM).</p><p><strong>Results: </strong>A total of 510 patients participated in the study; 335 (65.69%) were <65 years old, and 279 (54.71%) were male. The Turkish version of QoR-15 (QoR-15T) demonstrated good internal consistency, with Cronbach's α values of 0.896 and 0.888 for preoperative and postoperative administrations, respectively, and McDonald's Omega coefficients of 0.894 and 0.878. Confirmatory factor analysis confirmed the two-factor (two-dimensional) structure of the QoR-15T. The comparative fit indices for Models 1 and 2 were 0.970 and 0.991, respectively. QoR-15T showed responsiveness to changes in health status, with Cohen's effect size (1.22) and the standardized response mean (1.18) indicating its ability to detect clinically important changes.</p><p><strong>Conclusion: </strong>The QoR-15T is a reliable, valid, and responsive questionnaire for assessing the quality of recovery in patients undergoing major abdominal surgery. Its ability to capture patients' perspectives and multidimensional aspects of recovery makes it a valuable tool for clinical and research purposes.</p>","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":"60 1","pages":"93-102"},"PeriodicalIF":1.0,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Characteristics and Pregnancy Outcomes of Thyrotoxicosis During Pregnancy: A Retrospective Observational Study.","authors":"Ummu Mutlu, Ayşe Merve Ok Kurt, Evin Bozkur","doi":"10.14744/SEMB.2026.88528","DOIUrl":"10.14744/SEMB.2026.88528","url":null,"abstract":"<p><strong>Objectives: </strong>Thyrotoxicosis during pregnancy may be associated with adverse maternal and foetal outcomes; however, data comparing overt and subclinical thyrotoxicosis are limited. This study aimed to evaluate clinical characteristics, management, and pregnancy outcomes, and to explore associations with the achievement of euthyroidism in pregnant women with thyrotoxicosis.</p><p><strong>Methods: </strong>This retrospective study included 70 pregnant women diagnosed with thyrotoxicosis who presented to the outpatient clinics between 2022-2023. Patients were classified as having overt (n=34) or subclinical (n=36) thyrotoxicosis based on trimester-specific thyroid function tests. After excluding three patients with Graves' disease and one with a molar pregnancy, 31 overt and 35 subclinical gestational thyrotoxicosis patients were included in the analyses. Demographic features, clinical findings, biochemical parameters standardized as multiples of the upper limit of normal, treatment data, and pregnancy outcomes were obtained from medical records. Correlation analyses were performed to evaluate associations between gestational week and thyroid function tests.</p><p><strong>Results: </strong>The mean age was 29.6±5.3 years, and the mean GW at diagnosis was 10.7±3.0, with no significant differences between groups. At diagnosis, TSH was lower and fT4/fT3 higher in overt thyrotoxicosis compared to subclinical cases (p<0.05). Euthyroidism was achieved at a mean of 17.1±4.0 weeks, without significant group differences. Prior antithyroid drug therapy had been initiated in 18.2% of patients, mainly with PTU, with similar doses and treatment durations between groups. Pregnancy outcomes were available for 42 patients; 13 experienced complications (oligohydramnios, preterm delivery, pre-eclampsia, gestational diabetes, and intrauterine foetal death). Complication rates did not differ between groups, although anti-TPO positivity was more frequent among patients with complications (p=0.006). Correlation analyses showed that earlier gestational age at diagnosis was associated with higher thyroid hormone levels, while later achievement of euthyroidism correlated with lower TSH and higher peak fT3.</p><p><strong>Conclusion: </strong>Pregnancy outcomes were similar in overt and subclinical thyrotoxicosis. Gestational age at diagnosis was associated with thyroid hormone levels but not with maternal or foetal complications. Most patients achieved euthyroidism during pregnancy, and anti-TPO positivity was more common among those with pregnancy complications.</p>","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":"60 1","pages":"103-111"},"PeriodicalIF":1.0,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147693002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the Therapeutic Effects of Intra-Articular Injection of Ozone and Corticosteroid in Knee Osteoarthritis.","authors":"Aylin Ayyildiz, Selda Ciftci Inceoglu, Beril Dogu, Banu Kuran","doi":"10.14744/SEMB.2025.52460","DOIUrl":"10.14744/SEMB.2025.52460","url":null,"abstract":"<p><strong>Objectives: </strong>Knee osteoarthritis (KOA) is a chronic condition that gradually reduces functional capacity and limits daily activities. Treatment methods in the early stages of the disease are still under discussion. The efficacy of ozone therapy versus corticosteroid injection in treating KOA is examined in this study.</p><p><strong>Methods: </strong>This randomized clinical trial involved 60 patients aged 40-85 years who had been experiencing knee pain for at least 6 months and had received a clinical diagnosis of knee osteoarthritis through radiologic imaging. The patients were randomly assigned to two groups. One group received an intra-articular injection of 10 mL 15 µg/ml ozone for three sessions with a one-week interval, while the second group received a 1 mL intra-articular injection of betamethasone. All patients were evaluated before treatment, as well as 4 and 12 weeks after the first dose of treatment. The study evaluated treatment efficacy using the Visual Analog Scale (VAS) and the Western Ontario and McMaster Universities Arthritis Index (WOMAC).</p><p><strong>Results: </strong>The study participants had a mean age of 62.2±10 years, and 90% of them were female. Upon comparing the VAS and WOMAC scores with their respective pretreatment scores, both groups showed significant decreases at week 4 and week 12. Notably, the ozone group exhibited a significantly greater improvement in VAS and WOMAC scores at week 4.</p><p><strong>Conclusion: </strong>Intra-articular ozone injections have a rapid effect and provide better short-term results for KOA. In later periods, it has a similar effect to corticosteroids.</p>","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":"60 1","pages":"30-35"},"PeriodicalIF":1.0,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Sexual Dysfunctions in Male Patients with Androgenetic Alopecia.","authors":"Osman Vural, Ilknur Kivanc Altunay, Asli Aksu","doi":"10.14744/SEMB.2026.66915","DOIUrl":"10.14744/SEMB.2026.66915","url":null,"abstract":"<p><strong>Objectives: </strong>Androgenetic alopecia (AGA) is a common dermatologic condition among men. In this study, we aimed to investigate psychological comorbidities, sexual dysfunctions, and the relationship between them in male patients with AGA.</p><p><strong>Methods: </strong>A total of 220 individuals aged between 18 and 45 years who applied to our dermatology outpatient clinic between June 2022 and June 2023 were included in this study, including 110 healthy male volunteers and 110 male patients diagnosed with AGA. To collect information about the individuals comprising the sample, a sociodemographic characteristics form prepared by the researcher, the Hospital Anxiety and Depression Scale (HADS), the Body Perception Scale (BPS), the Golombok-Rust Inventory of Sexual Satisfaction (GRISS), and the Sexual Health Inventory for Men (SHIM) were completed by the participants under the supervision of the researcher. The severity of AGA was determined using the Hamilton-Norwood Scale (HNS).</p><p><strong>Results: </strong>In our study, it was found that the patient group was statistically significantly more negatively affected in terms of body satisfaction and had higher levels of anxiety, depression, and sexual dysfunction compared with the control group (p=0.028, p=0.001, p=0.001, respectively). It was found that impotence and the tendency to avoid sexual intercourse increased as anxiety symptoms increased in patients with AGA (p=0.010, r=0.245; p=0.006, r=0.259, respectively). Furthermore, an increase in depressive symptoms in patients with AGA was shown to increase the tendency toward erectile dysfunction and premature ejaculation (p=0.027, r=-0.210; p=0.001, r=0.366, respectively).</p><p><strong>Conclusion: </strong>Physicians should take into account that AGA may trigger anxiety, depression, decreased body satisfaction, and sexual dysfunction in male patients, and patients should be evaluated in a multidisciplinary manner. While our study sheds light on future research, larger sample studies are needed to clarify these relationships.</p>","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":"60 1","pages":"16-23"},"PeriodicalIF":1.0,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Author's Reply.","authors":"Enver Ipek, Yusuf Sulek, Bahadir Balkanli","doi":"10.14744/SEMB.2025.48107","DOIUrl":"https://doi.org/10.14744/SEMB.2025.48107","url":null,"abstract":"","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":"59 3","pages":"441"},"PeriodicalIF":0.9,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12821102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146031133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ChatGPT's Role in Coronary Artery Bypass Graft Information: A Critical Assessment.","authors":"Hakki Kursat Cetin, Hale Bolgi Demir, Tolga Demir","doi":"10.14744/SEMB.2025.35493","DOIUrl":"10.14744/SEMB.2025.35493","url":null,"abstract":"<p><strong>Objectives: </strong>This research evaluates the accuracy and reliability of ChatGPT's responses to inquiries concerning coronary artery bypass graft (CABG) surgery.</p><p><strong>Methods: </strong>Between December 1, 2024, and December 15, 2024, two sets of questions were used to assess ChatGPT's performance: (1) a list of frequently asked questions (FAQs) sourced from official cardiovascular surgery websites, professional healthcare platforms, and social media, and (2) a list of scientific questions derived from the 2021 American Association for Thoracic Surgery (AATS) Guidelines for CABG in patients with ischemic cardiomyopathy and heart failure. Responses were evaluated using the modified DISCERN scoring system. To test reproducibility, each question was asked twice on separate computers within the same day. Two experienced cardiovascular surgeons independently scored the responses, and any disagreements were resolved through discussion.</p><p><strong>Results: </strong>A total of 107 FAQs were assessed, of which 88 met the inclusion criteria. Based on the modified DISCERN scale, 71 responses (80.7%) received a score of 5, while 9 responses (10.2%) were rated as 4. The highest accuracy was observed in the preoperative preparation category, where all responses achieved a perfect score. Regarding scientific questions derived from the AATS Guidelines, 15 out of 20 (75.0%) were answered thoroughly and satisfactorily. The reproducibility rate was 92.0% for FAQs and 90.0% for guideline-based questions.</p><p><strong>Conclusion: </strong>This study is the first to demonstrate that ChatGPT provides highly accurate and dependable responses regarding CABG surgery, particularly for frequently asked questions. Although performance declines slightly when addressing scientific questions based on guidelines, the reproducibility rate remains high. These findings indicate that AI-driven tools like ChatGPT could play a valuable role in patient education and enhancing public awareness about CABG surgery.</p>","PeriodicalId":42218,"journal":{"name":"Medical Bulletin of Sisli Etfal Hospital","volume":"59 3","pages":"311-315"},"PeriodicalIF":0.9,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12821117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146031093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}