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    Before the Needle: The Impact of Ejaculation on Prostate Biopsy Outcomes in a Prospective Comparative Study
    (Springernature, 2025) Baba, Dursun; Dilek, Ismail Eyup; Ekici, Necati; Ozel, Mehmet Ali; Balik, Ahmet Yildirim; Basaran, Ekrem; Taskiran, Arda Taskin
    BackgroundAlthough transrectal ultrasound (TRUS)-guided prostate biopsy is widely used for prostate cancer diagnosis, the role of pre-biopsy ejaculation in influencing procedural outcomes and complication risk remains largely unexplored. This study aimed to evaluate whether recent ejaculation affects seminal vesicle volume, biopsy-related complications, and patient-reported outcomes.MethodsIn this prospective comparative study, 32 patients undergoing TRUS-guided 12-core prostate biopsy were divided into two groups based on their sexual activity: the ejaculation group (n = 14), who ejaculated within 24 h prior to the procedure, and the abstinence group (n = 18), who reported abstinence for at least 3 days. Data collected included seminal vesicle volume, pain scores, urinary symptoms, erectile function, quality of life, and post-procedural complications. Histopathological results were also recorded and summarized. ROC analyses were used to determine cutoff values for key complications. Although transperineal biopsy is now recommended by current EAU guidelines, our study was conducted using the transrectal approach, which remains widely practiced and relevant in clinical settings.ResultsWhile seminal vesicle volume tended to be higher in the abstinence group, the difference was not statistically significant (p = 0.184). No meaningful differences were found in pain perception, urinary symptoms, erectile function, or quality of life. However, hematospermia (p = 0.017) and hematochezia (p = 0.011) were significantly more frequent in the ejaculation group. ROC analysis showed that abstinence <= 7.5 days predicted hematospermia (AUC = 0.731), and abstinence <= 2 days predicted hematochezia (AUC = 0.760). A pain score >= 1.5 was predictive of hematuria (AUC = 0.810). Histological analysis revealed benign findings in the majority of patients, with no significant difference in cancer grade between groups.ConclusionEjaculation prior to TRUS-guided prostate biopsy may increase the risk of certain complications without negatively affecting patient comfort. Abstinence duration could serve as a simple and modifiable factor in optimizing biopsy preparation. Despite the limited sample size, this prospective study provides preliminary evidence supporting patient counseling on sexual activity prior to biopsy.
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    Does Loss of Appetite in Acute Appendicitis Indicate an Empty Stomach?
    (2025) Naldemir, İbrahim Feyyaz; Ozel, Mehmet Ali; Coşkun, Sinem Kantarcıoğlu; Selki, Kudret; Boğan, Mustafa
    Aim: Loss of appetite (anorexia) is a prevalent symptom in patients with acute appendicitis. In these cases, it can be hypothesized that the stomach is empty, and the gallbladder is contracted due to loss of appetite. In this study, we aimed to investigate gastric fullness and gallbladder status in patients with acute appendicitis. We investigated whether these parameters can be indirectly supported by imaging findings of anorexia and to what extent they are significant in terms of aspiration risk in emergency surgery planning. Material and Methods: CT images of patients with acute appendicitis and the control group were evaluated for gastric fullness and gallbladder appearance. Results: A total of 266 patients were included in the study. A hundred and thirty-nine patients (52.3%) were diagnosed with acute appendicitis, while 127 patients (47.7%) were classified as the control group. The proportion of patients with an empty stomach was statistically significantly higher in patients with acute appendicitis compared to the control group (p<0.001). Gastric filling grade 3 (high-risk solid gastric content for aspiration) was in 23% (n=32) of the cases with acute appendicitis. Conclusion: Gastric fullness and gallbladder contraction are straightforward findings on CT that can provide indirect evidence in suspected acute appendicitis cases. Although anorexia is a key symptom, over half of patients continue oral intake irregularly, leaving up to one-fifth at high risk for aspiration during emergency surgery. Therefore, preoperative starvation protocols should not rely solely on the presence of anorexia.
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    Evaluation of Serum Soluble Lectin-like Oxidised Low-Density Lipoprotein Receptor-1 (sLOX-1) Level in Children with Non-Complicated Type-1 Diabetes Mellitus (T1DM) and Its Relationship with Carotid Intima Media Thickness (cIMT)
    (Mdpi, 2025) Ozde, Sukriye; Yavuzyilmaz, Fatma; Ozel, Mehmet Ali; Kayapinar, Osman; Ozde, Cem; Akture, Gulsah; Arslanoglu, Ilknur
    Background: The objective of this study was to evaluate serum soluble lectin-like oxidized low-density lipoprotein receptor-1 (sLOX-1) levels in children with type-1 diabetes mellitus (T1DM) without any atherosclerotic complications and to investigate whether there was an association with early atherosclerotic processes in these children. Methods: The study's design entailed a prospective cross-sectional observational study methodology. The patient group consisted of 80 consecutive children aged 8-18 years who had been diagnosed with T1DM for at least ten years and had not developed any chronic clinical complications related to T1DM. The control group consisted of 72 completely healthy children with similar demographic characteristics. Serum levels of sLOX-1 were measured, and carotid intima-media thickness (cIMT) was evaluated using ultrasonography in all subjects. Results: A statistical analysis of the results was conducted. The serum sLOX-1 level was found to be significantly higher in the patient group than in the control group (0.49 +/- 0.11 vs. 0.82 +/- 0.35; p < 0.001). The statistical significance observed was maintained in the multivariable logistic regression analysis (p < 0.001). A significant correlation was identified between cIMT and serum sLOX-1 levels (r = 0.669, p < 0.001). The receiver operating characteristic curve for sLOX-1 indicated that a cutoff value greater than 0.65 ng/mL was associated with T1DM. Conclusions: Serum sLOX-1 levels were markedly elevated in children with T1DM who had not yet manifested chronic complications. These findings suggest that elevated serum sLOX-1 levels may be associated with the progression of atherosclerosis in children with T1DM.
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    Evaluation of the systemic-immune inflammation index (SII) and systemic immune-inflammation response index (SIRI) in children with type 1 diabetes mellitus and its relationship with cumulative glycemic exposure
    (Walter De Gruyter Gmbh, 2024) Ozde, Sukriye; Akture, Gulsah; Ozel, Mehmet Ali; Yavuzyilmaz, Fatma; Arslanoglu, Ilknur; Ozde, Cem; Kayapinar, Osman
    Objectives: In this study, the systemic proinflammatory status was assessed using the systemic immune-inflammation index (SII) and SIRI systemic immune-inflammatory response index (SIRI) in children and adolescents with type 1 diabetes mellitus (T1DM). Methods: The study involved 159 patients aged between 6 and 16 years. The SII and SIRI values were calculated based on the complete blood count. Basic blood biochemistry evaluated, and carotid intima-media thickness (cIMT) was measured and recorded. The cumulative glycemic exposure was calculated by multiplying the value above the normal reference range of the HbA1c value. The sum of all these values obtained from the time of diagnosis to obtain the cumulative glycemic exposure. All findings were compared statistically. All statistically significant parameters were evaluated in the multivariate logistic regression analysis. Results:The analysis revealed that only cIMT (Exp(B)/OR: 0.769, 95 % CI: 0.694-0.853, p<0.001), high-density lipoprotein (Exp(B)/OR: 3.924, 95 % CI: 2.335-6.596, p<0.001), monocyte count (Exp(B)/OR: 1.650, 95 % CI: 1.257-2.178, p<0.001), hematocrit (Exp(B)/OR: 0.675, 95 % CI: 0.523-0.870, p<0.001), and SIRI (Exp(B)/OR: 1.005, 95 % CI: 1.002-1.008, p<0.001) were significantly associated with T1DM. A statistically significant positive association was found between cumulative glycemic exposure and SIRI only (r=0.213, p=0.032). To our knowledge, this is the first study to evaluate SII and SIRI in children with type 1 diabetes. Conclusions: These findings indicate that SIRI could serve as a potential biomarker for detecting early-onset proatherosclerotic processes in diabetic children. However, further clinical studies are required to confirm this.
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    Evaluation of Variations of the Chorda Tympani Nerve from The Facial Nerve on Resolution CT
    (Duzce Univ, Fac Medicine, 2025) Ozel, Mehmet Ali; Buyukkaya, Ramazan
    Objective: The aim of this study is to define the anatomical variations of the chorda tympani nerve originating from the facial nerve on high resolution CT (HRCT). Method: A retrospective study of 100 patients who underwent temporal bone HRCT imaging in Duzce University, Department of Radiology. Individuals with normal bone structure at least on one side, were included in the study. Multiplanar reconstruction images were created then chorda tympani was imaged and measurements were performed. Results: Thirty-seven bone were excluded. When the originating localizations of the chorda tympani from the facial nerve were examined, 19(11.7%) Aanterior, 85(52.1%) anterolateral, 55(33.7%) lateral and 4(2.5%) posterolateral origins. The distance from the origin of the chorda tympani to the stylomastoid foramen was measured as 3.7 +/- 1.6 mm. The originating angle of the chorda tympani from the facial nerve was measured as 28.2 +/- 10.7 degrees. The widest distance between the chorda tympani and the mastoid segment of the facial nerve was measured as 2.3 +/- 0.6mm. The furthest distance between the mastoid segment of the facial nerve and chorda tympani is inversely correlated with the distance between chorda tympani and stylomastoid foramen. The angle of originating chorda tympani from facial nerve is directly correlated with the distance between chorda tympani and stylomastoid foramen. The ratio of extratemporal branching of chorda tympani is %2.4. Conclusions: The chorda tympani can be clearly seen on axial and reformat images on HRCT. Preoperative evaluation of the chorda tympani nerve might help to plan the surgical approach and thus prevent iatrogenic injury during middle ear surgery.
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    Gestational Hydronephrosis: A Retrospective Analysis of the Clinical Outcomes of Ureteral Stent Placement Versus Conservative Treatment
    (Mdpi, 2025) Baba, Dursun; Yurtcu, Engin; Ayvacik, Burak; Kucuk, Yusuf Salih; Taskiran, Arda Taskin; Ozel, Mehmet Ali; Balik, Ahmet Yildirim
    Background and Objectives: Gestational hydronephrosis (GH) is a physiological condition commonly observed during pregnancy, resulting from hormonal effects and mechanical compression of the ureters by the enlarging uterus. Although often asymptomatic, GH can cause urinary stasis, recurrent infections, and renal function impairment in symptomatic cases. The optimal management of such cases remains controversial, especially regarding the role of ureteral stent placement. This study aimed to compare clinical outcomes-including renal function, inflammatory markers, and obstetric parameters-in pregnant women with symptomatic GH who underwent ureteral stent placement versus those managed conservatively. Materials and Methods: We conducted a retrospective cohort study at D & uuml;zce University Hospital between 2020 and 2024, including 40 pregnant women diagnosed with symptomatic GH. The patients were divided into the following two groups: those who received a ureteral stent (n = 20) and those who were managed with conservative treatment (n = 20). Conservative management included hydration therapy, acetaminophen-based analgesia, and close clinical monitoring. The parameters assessed included serum creatinine, estimated glomerular filtration rate (GFR), inflammatory markers (C-reactive protein, erythrocyte sedimentation rate, and white blood cell count), urinary findings, obstetric outcomes, and postpartum complications. Statistical significance was set at p < 0.05. Results: Gestational age at diagnosis was significantly higher in the stent group (29.1 +/- 3.2 weeks) than in the non-stent group (27.1 +/- 3.5 weeks; p = 0.045), possibly reflecting increased mechanical compression in later pregnancy. Renal function parameters (serum creatinine and GFR), inflammatory markers (CRP, ESR, and WBC count), and obstetric outcomes (birth weight, Apgar scores) showed no significant differences between groups (p > 0.05). Interestingly, gestational diabetes mellitus (GDM) was more prevalent in the non-stent group (20% vs. 5%; p = 0.042), although no significant differences were found in fasting glucose levels. Conclusions: Ureteral stent placement in symptomatic GH does not appear to significantly improve renal function or obstetric outcomes. However, it may provide symptom relief in select patients with persistent or severe discomfort. Given the limitations of retrospective data and a small sample size, further prospective studies with larger cohorts and quality-of-life assessments are warranted to optimize management strategies and enhance patient-centered care.
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    Which localization method is optimal in ESWL: fluoroscopy or ultrasonography?
    (Bmc, 2025) Baba, Dursun; Ekici, Necati; Taskiran, Arda Taskin; Senoglu, Yusuf; Yuksel, Alpaslan; Basaran, Ekrem; Ozel, Mehmet Ali
    BackgroundUrinary stone disease is a common urological disorder, particularly among middle-aged individuals. Extracorporeal Shock Wave Lithotripsy (ESWL) is often the first-line treatment for kidney and ureteral stones. Traditionally, fluoroscopy is used for stone targeting in ESWL, but it exposes patients and clinicians to radiation and cannot visualize non-opaque stones. Ultrasonographic targeting eliminates these issues. This study compares the advantages and disadvantages of fluoroscopy and ultrasound-targeted ESWL. MethodsAt D & uuml;zce University Hospital, 100 patients with radio-opaque stones indicated for ESWL between February 2023 and February 2024 were divided into two groups. Group A underwent ESWL with fluoroscopic targeting, while Group B used ultrasonographic targeting. Patient demographics, stone size (measured by CT), and stone locations were recorded. The number of shocks per session, energy intensity (kV), and fluoroscopy time were noted for Group A. One week after each ESWL session, patients were evaluated by ultrasound or direct radiography. Success was defined as being stone-free or having <= 4 mm asymptomatic residual stones after up to four sessions. Failure was defined as no results after two sessions or the need for additional treatment. ResultsThe procedure success rate was 66% for men and 78% for women, with no statistically significant gender difference (p > 0.05). Stone locations were similar in both groups. Success rates were 66% in Group A and 74% in Group B, with no significant difference (p > 0.05). Successful procedures were associated with an average patient weight of 76.6 kg, stone size of 8.9 mm, and total energy of 12.2 kV, with significant differences compared to unsuccessful procedures (p < 0.04, p < 0.04, p < 0.001, respectively). No significant differences were found between Group A and Group B in terms of age, height, BMI, stone density (HU), and number of sessions (p > 0.05). ConclusionUltrasonography is as effective as fluoroscopy for imaging and focusing during ESWL treatment. It enhances the success of ESWL for non-opaque stones and reduces radiation exposure disadvantages.