Publications by authors named "Ali Celik"

113 Publications

The role of optic nerve sheath diameter measurement on CT in differentiating transient ischemic attack and acute ischemic stroke.

Clin Neurol Neurosurg 2022 Jan 16;212:107094. Epub 2021 Dec 16.

Department of Radiology, Recep Tayyip Erdoğan University Training and Research Hospital, Rize, Turkey. Electronic address:

Objective: This study aimed to determine if optic nerve sheath diameter (ONSD) measurement on computed tomography could differentiate transient ischemic attack (TIA) from acute ischemic stroke (AIS). Both TIA and AIS are the rings of the same disease chain. To exclude hemorrhagic stroke and stroke mimics in these patients, brain computed tomography (CT) remains the first step imaging modality.

Patients And Methods: In this retrospective study, ONSDs of patients with TIA and AIS within three hours from symptom onset to initial CT was measured. The right, left, mean, and delta ONSD measurements were compared between AIS and TIA groups. Then diagnostic accuracy metrics were calculated.

Results: A total of 196 patients (128 in the AIS group and 68 in the TIA group) were included. Both mean and delta ONSD of AIS patients were higher than those of the TIA group. The area under the receiver operating curve of mean and delta ONSD for predicting AIS were 0.746 with a sensitivity of 82.8% and a specificity of 42.7% (cut-off: 5.00 mm), and 0.826 with a sensitivity of 67.2% and a specificity of 86.8% (cut-off: 0.50 mm), respectively.

Conclusion: Increased mean or delta ONSD measured on initial CT could alert emergency physicians for an impending stroke.
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http://dx.doi.org/10.1016/j.clineuro.2021.107094DOI Listing
January 2022

Comparison of clinical, pathological and long-term renal outcomes of children with Henoch-Schonlein purpura nephritis and IgA nephropathy.

Int Urol Nephrol 2021 Nov 30. Epub 2021 Nov 30.

Department of Pediatric Nephrology, Medical Faculty, Dokuz Eylül University, Balçova, 35340, Izmir, Turkey.

Purpose: To compare clinical, pathological, and long-term renal outcomes of children with Henoch-Schonlein purpura nephritis (HSPN) and IgA nephropathy (IgAN).

Methods: The medical records of patients diagnosed as HSPN and IgAN during childhood were evaluated retrospectively. HSPN and IgAN groups were compared in terms of gender, age, upper respiratory infection history, blood pressure; presence of nephrotic and/or nephritic syndrome; hemoglobin level, leukocyte count, C-reactive protein (CRP), serum albumin (sAlb), creatinine, complement 3 (sC3), complement 4 (sC4) and immunoglobulin A (sIgA) levels; estimated glomerular filtration rate (eGFR) and proteinuria levels; and renal pathology findings at the onset of disease; total follow-up time; and blood pressure, eGFR and proteinuria levels at the last visit.

Results: Fifty-four patients were enrolled in the study [38 (70%) HSPN and 16 (30%) IgAN]. The median follow-up time was 60.5 and 72.0 months in HSPN and IgAN groups, respectively (p > 0.05). The HSPN and IgAN groups were also not different in terms of gender, age at the onset; leukocyte count, eGFR, sC3-sC4-sIgA levels; and the presence of endocapillary, extracapillary and mesangial proliferation, tubular atrophy, interstitial fibrosis and IgA, IgM, C3 accumulation in renal tissue. Upper respiratory tract infection history was more common in children with IgAN (8/16 vs 8/38, p = 0.045). sAlb (3.96 ± 0.58 vs 4.40 ± 0.46 g/dL, p = 0.005), hemoglobin (12.1 ± 1.3 vs 13.3 ± 1.2 g/dL, p = 0.004,) and the incidence of mesangial IgG deposition (15/38 vs 11/16, p = 0.049) were lower, while CRP (16.3 ± 7.2 vs 7.8 ± 4.4 mg/L, p = 0.002) and proteinuria (72.1 ± 92.4 vs 34.2 ± 37.9 mg/m/24 h, p = 0.041) was higher in HSPN group at the onset of disease. Proteinuria and eGFR were similar between the two groups at last visit.

Conclusion: Children with HSPN and IgAN have little clinical and histological differences in our population. The most prominent difference at presentation with nephritis was higher proteinuria in HSPN probably associated with inflammation due to systemic vasculitis. Long-term renal outcome was good in both HSPN and IgAN.
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http://dx.doi.org/10.1007/s11255-021-03063-7DOI Listing
November 2021

Causes of Granulomatous Inflammation in Native and Allograft Kidneys: Case Series from A Single Center and A Review of the Literature.

Turk Patoloji Derg 2021 Nov 10. Epub 2021 Nov 10.

Division of Nephrology, Muş State Hospital, Muş, TURKEY.

Objective: Granulomatous interstitial nephritis is a rare finding, and etiology differs by geography. We aimed to investigate the distribution of causes of granuloma/granulomata in the kidney and renal survival of these patients in a tertiary care hospital in Western Turkey.

Material And Method: Medical records of adults who underwent a kidney biopsy procedure in our institution between January 2000 and June 2019 were reviewed. Pathology reports were searched for biopsies where a granuloma was identified.

Results: Nineteen of 1121 (1.7%) kidney biopsies included granuloma, 17 in native kidneys, and 2 in transplants. The majority of indications for native kidney biopsy was a rise in serum creatinine. Etiologies of granuloma included the following: pauci-immune vasculitis (n=11, 64.7%), tuberculosis (n=2, 11.8%), drug-induced (n=2, 11.8%), tubulointerstitial nephritis/uveitis (TINU) syndrome (n=1, 5.9%), and systemic-lupus erythematosus (n=1, 5.9%). Despite treatment, 6 of 11 (54.5%) patients with vasculitis developed end-stage kidney disease (ESKD) during the median follow-up of 16 months. Both of the patients with tuberculosis, and the patient with TINU syndrome developed ESKD months after the kidney biopsy, despite appropriate therapies. The only case with drug-induced granuloma and both cases with allograft kidney granuloma responded well to glucocorticoids, achieving a complete renal recovery.

Conclusion: The majority of our series had granuloma in the kidney secondary to vasculitis and renal outcomes appear considerably unfavorable despite treatment, probably related to the primary diagnosis. Multicenter studies are needed to better determine the etiology and outcome of each granuloma etiology at different geographic locations.
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http://dx.doi.org/10.5146/tjpath.2021.01561DOI Listing
November 2021

IS GAMMA-GLUTAMYL TRANSFERASE A PROGNOSTIC INDICATOR FOR EARLY-STAGE LUNG CANCER TREATED SURGICALLY?

Wiad Lek 2021 ;74(8):1804-1808

THORACIC SURGERY, GAZI UNIVERSITY, ANKARA,TURKEY.

Objective: The aim: Gamma-glutamyl transferase (GGT) is a membrane-dependent enzyme and is primarily involved in glutathione metabolism. While a correlation between high GGT levels and oxidative stress, cardiovascular diseases, and some cancers has been shown in the literature, its prognostic ef f ect in patients with non-small-cell lung cancer remains unclear. The aim of this study was to investigate the correlation between the preoperative GGT levels and the prognosis of non-small-cell lung cancers treated surgically.

Patients And Methods: Materials and methods: Following the approval of the loc al ethics committee, the medical records of patients surgically treated in our department for stage-I non-small-cell lung cancer between January 2010 and December 2019 were retrospectively reviewed. The patients were classif i ed into a high group (high-GGT) and low group (low-GGT) according to the preoperative GGT cut-of f levels, which were specif i c to our series and calculated by receiver operating characteristic (ROC) analysis. Survival dif f erences between the groups were also investigated by Kaplan-Meier, log-rank, and Cox regression tests.

Results: Results: A total of 219 patients fulf i lled the inclusion criteria and were included in the study. The median survival was 75 (range: 58.4-91.1) months in the high-GGT group and 91 (range: 85-96.8) months in the low-GGT group, and this dif f erence was statistically signif i cant (Hazard Ratio: 2.0, 95% CI 1.0-3.9, p = 0.03).

Conclusion: Conclusions: Preoperative GGT may be an inexpensive and easily applicable prognostic indicator in early-stage non-small-cell lung cancers.
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September 2021

Analysis of Brush Cutter-Related Accidents: Describing an Extraordinary Kind of Agricultural Injury.

J Emerg Med 2021 Sep 13. Epub 2021 Sep 13.

Department of Emergency Medicine, Recep Tayyip Erdoğan University Training and Research Hospital, Rize, Turkey. Electronic address:

Background: Brush cutter (BC)-related penetrating trauma, similar to other types of power saws, can cause serious injuries, especially to the extremities. Studies of this particular injury are limited.

Objective: The objective of this study was to characterize injury patterns and patient demographic characteristics for BC-related injuries.

Methods: This was a retrospective, observational study on the victims of BC accidents admitted to the emergency department. Data on demographic characteristics, symptoms, physical examination signs, admission time, and outcomes were collected from the hospital database. The location of injuries and damaged tissues were also analyzed.

Results: One hundred and fifty-four male (90.1%) and 17 female (9.9%) patients were included retrospectively. Most injuries occurred in autumn (n = 90 [52.6%]) after the harvesting season. Ninety percent of the victims (n = 153) presented with lower extremity trauma. The most frequently injured body part was the anteromedial portion of the left foot (n = 61 [55.9%]). Seven (4.1%) cases had complete digits or limb amputations and 21 (12.3%) cases had incomplete amputation. Twenty-nine (17%) cases had a coexisting vascular injury, 61 (35.7%) had fractured bones, and 129 (75.4%) had tendon damage.

Conclusions: BC-related accidents are often preventable but can result in severe disabilities or death. Therefore, health care facilities should be provided in regions at risk to reduce hazards.
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http://dx.doi.org/10.1016/j.jemermed.2021.07.056DOI Listing
September 2021

Associations between nutritional factors and excessive daytime sleepiness in older patients with chronic kidney disease.

Aging Clin Exp Res 2021 Aug 27. Epub 2021 Aug 27.

Division of Nephrology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.

Background: Excessive daytime sleepiness (EDS) is prevalent in not only older adults, but also patients with chronic kidney disease (CKD), and is associated with higher risks of morbidity and mortality.

Aims: The aim of the present study is to determine associations between EDS and nutritional status and serum nutrient levels in older patients with CKD.

Methods: This cross-sectional study included 367 patients (aged ≥ 65 years) with CKD (eGFR < 60 ml/min/1.73 m and/or > 30 mg/day of albuminuria for > 3 months). EDS was recorded using the Epworth Sleepiness Scale (a score of ≥ 11). Malnutrition was diagnosed according to the Mini Nutritional Assessment (MNA) tool (a score of < 17).

Results: The mean age was 81 ± 7 years, and 248 (67%) were female. EDS was seen in 99 (26.9%) patients. Those with EDS had significantly lower MNA scores and more frequent malnutrition than those without EDS (p < 0.05). In multivariable analysis adjusted for age, sex, cerebrovascular disease, dementia, number of drugs, and number of urinations at night, and the Charlson Comorbidity Index the relationship between malnutrition and EDS persisted (OR 2.58, 95% CI 1.38-4.83, p = 0.003). There was no significant difference between the presence of EDS and serum levels or deficiencies of vitamin D, vitamin B, and folate (p > 0.05).

Conclusions: EDS is associated with malnutrition in older patients with CKD. Therefore, EDS and nutritional status should be evaluated together in clinical practice. However, future studies are needed to determine the direction of the association between malnutrition and EDS and to evaluate if dietary intervention can improve EDS.
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http://dx.doi.org/10.1007/s40520-021-01966-0DOI Listing
August 2021

Prognostic Analysis of Primary Pulmonary Malignant Mesenchymal Tumors Treated Surgically.

J Chest Surg 2021 Oct;54(5):356-360

Department of Thoracic Surgery, Faculty of Medicine, Gazi University, Ankara, Turkey.

Background: Primary pulmonary malignant mesenchymal tumors are rare, constituting only 0.4% of all lung cancers. Since sarcomas are chemo/radio-resistant, surgical resection is the optimal treatment choice for patients with suitable medical conditions and tumor stage. In the present study, we analyzed the surgical outcomes and survival of primary pulmonary malignant mesenchymal tumors treated surgically.

Methods: We retrospectively examined the records of patients with primary pulmonary malignant mesenchymal tumors who underwent surgical resection at our department between January 2010 and December 2020. Patient data were analyzed according to age, sex, tumor grade and stage, resection completeness, surgical type, and tumor histopathology.

Results: Twenty patients were included in the study. There were 13 men (65%) and 7 women (35%). The median survival rate was 36 months (range, 19-53 months), and the 5-year overall survival rate was 37%. Unfavorable prognostic factors for overall survival included parietal pleural invasion (p=0.02), high tumor grade (p=0.02), advanced tumor stage (p=0.02), and extensive parenchymal resection (pneumonectomy and bilobectomy, p=0.01). The median length of disease-free survival was 31 months (interquartile range, 21-41 months), and the 5-year disease-free survival rate was 32%. The most unfavorable prognostic factors for recurrence were parietal pleural invasion (p=0.02), high tumor grade (p=0.01), and tumors requiring lung resection with chest wall resection (p=0.02).

Conclusion: Primary malignant mesenchymal lung tumors are aggressive and have a high mortality rate. However, acceptable overall and disease-free survival rates can be obtained with surgical therapy.
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http://dx.doi.org/10.5090/jcs.21.032DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8548186PMC
October 2021

Videothoracoscopic Left Upper Lobectomy for Lung Cancer in a Case of Situs Inversus Totalis.

Cureus 2021 Jul 6;13(7):e16217. Epub 2021 Jul 6.

Thoracic Surgery, Gazi University, Ankara, TUR.

The coexistence of situs inversus totalis (SIT) and lung cancer is exceedingly rare; therefore, only a single case report about this exists in the literature. Recent technological advancements in endoscopic surgery have allowed the execution of videothoracoscopic lung resection in these cases. However, the distinct placement of thoracic structures, bronchovascular anatomy, and additional anomalies in SIT should be investigated using bronchoscopy and contrast-enhanced computed tomography (CT). We present a case report of a videothoracoscopic left upper lobectomy with mediastinal lymph node dissection in a 50-year-old female patient with SIT.
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http://dx.doi.org/10.7759/cureus.16217DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8341550PMC
July 2021

Exercise capacity, muscle strength, dyspnea, physical activity, and quality of life in preoperative patients with lung cancer.

Turk J Med Sci 2021 07 21. Epub 2021 Jul 21.

Background: To detect the extent to which physical impairments are observed in patients with lung cancer awaiting lung surgery, exercise capacity, muscle strength, physical activity, dyspnea, and quality of life (QOL) were objectively compared between the patients and healthy individuals in current study.

Methods: Patients with lung cancer (n= 26) and healthy individuals (n= 21) were included. Exercise capacity, respiratory (maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP)) and quadriceps femoris muscle strength, physical activity, dyspnea and QOL were evaluated using 6-minute walk test (6-MWT), a mouth pressure device, a hand-held dynamometer, a metabolic holter device, Modified Medical Research Council dyspnea scale and European Organization for Research and Treatment of Cancer QOL Questionnaire C30 version3.0, respectively.

Results: The 6-MWT distance (mean difference: 78.97 m), percentages of predicted MIP and MEP values, physical activity parameters (energy expenditures, physical activity duration, average metabolic equivalent and number of steps) and QOL subscales scores (functional, social function and global health status) were significantly lower in the patients than healthy individuals (p < 0.05). Dyspnea perception and other QOL subscales scores (symptom and fatigue) were significantly higher in patients than healthy individuals (p < 0.05). No significant difference was prevalent in quadriceps femoris muscle strength (p > 0.05). Sixteen (66.7%) patients were sedentary.

Conclusion: Severe reductions in exercise capacity, respiratory muscle strength, and physical activity level, poorer QOL and evident dyspnea exist in preoperative patients with lung cancer. Therefore, patients should be included in early protective rehabilitation program including aerobic exercise, respiratory muscle training and physical activity counseling before lung surgery.
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http://dx.doi.org/10.3906/sag-2102-55DOI Listing
July 2021

Alcohol-impaired Walking in 16 Countries: A Theory-Based Investigation.

Accid Anal Prev 2021 Sep 4;159:106212. Epub 2021 Jun 4.

Chang'an University, China.

Alcohol is a global risk factor for road trauma. Although drink driving has received most of the scholarly attention, there is growing evidence of the risks of alcohol-impaired walking. Alcohol-impaired pedestrians are over-represented in fatal crashes compared to non-impaired pedestrians. Additionally, empirical evidence shows that alcohol intoxication impairs road-crossing judgements. Besides some limited early research, much is unknown about the global prevalence and determinants of alcohol-impaired walking. Understanding alcohol-impaired walking will support health promotion initiatives and injury prevention. The present investigation has three aims: (1) compare the prevalence of alcohol-impaired walking across countries; (2) identify international groups of pedestrians based on psychosocial factors (i.e., Theory of Planned Behaviour (TPB) and perceptions of risk); and (3) investigate how segments of pedestrians form their intention for alcohol-impaired walking using the extended TPB (i.e. subjective norm, attitudes, perceived control, and perceived risk). A cross-sectional design was applied. The target behaviour question was "have you been a pedestrian when your thinking or physical ability (balance/strength) is affected by alcohol?" to ensure comparability across countries. Cluster analysis based on the extended TPB was used to identify groups of countries. Finally, regressions were used to predict pedestrians' intentions per group. A total of 6,166 respondents (Age M(SD) = 29.4 (14.2); Males = 39.2%) completed the questionnaire, ranging from 12.6% from Russia to 2.2% from Finland. The proportion of participants who reported never engaging in alcohol-impaired walking in the last three months ranged from 30.1% (Spain) to 83.1% (Turkey). Four groups of countries were identified: group-1 (Czech Republic, Spain, and Australia), group-2 (Russia and Finland), group-3 (Japan), and group-4 (final ten countries including Colombia, China, and Romania). Pedestrian intentions to engage in alcohol- impaired walking are predicted by perceptions of risk and TPB-psychosocial factors in group-1 and group-4. Favourable TPB-beliefs and low perceived risk increased alcohol-impaired walking intentions. Conversely, subjective norms were not significant in group-2 and only perceived risk predicted intention in group-3. The willingness of pedestrians to walk when alcohol-impaired differs significantly across the countries in this study. Perceived risk was the only common predictor among the 16 countries.
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http://dx.doi.org/10.1016/j.aap.2021.106212DOI Listing
September 2021

Thoracic Air Leak Syndrome, Pulmonary Aspergillosis, and COVID-19 Pneumonia After Allogeneic Stem Cell Transplantation in a Child With Myelodysplastic Syndrome.

J Pediatr Hematol Oncol 2021 May 18. Epub 2021 May 18.

Unit of Pediatric Hematology and Oncology, Department of Pediatrics Department of Thoracic Surgery Unit of Pediatric Radiology, Department of Radiology Unit of Pediatric Chest Diseases, Department of Pediatrics Unit of Pediatric Infectious Diseases, Department of Pediatrics, Gazi University School of Medicine, Ankara, Turkey.

Thoracic air leak syndromes (TALS) are very rare among the noninfectious pulmonary complications (PCs). They can either be idiopathic or have several risk factors such as allogeneic hematopoietic stem cell transplantation (allo-HSCT), graft versus host disease and rarely pulmonary aspergillosis. We present a 14-year-old girl with hypoplastic myelodysplastic syndrome who developed graft versus host disease on day 60, TALS on day 150, bronchiolitis obliterans syndrome on day 300, pulmonary aspergillosis on day 400 and COVID-19 pneumonia on day 575 after allo-HSCT. This is the first report of a child who developed these subsequent PCs after allo-HSCT. Therefore, the manifestations of these unfamiliar PCs like TALS and COVID-19 pneumonia, and concomitant pulmonary aspergillosis with management options are discussed.
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http://dx.doi.org/10.1097/MPH.0000000000002203DOI Listing
May 2021

Diagnostic Accuracy of Early Systolic Notching in Pulmonary Embolism.

J Ultrasound Med 2021 May 14. Epub 2021 May 14.

Department of Emergency Medicine, Gazi University School of Medicine, Ankara, Turkey.

Objective: Recently, a cardiac sonography finding, early systolic notching (ESN), was reported with high sensitivity and specificity for the diagnosis of pulmonary embolism (PE) in a limited population. The aim of this study was to determine the diagnostic accuracy of ESN finding for PE in emergency department (ED) patients.

Method: This prospective multicenter study was conducted in 4 academic EDs. All patients who underwent computed tomography angiography for suspected PE were included in the study. After inclusion, cardiac ultrasound including the right ventricular outflow tract Doppler signal was performed. The diagnostic tests of ESN finding were used for PE and its subgroups.

Results: In the study, 183 of 201 patients met the study criteria. Of all patients, 52.5% had PE (n = 96), and 19.7% (n = 36) had ESN finding. In all ED patients, the sensitivity of ESN for PE was 34% (95% CI 25-45), and the specificity was 97% (95% CI 90-99). In the subgroup analysis, the sensitivity of ESN for PE with high or intermediate-high risk was 69% (95% CI 49-85), and the specificity was 90% (95% CI 84-94). Inter-rater reliability for ESN finding between the cardiologist and emergency physician was strong with a kappa statistic of 0.87.

Conclusion: The pulmonary Doppler flow of ESN was moderate to high specific but low sensitive for PE in all ED patients. In the subgroup analysis, this finding was moderate specific and low sensitive.
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http://dx.doi.org/10.1002/jum.15744DOI Listing
May 2021

The analysis of pleural complications of COVID-19 pneumonia

Turk J Med Sci 2021 12 13;51(6):2822-2826. Epub 2021 Dec 13.

Department of Thoracic Surgery, Faculty of Medicine, Gazi University, Ankara, Turkey

Background/aim: As the number of case reports related to the new type of coronavirus (COVID-19) increases, knowledge of and experience with the virus and its complications also increase. Pleural complications are one relevant issue. We aimed in this study to analyze pleural complications, such as pneumothorax, pneumomediastinum, and empyema, in patients hospitalized with the diagnosis of COVID-19 pneumonia.

Materials And Methods: The files of patients who have pleural complications of COVID-19 pneumonia and were consulted about thoracic surgery between March 2020 and December 2020 were retrospectively reviewed. The data of the patients were analyzed according to age, sex, length of stay, treatment method for pleural complications, mortality, severity of COVID-19 pneumonia, tube thoracostomy duration, and presence of a mechanical ventilator.

Results: A total of 31 patients fulfilling the inclusion criteria were included in the study. There were 11 female (35.5%) and 20 male (65.5%) patients. The most common complication was pneumothorax in 20 patients (65%). The median duration of hospitalization was 22 days and the mortality rate was 71%. Mortality was significantly higher in patients on mechanical ventilation (p = 0.04).

Conclusion: The mortality rate is very high in patients with pleural complications of COVID-19 pneumonia. Pneumothorax is a fatal complication in critically ill patients with COVID-19 pneumonia.
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http://dx.doi.org/10.3906/sag-2012-268DOI Listing
December 2021

Videothoracoscopic Bronchial Sleeve Resection for Non-Small Cell Lung Cancer.

Cureus 2021 Mar 4;13(3):e13686. Epub 2021 Mar 4.

Department of Thoracic Surgery, Gazi University Faculty of Medicine, Ankara, TUR.

Nowadays, videothoracoscopic lobectomy is accepted as the standard treatment method in early-stage lung cancer. Sleeve lobectomy, which is an alternative to pneumonectomy in centrally located tumors or peribronchial tumor infiltration, was previously performed via thoracotomy, but it can be performed by video-assisted thoracoscopic surgery (VATS) in recent years. In this method, without compromising oncological principles, a more comfortable and less morbid postoperative process can be provided to the patient compared to thoracotomy. Here, we aimed the presenting two cases that underwent VATS sleeve lobectomy for non-small cell lung cancer and their results.
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http://dx.doi.org/10.7759/cureus.13686DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8012266PMC
March 2021

Hemopneumothorax as an Unusual and Delayed Complication of Coronavirus Disease 2019 Pneumonia: A Case Report.

J Chest Surg 2021 Dec;54(6):521-523

Department of Thoracic Surgery, Gazi University, Ankara, Turkey.

The increasing number of studies published on coronavirus disease 2019 (COVID-19) pneumonia has improved our knowledge of the disease itself and its complications. Despite a considerable number of publications on COVID-19 pneumonia-associated pneumothorax, no article on spontaneous hemopneumothorax has been found in the English-language literature. According to published case reports, pneumothorax generally occurs in hospitalized patients during treatment, whereas cases that arise in the late period after discharge are exceptional. Herein, we present a case of spontaneous hemopneumothorax occurring as a late complication of COVID-19 pneumonia on day 17 after discharge.
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http://dx.doi.org/10.5090/jcs.20.149DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8646073PMC
December 2021

Corrigendum to: Investigation of Pycnogenol Content in Five Different Pine Barks Species Grown in Turkey by HPLC-UV and LC-MS.

J Chromatogr Sci 2021 Oct;59(10):1004

EGE MATAL (Ege University Application and Research Center for Testing and Analysis), Ege University, Bornova, 35100 İzmir, Bornova-İzmir-Turkey, Turkey.

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http://dx.doi.org/10.1093/chromsci/bmab039DOI Listing
October 2021

Survival outcomes of pneumonectomy with left atrial resection for non-small cell lung cancer.

Indian J Cancer 2021 Jan 27. Epub 2021 Jan 27.

Department of Thoracic Surgery, Gazi University School of Medicine, Besevler, Ankara, Turkey.

Background: Lung cancer invading left atrium is accepted as T4 tumor and surgical treatment in this situation is controversial. The aim of our study was to determine the prognostic factors of patients with surgically treated non-small cell lung cancer (NSCLC) invading left atrium.

Methods: After the approval of local ethics committee, the study was conducted in Gazi University, Department of Thoracic Surgery (Ankara-Turkey). The records of the patients were obtained from the encrypted hospital management software. Sequential codes were given to the data of patients and it was transferred to the statistics program without their names and ID numbers. The data of patients were collected as follows: those who had extended pneumonectomy from the surgery reports were found, then their pathology reports were examined, and those who had atrial muscle tissue were included in the study. Selected cases included as follows: patients who were medically suitable for surgery, patients who could tolerate surgery in cardiology evaluation, patients who had adequate lung capacity for pneumonectomy. Data of patients were analyzed according to age, gender, lymph node invasion, complete resection, and operative mortality.

Results: A total of 18 patients were included in the study. There were 16 (88.8%) men and 2 (12.2%) women. The mean age was 60.8 (range: 44 -76; Standard deviation: ± 1.8) years. Cardiopulmonary bypass was used in only one patient. The 30-day mortality was 5.5%. 1, 3, and 5-years overall survivals were 77%, 18.6%, and 9.3%, respectively. Mediastinal lymph node metastasis in N1 and N2 stations was detected 10 and 2, respectively. There was statistically significant correlation between recurrence and lymph node invasion status including N1 and N2 station (P = 0.04).

Conclusion: Although surgery is controversial in patients with NSCLC invading left atrium, it can be performed in selected cases. Morbidity and mortality rates were acceptable.
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http://dx.doi.org/10.4103/ijc.IJC_709_19DOI Listing
January 2021

Various Uses of Laryngeal Mask Airway during Tracheal Surgery.

Thorac Cardiovasc Surg 2021 Dec 19;69(8):764-768. Epub 2021 Mar 19.

Department of Thoracic Surgery, Gazi University Faculty of Medicine, Ankara, Turkey.

Background:  The use of laryngeal mask airway (LMA) ventilation in surgeries to be performed in upper tracheal stenosis has been reported in the case series. However, there is no generally accepted standardized approach for the use of LMA. In this study, LMA usage areas and advantages of trachea surgery were examined.

Methods:  The records of 21 patients who underwent tracheal surgery using LMA ventilation between March 2016 and May 2020 were evaluated retrospectively. The patient data were analyzed according to age, gender, mean follow-up time, surgical indication, mean tracheal resection length, anastomosis duration, mean oxygen saturation, mean end-tidal CO levels, and postoperative complications.

Results:  Four patients were female and 17 were male, their median age was 43 (11-72 range) and the mean follow-up time was 17.6 months. The most common surgical indication was postintubation tracheal stenosis. The mean tracheal resection length was 26.6 mm and the mean anastomosis duration was 11.3 minutes. The mean pulse oximetry and mean end-tidal CO during laryngeal mask ventilation was 97.6% ± 2.1 and 38.1 ± 2.8 mm Hg, respectively. Postoperative complications were higher in patients with comorbidities.

Conclusion:  LMA-assisted tracheal surgery is a method that can be used safely as a standard technique in the surgery of benign and malignant diseases of both the upper and lower airway performed on pediatric patients, patients with tracheostomy, and suitable patients with tracheoesophageal fistula.
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http://dx.doi.org/10.1055/s-0041-1724103DOI Listing
December 2021

The effect of diagnostic hysteroscopy performed before fresh and frozen-thawed embryo transfer in IVF cycles on reproductive outcomes

J Turk Ger Gynecol Assoc 2021 08 5;22(3):206-211. Epub 2021 Mar 5.

Department of Obstetrics and Gynecology, Acıbadem Mehmet Ali Aydınlar University Faculty of Medicine, İstanbul, Turkey

Objective: Hysteroscopy is frequently performed in infertile women and thought to improve pregnancy rates. The data obtained from studies investigating the effect of hysteroscopy in in-vitro fertilization (IVF) cycles is variable. We aimed to evaluate the effect of hysteroscopy on pregnancy outcomes of fresh and frozen-thawed embryo transfers (FET) performed during IVF cycles.

Material And Methods: The data of the 765 patients, who had IVF treatment between January 2015 and July 2017 in an infertility center, were retrospectively analyzed. Of those, 586 (76.6%) patients underwent fresh embryo transfer, while 179 (23.4%) patients underwent FET. Hysteroscopy performed by a single experienced surgeon was scheduled two months before transfer. Hysteroscopy was performed in 101/586 (17.2%) in those undergoing fresh embryo transfer and 44/179 (24.6%) patients in the FET group. Pregnancy outcomes of the groups were compared respectively within their own group.

Results: The mean age was similar in patients in the fresh and FET groups (p=0.365, respectively). There was no difference in the number of transferred embryos between the groups (p=0.218). In the fresh embryo group there were 246 pregnancies, of which 44 had undergone diagnostic hysteroscopy while 202 had not, (p=0.516) and 79 pregnancies in the FET group, of which 20 had undergone diagnostic hysteroscopy while 59 had not (p=0.711). There was no statistical difference according to pregnancy rate between the groups (p=0.538).

Conclusion: Performing diagnostic hysteroscopy before fresh or FET does not improve the pregnancy rates.
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http://dx.doi.org/10.4274/jtgga.galenos.2021.2020.0136DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8420750PMC
August 2021

Investigation of Phenolic Content in Five Different Pine Barks Species Grown in Turkey by HPLC-UV and LC-MS.

J Chromatogr Sci 2021 May;59(6):491-501

EGE MATAL (Ege University Application and Research Center for Testing and Analysis), Ege University, Bornova, 35100 İzmir, Bornova-İzmir-Turkey, Turkey.

Investigation of phenolic content from different pine bark species grown in Turkey was performed using a reversed-phase high pressure liquid chromatography with ultraviolet (RP-HPLC-UV) method. All phenolic constituents were separated in <26 min on reversed-phase C18 column with gradient mobile phase that consists of orthophosphoric acid, methanol and acetonitrile. Detections were made on an UV detector at 280 nm and at a flow rate of 1 mL/min. Samples were prepared according to Masqueller's conventional sample preparation method with slight modifications. To avoid the reduction in extraction efficiency the sample preparation step was carried out under argon atmosphere. The linearity of the method was between 0.9994 and 0.9999. The detection limits for the five phenolic constituents ranged from 0122 to 0.324 mg/L. Catechin and taxifolin were found in all pine barks at a concentration of 0.065 ± 0.002-1.454 ± 0.004 and 0.015 ± 0.001-23.164 ± 0.322 mg/g, respectively. Epicatechin was determined in four pine barks between 0.027 ± 0.001 and 0.076 ± 0.002 mg/g, ferulic acid in two pine barks between 0.010 ± 0.001 and 0.022 ± 0.001 mg/g and epicatechin gallate in only one of the pine barks at 0.025 ± 0.001 mg/g. Finally, the total amount of phenolic compounds and antioxidant capacities of the pine barks were found to be very high.
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http://dx.doi.org/10.1093/chromsci/bmab022DOI Listing
May 2021

Primary pulmonary angiosarcoma presenting as Pancoast tumor.

Asian Cardiovasc Thorac Ann 2021 Jun 12;29(5):434-437. Epub 2021 Jan 12.

Department of Thoracic Surgery, Gazi University, Ankara, Turkey.

A primary pulmonary angiosarcoma is an extremely rare entity with fewer than 30 cases reported in the literature. We found no reports of primary pulmonary angiosarcoma presenting as a Pancoast tumor. We describe a case of pulmonary angiosarcoma located in the right superior sulcus that was treated by surgery.
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http://dx.doi.org/10.1177/0218492320988456DOI Listing
June 2021

The Diagnostic Accuracy of Ultrasonography for the Diagnosis of Rib Fractures in Patients Presenting to Emergency Department With Blunt Chest Trauma.

J Emerg Med 2021 Jan 18;60(1):90-97. Epub 2020 Nov 18.

Department of Emergency Medicine, Marmara University School of Medicine, Istanbul, Turkey.

Background: Rib fractures are the most common complications of blunt chest trauma (BCT). Computed tomography (CT) is the modality of choice for BCT, but with several disadvantages. Ultrasonography (US) is an inexpensive, readily available, and relatively harmless imaging alternative. However, a direct comparison of the sonographic evaluation of the rib as a whole with CT as a reference has not been performed to date.

Objective: This study aimed to compare the diagnostic accuracy of US with CT for the detection of rib fractures in patients who presented to emergency department (ED) with BCT.

Methods: We included a convenience sample of adult patients who presented to the ED with thoracic pain after BCT in the last 24 h in this prospective, observational, diagnostic accuracy study. The diagnostic utility of US performed by an emergency physician was compared with thorax CT.

Results: The final study population included 145 patients. The diagnostic accuracy of US was 80% with a sensitivity of 91.2% and specificity of 72.7% for the detection of any rib fracture (positive likelihood ratio 3.4 and negative likelihood ratio 0.12). If we considered each rib separately, the sensitivity of US decreased to 76.7% and specificity increased to 82.7% (81.3% accuracy).

Conclusions: A negative US of the site of the highest tenderness and neighboring ribs in a patient with BCT who presented to the ED with lateralizing pain decreases the possibility of a rib fracture significantly. However, a positive US performs poorly to specify the exact location and number of the fractured ribs.
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http://dx.doi.org/10.1016/j.jemermed.2020.06.063DOI Listing
January 2021

Prognostic factors for sarcomatoid carcinomas of lung: A single-centre experience.

Lung India 2020 Nov-Dec;37(6):506-510

Department of Thoracic Surgery, School of Medicine, Gazi University, Ankara, Turkey.

Background: Although lung sarcomatoid carcinomas (LSCa) arised from the epithelial tissue, they have very distinctive features than other non-small cell lung carcinomas in terms of histopathology and survival. It constitutes 0.1%-0.4% of all lung cancers. The aim of our study is to evaluate the survival analysis of LSCa in a single thoracic surgery clinic and to determine the prognostic factors.

Materials And Methods: It was a retrospective cohort study. After the approval of the local ethics committee, a total of 34 patients who were operated in our department between January 2010 and December 2018, whose pathologies were reported as sarcomatoid carcinoma was included in the study. The patients were analyzed by age, gender, presence of necrosis in the histopathological examination, tumor stage, tumor diameter, and tumor location.

Results: There were 28 males and 6 females. The median age was 60 years (range: 36-80 years). The median survival was 42 months (32.6-52.2 months), and the 5-year overall survival was 33.6%. Significantly negative prognostic factors were tumor diameter and tumor stage (P = 0.003 and 0.001, respectively). Median disease-free interval (DFI) was 38 months (27.3-49.1 months), and 5-year DFI was 32.6%.

Conclusion: LSCa are highly heterogeneous epithelial malignancies, and it has worse survival than other epithelial cancers. Relatively, satisfactory results can be obtained in these tumors with surgical treatment.
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http://dx.doi.org/10.4103/lungindia.lungindia_525_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7879877PMC
November 2020

Silicon nitride ceramic for all-ceramic dental restorations.

Dent Mater J 2020 Dec 7;39(6):1080-1086. Epub 2020 Oct 7.

Department of Metallurgical and Materials Engineering, Ankara Yıldırım Beyazıt University.

Silicon nitride (SiN) is one of the promising ceramics for dental restoration due to providing significant benefits during the application. This study aimed to investigate the potential use of SiN for all-ceramic dental restorations by characterizing some critical properties as color shade, mechanical resistance, shear-bond strength and radiolucency. For our study, porous SiN ceramic was produced by partial sintering process with limited amounts of sintering additives and low temperature. A commercial ZrO ceramic was prepared according to manufacturer's instructions and results were compared with SiN. SiN is an attractive ceramic for dental applications with good mechanical properties even in porous form, it has additional advantages over the conventional ceramics used as restorative material, such as, inherent antibacterial/anti-infective activity, radiolucency, and lower hardness. It is expected that SiN will become popular in dental applications as well.
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http://dx.doi.org/10.4012/dmj.2020-134DOI Listing
December 2020

Determination of prognostic factors of surgically treated pathological Stage IIIA non-small cell lung cancer.

Turk Gogus Kalp Damar Cerrahisi Derg 2020 Jul 28;28(3):496-504. Epub 2020 Jul 28.

Department of Thoracic Surgery, Medicine Faculty of Gazi University, Ankara, Turkey.

Background: This study aims to identify the prognostic factors in Stage IIIA non-small cell lung cancer and to investigate whether there was a significant difference in terms of overall survival and diseasefree survival among the subgroups belonging to this disease stage.

Methods: Between January 2010 and December 2018, a total of 144 patients (125 males, 19 females; median age 60 years; range, 41 to 80 years) who were operated for non-small cell lung cancer in our clinic and whose pathological stage was reported as IIIA were retrospectively analyzed. Data including demographic and clinical characteristics of the patients, histopathological diagnosis, the standardized uptake value of the mass on positron emission tomography-computed tomography, tumor diameter, type of surgery, lymph node metastasis status, visceral pleural invasion, and overall and disease-free survival rates were recorded.

Results: The median survival was 39 (range, 27.8 to 46.1) months and the five-year overall survival rate was 28%. The mean tumor diameter was 4.3±2.7 cm. The median disease-free survival was 37 (range, 28.1 to 48.6) months and the five-year disease-free survival rate was 26.9%. In the multivariate analysis, overall survival and disease-free survival in T2N2M0 subgroup were significantly worse than the other subgroups. The other poor prognostic factors of survival were the standardized uptake value of the tumor, pneumonectomy, and histopathological subtypes other than squamous cell carcinoma and adenocarcinoma. Parietal pleural invasion was significantly associated with worse disease-free survival rates.

Conclusion: Our results showed that there may be significant survival differences between subgroups created by tumor histopathology, lymph node invasion and the type of surgery in a heterogeneous lung cancer stage.
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http://dx.doi.org/10.5606/tgkdc.dergisi.2020.18824DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7493618PMC
July 2020

Surgical outcomes of sleeve resections performed for non-small cell lung cancer; A single center experience.

Niger J Clin Pract 2020 Jun;23(6):829-834

Department of Thoracic Surgery, Faculty of Medicine, Gazi University, 06500, Besevler, Ankara, Turkey.

Background: Although bronchial sleeve resections were performed instead of pneumonectomy in patients with insufficient pulmonary function initially, it is currently available as an alternative to pneumonectomy even in patients with adequate pulmonary reserve.

Aims: In this study, we aimed to evaluate the sleeve resections performed for lung cancer in terms of technical, postoperative complication mortality, survival rates and survival factors, complication and to compare them with the literature.

Methods: Patients who underwent sleeve lung resection with diagnosis of non-small cell lung cancer at our department between January 2012 and December 2017 were included in the study. Patients' data were analyzed according to tumor size, tumor histopathology, hilar/mediastinal lymph nodes invasion status, postoperative complications, operative mortality, resection type, overall survival and diseases-free survival, tumor location, and length of stay in intensive care unit.

Results: A total of 71 patients included the study. Right upper sleeve lobectomy was applied to 40 (56.3%) patients and left upper sleeve lobectomy was performed to 19 (26.8%) patients. The most common histopathological diagnosis was squamous cell carcinoma. The mean tumor diameter was 3.39 (SD: 2.25) cm. There was no nodal invasion in 41 (57.7%) patients and N1 nodal positivity was detected in 18 (25.4%) patients and N2 positivity in 12 (16.9%) patients. Median survival time was 43.6 months (35.4-51.8 months), the 3- and 5-year overall survival were 65.7% and 40.6%, respectively. There was a statistically significant correlation relationship between nodal invasion and recurrence, but this relation was not found in overall survival.

Conclusion: In our study, no significant correlation was found between mediastinal lymph node invasion and overall survival. Supporting this result with multi-centered and prospective studies may encourage surgeons for sleeve resection in indicated patients had lung cancer with nodal invasion.
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http://dx.doi.org/10.4103/njcp.njcp_603_18DOI Listing
June 2020

Acute kidney injury following colistin treatment in critically-ill patients: may glucocorticoids protect?

J Chemother 2021 Apr 5;33(2):85-94. Epub 2020 Jun 5.

Department of Internal Medicine, Division of Intensive Care Medicine, Dokuz Eylül University School of Medicine, Izmir, Turkey.

Nephrotoxicity following colistin administration is common and factors alleviating nephrotoxicity are yet to be determined. We retrospectively evaluated outcomes of subjects who were treated with colistin (n = 133) and with antibiotics other than colistin (control, n = 133) in intensive care units. Acute kidney injury (AKI) occurred in 69.2% and 29.3% of patients in colistin and control groups, respectively ( < 0.001). In the colistin group, glucocorticoid exposure was more common in subjects who did not develop AKI ( < 0.001). This was not the case in the control group. In the colistin cohort, older age (per 10 years, odds ratio [OR] 1.41, 95% CI 1.05-1.91;  = 0.025), PPI use (OR 3.30, 95% CI 1.18-9.23;  = 0.023) and furosemide treatment (OR 2.66, 95% CI 1.01-6.98;  = 0.047) were independently associated with the development of AKI while glucocorticoid treatment (OR 0.23, 95% CI 0.10-0.53;  = 0.001) was independently associated with reduced risk of AKI. Mortality was observed in 74 patients in the colistin cohort (55.6%). A higher APACHE-II score (OR 1.17, 95% CI 1.08-1.26;  < 0.001) was independently associated with mortality while a higher serum albumin level (per 1 g/dL increase, OR 0.20, 95% CI 0.070-0.60;  = 0.004) was associated with a lower risk of mortality. In conclusion, glucocorticoid exposure is associated with a lower risk of AKI caused by colistin therapy in critically-ill patients. Prospective studies are needed to confirm these findings and determine the optimal type, dose and duration of glucocorticoid therapy.
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http://dx.doi.org/10.1080/1120009X.2020.1770027DOI Listing
April 2021

Does an N-shaped association exist between pollution and ICT in Turkey? ARDL and quantile regression approaches.

Environ Sci Pollut Res Int 2020 Jun 4;27(17):20786-20799. Epub 2020 Apr 4.

Faculty of Economics and Administrative Sciences, Department of Business Administration, Ardahan University, 75002, Ardahan, Turkey.

It is a debated issue that the influence of information and communications technologies (ICTs) on the environment is positive or negative in the literature. For instance, usage and disposal of ICTs may lead to environmental degradation and it may also increase carbon emission arising from electricity generation. However, ICT applications may contribute to environmental quality creating great opportunities for smarter cities, transport systems, electrical grids, and industrial processes. These two effects reveal the possible relationship of an inverted U-shaped association also known as the environmental Kuznets curve (EKC) hypothesis relationship between ICT and CO. The objective of this study is to determine the structure of the relationship between environmental degradation and ICTs in Turkey for 1980-2017. The findings of the autoregressive distributed lag (ARDL) analysis indicate the validity of inverted N-shaped EKC hypothesis. However, the results of the quantile regression test are inconsistent with those of ARDL. When the coefficients from 30th to 95th quantiles are examined, it is observed that there is an inverted N-shaped relationship between ICT and CO, but these coefficients are not statistically significant. In addition, in the 95th quantile, coefficients of the square of ICT and ICT are statistically significant, contrary to the cube of ICT which is not. This reveals that the relationship between the variables is U-shaped.
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http://dx.doi.org/10.1007/s11356-020-08513-wDOI Listing
June 2020

Tumour cell PD-L1 expression is prognostic in patients with malignant pleural effusion: the impact of C-reactive protein and immune-checkpoint inhibition.

Sci Rep 2020 04 1;10(1):5784. Epub 2020 Apr 1.

University Duisburg-Essen, University Medicine Essen - Ruhrlandklinik, Department of Thoracic Surgery, Essen, Germany.

Malignant pleural effusion (MPE) confers dismal prognosis and has limited treatment options. While immune-checkpoint inhibition (ICI) proved clinical efficacy in a variety of malignancies, data on the prognostic role of PD-L1 in MPE is scarce. We retrospectively studied PD-L1 tumour proportion score and Ki-67 index in pleural biopsies or cytologies from 123 patients (69 lung cancer, 25 mesothelioma, and 29 extrathoracic primary malignancies). Additionally, the impact of C-reactive protein (CRP) and platelet count was also analysed. Median overall survival (OS) after MPE diagnosis was 9 months. Patients with PD-L1 positive tumours (≥1%) had significantly shorter OS than patients with negative PD-L1 status (p = 0.031). CRP and Ki-67 index were also prognostic and remained independent prognosticators after multivariate analysis. Interestingly, Ki-67 index and CRP influenced the prognostic power of PD-L1. Finally, patients receiving ICI tended to have a longer median OS and CRP - but not PD-L1 - was a significant prognosticator in this subgroup. In summary, histological and circulating biomarkers should also be taken into account as potential biomarkers in ICI therapy and they may have an impact on the prognostic power of PD-L1. Our findings might help personalizing immune-checkpoint inhibition for patients with MPE and warrant further prospective validation.
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http://dx.doi.org/10.1038/s41598-020-62813-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7113285PMC
April 2020
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