Browsing by Author "Aslan, G"
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Item Vitamin D receptor gene polymorphism in children with urinary tract infectionAslan, S; Akil, I; Aslan, G; Onay, H; Ozyurt, BC; Ozkinay, FIt is known that small alterations leading to different vitamin D receptor (VDR) alleles affect resistance or susceptibility to infections. In this study, we examined VDR gene polymorphisms in urinary tract infections (UTI), which are common and an important cause of morbidity in children and subsequently of renal scar formation. We evaluated 92 patients diagnosed with UTI and 105 children without prior history of UTI as a control group. The VDR gene polymorphisms BsmI, FokI, ApaI, and TaqI were evaluated in patients and controls. BsmI polymorphism genotype distribution was similar between groups. There was a significant difference between groups for FokI (p = 0 < 001); for the ff genotype, the risk of UTI was significantly increased (p < 0.01) ,at 3.94 times higher (odds ratio = 3.94; 95% confidence interval 1.71-9.09). ApaI polymorphism was significantly increased in the control group (p < 0.01) and evaluated as a protective factor. Comparing the TaqI genotype between groups, there was no statistically significant difference, but in both Tt and tt genotypes, there was minimal increased risk of UTI. The results of this study suggest that VDR gene polymorphisms can be important for susceptibility to UTI and renal scar formation. Association between VDR polymorphisms and UTI is in accordance with the understanding of how vitamin D modulates the immune response against infections.Item Vitamin D receptor gene polymorphism in children with urinary tract infecionAkil, I; Aslan, S; Aslan, G; Onay, H; Ozyurt, B; Ozkinay, FItem Multicenter evaluation of crystal violet decolorization assay (CVDA) for rapid detection of isoniazid and rifampicin resistance in Mycobacterium tuberculosisCoban, AY; Akbal, AU; Bicmen, C; Albay, A; Sig, AK; Uzun, M; Selale, DS; Ozkutuk, N; Surucuoglu, S; Albayrak, N; Ucarman, N; Ozkutuk, A; Esen, N; Ceyhan, I; Ozyurt, M; Bektore, B; Aslan, G; Delialioglu, N; Alp, AThe aim of this multicenter study was to evaluate the performance of the crystal violet decolorization assay (CVDA) for detection of multidrug resistant tuberculosis (MDR-TB). This study was performed in 11 centers in two phases. A total of 156 isolates were tested for INH and RIF resistance. In the phase I, 106 clinical isolates were tested in the Center 1-7. In the phase 2, 156 clinical isolates were tested in the center 1-6, center 8-11. Eighty six of 156 tested isolates were the same in phase I. Agreements were 96.2-96.8% for INH and 98.1-98.7% for RIF in the phase I-II, respectively. Mean time to obtain the results in the phase I was 14.3 +/- 5.4 days. In the phase II, mean time to obtain the results was 11.6 +/- 3.5 days. Test results were obtained within 14days for 62.3% (66/106) of isolates in the phase I and 81.4% (127/156) of isolates in the phase II. In conclusion, CVDA is rapid, reliable, inexpensive, and easy to perform for rapid detection of MDR-TB isolates. In addition, it could be adapted for drug susceptibility testing with all drugs both in developed and developing countries.Item Oncological Outcomes of Patients with Non-Clear Cell Renal Cell Cancers: Subtypes of Unclassified and Translocation Renal Cell CancersGokalp, F; Celik, S; Sozen, TS; Ozen, AH; Aslan, G; Izol, V; Baltaci, S; Muezzinoglu, T; Akdogan, B; Suer, E; Tinay, IPurpose: We aimed to compare oncological outcomes in the two rare subtypes, unclassified renal cell cancer (un-RCC) and translocation RCC (tRCC), vs clear cell RCC (ccRCC). Materials and Methods: Between 2004 and 2019, from Turkish Urooncology Society Database, we identified 2324 patients for histological subtypes including 80 unRCC (3.4%), 19 tRCC (0.8%) and 2225 ccRCC (95.8%). Results: The overall (15.8%) and cancer-specific mortalities (11.1%) were found to be higher in tRCC group and the recurrence free mortality (13.8%) was found to be higher in unRCC group. Larger pathological tumor size (p = 0.012) and advanced pathological T stage (p = 0.042) were independent predictive factors on overall mortality in patients with unRCC tumors. Conclusion: The oncological outcomes of the unRCC and tRCC are worse than ccRCC and pathological tumor size and pathological stage are predictive factors for mortality in the unRCC.Item Oncological Outcomes of Chromophobe Versus Clear Cell Renal Cell Carcinoma: Results from A Contemporary Turkish Patient CohortCetin, T; Celik, S; Sozen, S; Ozen, H; Akdogan, B; Aslan, G; Baltaci, S; Suer, E; Bayazit, Y; Izol, V; Muezzinoglu, T; Gokalp, F; Tinay, IPurpose: To compare the oncological outcomes of clear cell RCC (ccRCC), which is common in renal cell carcinomas (RCC), and chromophobic RCC (chRCC), which is less common, and to define the factors affecting survival in the Turkish patient population for both RCC subclassifications. Materials and Methods: Patients with a pathologically confirmed RCC diagnosis after radical or partial nephrectomy in the Turkish Urooncology Association (TUOA), Urological Cancers Database-Kidney (UroCaD-K), were retrospectively reviewed. Patients with ccRCC and chRCC were included in the study. The primary outcomes of this study are recurrence-free survival (RFS), overall survival (OS) and cancer-specific survival (CSS) for each histological subtype. Results: Data from 5300 patients in the TUOA UroCaD-K are reviewed and a total of 2560 patients (2225 in the ccRCC group and 335 in the chRCC group) are included in the final analysis. In the comparison of the groups, tumor size was greater both radiologically and pathologically in chRCC (p p = 0.019 vs 0.002 respectively). Recurrence-free survival (RFS), overall survival (OS) and cancer-specific survival (CSS) rates are worse in ccRCC subgroup. In the evaluation of risk factors; pathological stage, local invasion and Fuhrmann grade were found to be significant for recurrence in ccRCC. Age, body mass index and pathological stage were the risk factors affecting overall mortality (OM). Pathological tumor size was an independent risk factor for recurrence in chRCC, while age was analyzed as the only parameter affecting OM. Conclusion: chRCC oncological data and OS, CSS and RFS rates were found to be better than ccRCC in the Turkish patient population.Item Effect of pelvic lymph node dissection and its extent on oncological outcomes in intermediate-risk prostate cancer patients: A multicenter study of the Turkish Uro-oncology AssociationIzol, V; Ok, F; Aslan, G; Akdogan, B; Sozen, S; Ozden, E; Celik, O; Muezzinoglu, T; Turkeri, L; Akdogan, N; Baltaci, SBackground Pelvic lymph node dissection (PLND) is the gold standard method for lymph node staging in prostate cancer. We aimed to evaluate the effect of PLND combined with radical prostatectomy (RP) on oncological outcomes in D'Amico intermediate-risk prostate cancer (IRPC) patients. Methods Patients with D'Amico IRPC were included in the study. In the overall cohort and subgroups (biopsy International Society of Urological Pathology [ISUP] grade group 2 and 3), patients were divided into two groups as PLND and no-PLND. More extensive PLND, defined as a number of removed nodes (NRN) >= 75th percentile. Results After exclusion, a total of 631 patients were included: 351 (55.6%) had PLND and 280 (44.4%) had no-PLND. The mean age was 63.1 +/- 3.60 years. The median NRN was 8.0 (1.0-40.0). The mean follow-up period was 47.7 +/- 37.5 months. The lymph node involvement (LNI) rate was 5.7% in the overall cohort, 3.9% in ISUP grade 2, and 10.8% in ISUP grade 3. Patients with PLND were associated with more aggressive clinicopathologic characteristics but no significant difference in biochemical recurrence-free survival (BCRFS) was found between patients with PLND and no-PLND (p = 0.642). In the subgroup analysis for ISUP grades 2 and 3, no significant difference in BCRFS outcomes was found in patients with PLND and No-PLND (p = 0.680 and p = 0.922). Also, PLND extent had no effect on BCRFS (p = 0.569). The multivariable Cox regression model adjusted for preoperative tumor characteristics revealed that prostate specific antigen (PSA) (HR: 1.18, 95% CI: 1.01-1.25; p = 0.048) was an independent predictor of biochemical recurrence (BCR). The optimum cut-off value for PSA, which can predict BCRFS, was assigned to be 7.81 ng/ml, with an AUC of 0.63 (95% CI: 0.571-0.688). The highest sensitivity and specificity were 0.667 and 0.549. Conclusion Overall and cancer-specific survival analyzes were not evaluated because not enough events were observed. Neither PLND nor its extent improved BCRFS outcomes in IRPC. The LNI rate is low in patients with biopsy ISUP grade 2 and the BCR rate is low in those with PSA < 7.81 ng/dl so PLND can be omitted in these IRPC patients.Item Radical Prostatectomy Outcomes in Patients with Clinical Lymph Node Involvement from The Turkish Urooncology DatabaseTavukçu, HH; Erbatu, O; Akdogan, B; Izol, V; Yücetas, U; Sözen, S; Aslan, G; Sahin, B; Tinay, I; Müezzinoglu, T; Baltaci, SObjective: This study aimed to investigate pathological lymph node involvement in selected patients and the relationship of prostate-specific antigen (PSA) progression-free survival rates between patients with and without lymph node involvement on preoperative conventional radiologic imaging. Limited data is available about local treatment outcomes in patients with prostate cancer (PCa) having clinical lymph node involvement. Materials and Methods: Using the national PCa database, patients who underwent radical prostatectomy (RP) and pelvic lymph node dissection between 2001 and 2019, with pathologic lymph node involvement, were included in the study. Patients were divided into two groups as those with and without clinical lymph node involvement by preoperative imaging. Results: A total of 213 patients were included in the final analysis, wherein 164 are with and 49 are without lymph node involvement. After the mean follow-up periods of 33.9 months, a significant difference was not found between the two groups in terms of recurrence, adjuvant treatment necessity, and final status. The multivariate analysis for 5-year PSA recurrence-free survival revealed that surgical margin positivity was the only significant factor (p=0.016, hazard ratio: 2.67, confidence interval: 1.19-5.98). Conclusion: Our results revealed that preoperative clinical lymph node status did not affect the 5-year PSA recurrence-free survival in pathologic lymph node involvement of patients treated with RP and pelvic lymph node dissection. Therefore, RP stands as an effective treatment option in selected patients with PCa having clinical lymph node involvement.Item Treatment Options in Low-risk Prostate Cancer Patients: A Retrospective Database ReportErbatu, O; Müzzinoglu, T; Akdogan, B; Aslan, G; Sözen, S; Baltaci, S; Süer, E; Izol, V; Üçer, O; Ataus, S; Türkeri, L; Tinay, IObjective: This report examined the approaches to low-risk patients using the data from the Urologic Cancer Database -Prostate, Urooncology Association.Materials and Methods: In this study, there were 920 patients with low-risk prostate cancer according to the current guidelines of the European Urology Association. Patient data were obtained from the Urological Cancer Database -Prostate, the Turkish Urooncology Association (UroCaD-P) from records of the years 1995-2021. Ethics committee approval was obtained for this study to publish in the form of a database report.Results: Our study was conducted with 920 patients with low-risk prostate cancer. Therefore, at the time of diagnosis, all patients in the study were ISUP 1, had a prostate specific antigen (PSA) level lower than 10 ng/mL, and clinically T1-T2a. Surgical treatment was used in 750 (81.5%) of the patients. At the time patients were retrieved from the database for the study, 140 patients (15.2%) were in the active surveillance (AS) process. Thirty patients (3.2%) in the study received their local treatment as radiotherapy (RT). The mean age value at cancer detection in the study was 61.9. The mean ages of the patients who were under AS and who underwent radical prostatectomy (RP) were 61.3 and 61.7 years, respectively. In the RT group, the mean age was 66.7 years. The mean PSA value of the whole group was 5.81 ng/mL. While it was 5.94 in AS patients, it was calculated as 5.89 in patients who underwent radical surgery. The mean PSA value of the RT group was 5.40. The pathological upgrade was detected in 225 patients (30%) after surgery. Surgical margin positivity was in 160 of the patients (21.3%) who underwent surgery. In addition, 100 patients (13.3%) had extracapsular disease. The seminal vesicle invasion was detected in 25 patients (3.3%) after surgery.Conclusion: We predict that the incidence of low-risk prostate cancer will increase over time due to the aging of the population, the use of PSA, advances in imaging modalities, and increasing biopsy success rates. Therefore, the importance of the existence of multicentric databases containing this patient group is undeniable. More studies are needed with these databases, including both patient demographics and treatment outcomes. Hopefully, this database report will be an important step in this direction.Item Are the Recommended Criteria for Clinically Insignificant Prostate Cancer Applicable to 12-core Prostate Biopsy Scheme? A Multicentre Study of Urooncology Association, TurkeyÇelik, S; Kizilay, F; Yörükoglu, K; Özen, H; Akdogan, B; Izol, V; Bayazit, Y; Aslan, G; Sözen, S; Baltaci, S; Müezzinoglu, T; Narter, F; Türkeri, LObjective: The aim of this study is to investigate the relevance of the Epstein criteria for the 12-core transrectal prostate biopsy (TRUS-Bx) scheme with the evaluation of clinicopathologic data recorded in the Urologic Cancer Database - Prostate (UroCaD-P), Urooncology Association, Turkey (UOAT). Materials and Methods: Patients with detailed pathological 12-core TRUS-Bx data for each biopsy core and who underwent RP due to PCa were included in this study. A total of 1167 patients from seven different centres were analysed. TRUS-Bx pathological findings were separately evaluated in the areas matching the sextant biopsy (6-core paramedian-lateral) scheme and in all 12-core biopsy areas (12-core biopsy scheme). Overall detection rates of PCa and ratios of clinically significant (sPCa) and insignificant PCa (insPCa) after RP were defined and compared between the biopsy schemes. Biopsy findings, according to the Epstein criteria, were also compared between the two schemes. A model for each biopsy scheme was created, including the Epstein criteria and additional biopsy findings using logistic regression analysis to predict clinically sPCa after RP. Results: There was a high correlation for the prediction of clinically insPCa between the two biopsy schemes in the same population. However, 7.3% of PCa could not be diagnosed in the 6-core TRUS-Bx scheme. Also, 69.4% of these had clinically sPCa according to the Epstein criteria in 12-core TRUS-Bx scheme and 51.8% of these were clinically sPCa after RP. The presence of perineural invasion (PNI) in 12-core biopsy was also significant regarding predicting sPCa (p<0.001). Conclusion: The Epstein criteria in 12-core prostate biopsy provide a better prediction of clinically sPCa than the 6-core biopsy scheme. Biopsy PNI findings appeared to improve the effectiveness of 12-core prostate biopsy, in addition to the Epstein criteria.Item Sextant Biopsy-Based Criteria for Clinically Insignificant Prostate Cancer Are Also Valid for the 12-Core Prostate Biopsy Scheme: A Multicenter Study of Urooncology Association, TurkeyÇelik, S; Kizilay, F; Yörükoglu, K; Aslan, G; Ozen, H; Akdogan, B; Sozen, S; Baltaci, S; Muezzinoglu, T; Izol, V; Bayazit, Y; Narter, F; Türkeri, LBackground: Epstein criteria based on sextant biopsy are assumed to be valid for 12-core biopsies. However, very scarce information is present in the current literature to support this view. Objectives: To investigate the validity of Epstein criteria for clinically insignificant prostate cancer (PCa) in a cohort of the currently utilized 12-core prostate biopsy (TRUS-Bx) scheme in patients with low-risk and intermediate-risk PCa. Method: Pathological findings were separately evaluated in the areas matching the sextant biopsy (6-core paramedian) scheme and in all 12-core schemes. Patients were divided into 2 groups according to the final pathology report of RP as true clinically significant PCa (sPCa) and insignificant PCa (insPCa) groups. Predictive factors (including Epstein criteria) and cutoff values for the presence of insPCa were separately evaluated for 6- and 12-core TRUS-Bx schemes. Then, different predictive models based on Epstein criteria with or without additional biopsy findings were created. Results: A total of 442 patients were evaluated. PSA density, biopsy GS, percentage of tumor and number of positive cores, PNI, and HG-PIN were independent predictive factors for insPCa in both TRUS-Bx schemes. For the 12-core scheme, the best cutoff values of tumor percentage and number of positive cores were found to be <= 50% (OR: 3.662) and 1.5 cores (OR: 2.194), respectively. The best predictive model was found to be that which added 3 additional factors (PNI and HG-PIN absence and number of positive cores) to Epstein criteria (OR: 6.041). Conclusions: Using a cutoff value of 1 for the number of positive biopsy cores and absence of biopsy PNI and HG-PIN findings can be more useful for improving the prediction model of the Epstein criteria in the 12-core biopsy scheme.Item How accurate is radiological imaging for perirenal fat and renal vein invasion in renal cell carcinoma?Ucer, O; Muezzinoglu, T; Ozden, E; Aslan, G; Izol, V; Bayazit, Y; Altan, M; Akdogan, B; Ozen, H; Sozen, S; Cetin, S; Suer, E; Esen, B; Baltaci, SObjective To evaluate the accuracy of radiological staging, especially renal venous and perirenal fat invasion, in renal cell carcinoma (RCC). Material and Methods Data of 4823 renal tumour patients from Renal Tumor Database of Association of Uro-oncology in Turkey were evaluated. Of 4823 patients, 3309 RCC patients had complete radiological, and histopathological data were included to this study. The Pearson chi-squared test (chi(2)) was used to compare radiological and histopathological stages. Results The mean (SD) age of 3309 patients was 58 (12.3). Preoperative radiological imaging was performed using computed tomography (CT) (n = 2510, 75.8%) or magnetic resonance imaging (MRI) (n = 799, 24.2%). There was a substantial concordance between radiological and pathological staging (k = 0.52, P < .001). Sensitivities of radiological staging in stages I, II, III and IV were 90.7%, 67.3%, 27.7% and 64.2%, respectively. The sensitivity in stage III was lower than the other stages. Subanalysis of stage IIIa cases revealed that, for perirenal fat invasion and renal vein invasion, sensitivity values were 15.4% and 11.3%, respectively. Conclusions There was a substantial concordance between radiological (CT and/or MRI) and pathological T staging in RCC. However, this is not true for T3 cases. Sensitivity of preoperative radiological imaging in patients with pT3a tumours is insufficient and lower than the other stages. Consequently, preoperative imaging in patients with T3 RCC has to be improved, in order to better inform the patients regarding prognosis of their disease.Item Effect of pelvic lymph node dissection and its extent on oncological outcomes in intermediate-risk prostate cancer patients: A multicenter study of the Turkish Urooncology AssociationIzol, V; Ok, F; Aslan, G; Akdogan, B; Sozen, S; Ozden, E; Celik, O; Muezzinoglu, T; Turkeri, L; Akdogan, N; Baltaci, SItem Can We Predict Recurrence of pT1-2 Renal Cell Carcinoma?Üçer, O; Mueezzinoglu, T; Aslan, G; Sueer, E; Baltaci, S; Izol, V; Özden, E; Akdogan, B; Yazici, S; Bulut, EC; Akdogan, N; Sözen, SObjective: Some prognostic models have been described for localized and metastatic renal cell carcinoma (RCC). The European Association of Urology guidelines on RCC recommend using these models. However, there is no model for T1 and T2. The study evaluated the risk factors for recurrence in T1 and T2 RCC. Materials and Methods: Data of 4823 renal tumor patients from the Renal Tumor Database of the Association of Urooncology in Turkey were evaluated. Of 4823 patients, 1845 RCC patients with pathological T1 or T2 were included in this study. The patients were divided into two groups according to the recurrence status. Anatomical, histological, and clinical prognostic factors were statistically compared between the groups. Afterwards, multivariate analysis was performed for the variables that were found to be statistically significant. Results: The mean follow-up time was 30 (4-180) months. Of 1845 RCC patients, 117 (6.3%) had recurrence. Univariate analysis revealed statistically significant differences between age, preoperative hemoglobin, albumin, neutrophil, alkaline phosphates, platelet and calcium values, histological subtype, Fuhrman grade, surgical technique (radical or partial), and pathological stage in the groups. However, in multivariate analysis, only pathological stage was found to be a risk factor for recurrence (2.17 95%, 1.25-3.77). Conclusions: The results of our study show that it is difficult to design a prognostic model for the recurrence of pT1 and pT2 RCC. We suggest that patients with a higher tumor diameter should be followed up more frequently.Item Prognostic Significance of Surgical Margin Status and Gleason Grade at the Positive Surgical Margin in Predicting Biochemical Recurrence After Radical Prostatectomy in a Turkish Patient CohortKoparal, MY; Sözen, TS; Aslan, G; Baltaci, S; Süer, E; Müezzinoglu, T; Akdogan, B; Türkeri, LObjective: To investigate the prognostic role of positive surgical margin (PSM) features in addition to well-defined risk factors in predicting biochemical recurrence (BCR) after radical prostatectomy. Materials and Methods: This study used the prostate cancer database from the Urooncology Association in Turkey. Clinical, surgical, pathological and follow-up data were recorded from the database. PSM features, including number, location, linear length and Gleason grade (GG) were also recorded. Kaplan-Meier survival analyses were performed to assess differences in BCR-free survival (BCR-FS). In order to identify prognostic factors affecting BCR-FS, univariate and multivariate Cox regression analyses were performed. Results: The study included 984 patients who met the eligibility criteria. The median follow-up time was 29 (minimum: 6, maximum: 210) months, and BCR was detected in 178 (18.1%) patients. BCR-FS was found to be significantly lower in patients with higher total prostate-specific antigen, higher International Society of Urological Pathology (ISUP) grade, extraprostatic extension (EPE), seminal vesicle invasion, lymphovascular invasion, lymph node involvement, PSM and GG at PSM (PSMGG) >= 4 (log-rank p<0.001, p<0.001, p<0.001, p<0.001, p<0.001, p<0.001, p<0.001 and p=0.005). ISUP grade, EPE and PSM were identified as independent prognostic factors in predicting BCR-FS [Hazard ratio (HR): 1.89, p=0.035 and HR: 4.65, p<0.001, HR: 1.82, p=0.030, HR: 1.77, p=0.042, respectively]. Unlike the univariate analysis, in multivariate analysis, PSMGG did not prove to be an independent prognostic factor in predicting BCR-FS. Conclusion: PSM GG >= 4 was found to be significantly associated with shorter BCR-FS. There is a need for large, randomised prospective studies to clarify the role of PSMGG to be used in nomograms as an independent predictor to determine patients who would benefit from adjuvant radiation therapy.Item A new colorimetric method for rapid detection of ethambutol and streptomycin resistance in Mycobacterium tuberculosis: crystal violet decolorization assay (CVDA)Coban, AY; Akbal, AU; Ceyhan, I; Uzun, M; Selale, DS; Aslan, G; Delialioglu, N; Ozyurt, M; Bektore, B; Bicmen, C; Aslanturk, A; Ucarman, N; Albay, A; Sig, AK; Ozkutuk, N; Surucuoglu, SStreptomycin (STR) and ethambutol (EMB) are important drugs used for the treatment of tuberculosis. There is a need for fast, reliable and inexpensive methods for detecting resistance to these drugs. The aim of this study was to evaluate the performance of the crystal violet decolorization assay (CVDA) for the detection of STR and EMB resistance that is important drugs in tuberculosis treatment. In this study, drug susceptibility testing was performed on 140 Mycobacterium tuberculosis isolates provided from nine centers. Three tubes were used for each isolate. One of the tubes had a concentration of 2mg/L STR and the other 5mg/L EMB. The third was drug-free control tube. Sensitivity, specificity, positive predictive value (PPD), negative predictive value (NPD) and agreement for STR were found to be 81.8%, 94.6%, 87.8%, 91.5% and 90.57%, respectively. For EMB, sensitivity, specificity, PPD, NPD, and agreement were found to be 76%, 98.23%, 90.47%, 94.87% and 94.2%, respectively. The results were obtained in 11.3 +/- 2.7days (8-21days). CVDA is rapid, reliable, inexpensive, and easy to perform for rapid detection of STR and EMB resistance, and it could be adapted for drug susceptibility testing.Item Oncological outcomes of patients with non-clear cell renal cell cancers: Subtypes of unclassified and translocation renal cell cancersGökalp, F; Celik, S; Sozen, TS; Ozen, AH; Aslan, G; Izol, V; Baltaci, S; Muezzinoglu, T; Akdogan, B; Suer, E; Tinay, IItem Multicenter evaluation of AYC.2.2 agar for the isolation of mycobacteria from clinical samplesCoban, AY; Ceyhan, I; Uzun, M; Genc, GE; Bicmen, C; Ozkutuk, N; Surucuoglu, S; Yanar, O; Aslan, G; Kurnaz, N; Cayci, YTPurpose: The aim of this multicenter study is to evaluate AYC.2.2 agar for the isolation of mycobacteria from clinical samples. Methods: Totally 5559 media were tested in 7 centers. AYC.2.2 agar media for the study were prepared by C1 and sent to other centers under appropriate conditions. Other media except AYC.2.2 agar were purchased commercially. The media were subjected to routine laboratory operations in the center where they were sent. After the samples received for routine processing (in all centers, samples were processed with the same method (NALC-NaOH)), they were cultivated on routine media and AYC.2.2 agar afterward. Results: C1: Average growth time was determined as 12.74 +/- 3.74 days with MGIT 960 system; 24.42 +/- 4.75 days with LJ and 24.37 +/- 4.96 days with AYC.2.2 agar. C2: Average growth time was determined as 18.25 +/- 9.32 days with TK-Medium, 28.73 +/- 7.44 days with LJ, and 31.72 +/- 6.35 days with AYC.2.2 agar. C3: Average growth time was determined as 20.48 +/- 7.24 days with Ogawa medium, 20.74 +/- 7.12 days with LJ, and 20.26 +/- 7.43 days with AYC.2.2 agar. C4: Average growth time was determined as 15.27 +/- 6.37 days with MGIT 960 system, 22.14 +/- 9.1 days with LJ, and 22 +/- 8.45 days with AYC.2.2 agar. C5: Average growth time was determined as 13 +/- 4.24 days with MGIT 960 system, 32.16 +/- 6.23 days with LJ, and 33 +/- 5.73 days with AYC.2.2 agar. C6: Average growth time was determined as 9 +/- 3.11 days with MGIT 960 system, 18.68 +/- 5.32 days with LJ, and 18.34 +/- 4.63 days AYC.2.2 agar. C7: Average growth time was determined as 14.74 +/- 7.65 with MGIT 960 system, 26.01 +/- 8.21 days with LJ, and 26.24 +/- 7.88 days with AYC.2.2 agar. Conclusions: In conclusion, similar results were obtained with LJ and Ogawa media and AYC.2.2 agar. Furthermore, more studies should be conducted for isolation of M. tuberculosis and performing antibiotic susceptibility tests using AYC.2.2 agar before it can be used as a routine media in the laboratories.Item The course of spinal tuberculosis (Pott disease): results of the multinational, multicentre Backbone-2 studyBatirel, A; Erdem, H; Sengoz, G; Pehlivanoglu, F; Ramosaco, E; Gulsun, S; Tekin, R; Mete, B; Balkan, II; Sevgi, DY; Giannitsioti, E; Fragou, A; Kaya, S; Cetin, B; Oktenoglu, T; Celik, AD; Karaca, B; Horasan, ES; Ulug, M; Senbayrak, S; Kaya, S; Arslanalp, E; Hasbun, R; Ates-Guler, S; Willke, A; Senol, S; Inan, D; Guclu, E; Ertem, GT; Koc, MM; Tasbakan, M; Ocal, G; Kocagoz, S; Kusoglu, H; Guven, T; Baran, AI; Dede, B; Karadag, FY; Yilmaz, H; Aslan, G; Al-Gallad, DA; Cesur, S; El-Sokkary, R; Sirmatel, F; Savasci, U; Karaahmetoglu, G; Vahaboglu, HWe aimed to describe clinical, laboratory, diagnostic and therapeutic features of spinal tuberculosis (ST), also known as Pott disease. A total of 314 patients with ST from 35 centres in Turkey, Egypt, Albania and Greece were included. Median duration from initial symptoms to the time of diagnosis was 78 days. The most common complications presented before diagnosis were abscesses (69%), neurologic deficits (40%), spinal instability (21%) and spinal deformity (16%). Lumbar (56%), thoracic (49%) and thoracolumbar (13%) vertebrae were the most commonly involved sites of infection. Although 51% of the patients had multiple levels of vertebral involvement, 8% had noncontiguous involvement of multiple vertebral bodies. The causative agent was identified in 41% of cases. Histopathologic examination was performed in 200 patients (64%), and 74% were consistent with tuberculosis. Medical treatment alone was implemented in 103 patients (33%), while 211 patients (67%) underwent diagnostic and/or therapeutic surgical intervention. Ten percent of the patients required more than one surgical intervention. Mortality occurred in 7 patients (2%), and 77 (25%) developed sequelae. The distribution of the posttreatment sequelae were as follows: 11% kyphosis, 6% Gibbus deformity, 5% scoliosis, 5% paraparesis, 5% paraplegia and 4% loss of sensation. Older age, presence of neurologic deficit and spinal deformity were predictors of unfavourable outcome. ST results in significant morbidity as a result of its insidious course and delayed diagnosis because of diagnostic and therapeutic challenges. ST should be considered in the differential diagnosis of patients with vertebral osteomyelitis, especially in tuberculosis-endemic regions. Early establishment of definitive aetiologic diagnosis and appropriate treatment are of paramount importance to prevent development of sequelae. Clinical Microbiology and Infection (C) 2015 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.