Browsing by Author "Oktay A."

Now showing 1 - 2 of 2
  • No Thumbnail Available
    Item
    Outcomes of high-risk breast lesions diagnosed using image-guided core needle biopsy: results from a multicenter retrospective study
    (Galenos Publishing House, 2023) Oktay A.; Aslan Ö.; Taşkın F.; Tunçbilek N.; İçten S.G.E.; Balcı P.; Arıbal M.E.; Çelik L.; Örgüç İ.Ş.; Demirkazık F.B.; Gültekin S.; Aydın A.M.; Durmaz E.; Kul S.; Binokay F.; Çetin M.; Emlik G.D.; Akpınar M.G.; Voyvoda S.N.K.; Polat A.V.; Akın I.B.; Yıldız Ş.; Poyraz N.; Özsoy A.; Öztekin P.S.; Elverici E.; Bayrak İ.K.; İkizceli T.; Dinç F.; Sezgin G.; Gülşen G.; Tunçbilek I.; Yalçın S.R.; Çolakoğlu G.; Ağlamış S.; Yılmaz R.; Rona G.; Durhan G.; Güner D.C.; Yabul F.Ç.; Karabekmez L.G.; Tutar B.; Göktaş M.; Buğdaycı O.; Suner A.; Özdemir N.
    Purpose: The clinical management of high-risk lesions using image-guided biopsy is challenging. This study aimed to evaluate the rates at which such lesions were upgraded to malignancy and identify possible predictive factors for upgrading high-risk lesions. Methods: This retrospective multicenter analysis included 1.343 patients diagnosed with high-risk lesions using an image-guided core needle or vacuum-assisted biopsy (VAB). Only patients managed using an excisional biopsy or with at least one year of documented radiological follow-up were included. For each, the Breast Imaging Reporting and Data System (BI-RADS) category, number of samples, needle thickness, and lesion size were correlated with malignancy upgrade rates in different histologic subtypes. Pearson's chi-squared test, the Fisher-Freeman-Halton test, and Fisher's exact test were used for the statistical analyses. Results: The overall upgrade rate was 20.6%, with the highest rates in the subtypes of intraductal papilloma (IP) with atypia (44.7%; 55/123), followed by atypical ductal hyperplasia (ADH) (38.4%; 144/375), lobular neoplasia (LN) (12.7%; 7/55), papilloma without atypia (9.4%; 58/611), flat epithelial atypia (FEA) (8.7%; 10/114), and radial scars (RSs) (4.6%; 3/65). There was a significant relationship between the upgrade rate and BI-RADS category, number of samples, and lesion size Lesion size was the most predictive factor for an upgrade in all subtypes. Conclusion: ADH and atypical IP showed considerable upgrade rates to malignancy, requiring surgical excision. The LN, IP without atypia, pure FEA, and RS subtypes showed lower malignancy rates when the BI-RADS category was lower and in smaller lesions that had been adequately sampled using VAB. After being discussed in a multidisciplinary meeting, these cases could be managed with follow-up instead of excision. © 2023, Galenos Publishing House. All rights reserved.
  • No Thumbnail Available
    Item
    Nationwide prospective audit for the evaluation of appendicitis risk prediction models in adults: Right iliac fossa treatment (RIFT) - Turkey
    (Oxford University Press, 2024) Yalcinkaya A.; Yalcinkaya A.; Balci B.; Keskin C.; Erkan I.; Yildiz A.; Kamer E.; Leventoglu S.; Caglikulekci M.; Zarbaliyev E.; Sevmis M.; Ulgen Y.; Altinel Y.; Meric S.; Akbas A.; Hacim N.A.; Vartanoglu Aktokmanyan T.; Aktimur Y.E.; Calikoglu F.; Gullu H.F.; Durma A.G.; Acar S.; Ciftci E.; Balik E.; Kulle C.B.; Ozata I.H.; Tufekci T.; Tatar C.; Sevinc M.M.; Sevik H.; Ertürk C.; Kiraz I.N.; Ozben V.; Aytac E.; Aliyeva Z.; Mutlu A.U.; Tanal M.; Celayir M.F.; Bozkurt E.; Yetkin S.G.; Ergin E.; Attaallah W.; Uprak T.K.; Omak A.; Simsek O.; Bozkurt M.A.; Kara Y.; Bozdag E.; Yirgin H.; Ozcan A.; Okkabaz N.; Ozdenkaya Y.; Haksal M.C.; Pekuz C.K.; Duru S.; Sivrikoz E.; Ozdemir Y.; Tan N.; Yarbug Karayali F.; Taghiyeva A.; Tirnova I.; Erenler Bayraktar I.; Bayraktar O.; Emsal E.Z.; Dalkilic M.I.; Yesiltas M.; Tok H.; Karakas D.O.; Pusane A.; Demirer A.I.; Sahin H.B.; Gok A.F.K.; Bozkurt H.A.; Yildirim M.; Uzunyolcu G.; Yanar H.T.; Ergun S.; Kutluk F.; Uludag S.S.; Zengin A.K.; Ozcelik M.F.; Sanli A.N.; Altuntas Y.E.; Memisoglu E.; Sari R.; Akdogan O.; Kucuk H.F.; Ozkan O.F.; Ulgur H.S.; Kirkan E.F.; Yuksekdag S.; Rencuzogullari A.; Aktas M.K.; Aba M.; Demirel A.O.; Eray I.C.; Aydogan B.; Cetinkunar S.; Yener K.; Sozutek A.; Irkorucu O.; Bayrak M.; Altintas Y.; Alabaz O.; Atasever A.; Erdogrul G.; Kupeli A.H.; Muhammedoglu B.; Kokdas S.; Kaya M.; Uysal E.; Yildirim A.C.; Zeren S.; Ekici M.F.; Algin M.C.; Kucuk G.O.; Eraslan H.; Aybar E.; Polat S.; Ceylan A.; Isik O.; Kural S.; Aktas A.; Bakar B.; Uzunoglu M.Y.; Gulcu B.; Ozturk E.; Devay A.O.; Taspinar E.; Balcin O.; Aksoy F.; Garip G.; Yalkin O.; Iflazoglu N.; Yigit D.; Kaya R.B.; Ugur M.; Kilic E.; Dedemoglu A.; Arslan R.E.; Temiz M.; Aydin C.; Demirli Atici S.; Kaya T.; Ozturk S.; Calik B.; Kilinc G.; Acar T.; Acar N.; Cengiz F.; Ureyen O.; Tan S.; Ilhan E.; Turk Y.; Durak A.T.; Yilmaz M.; Mercan M.; Atci R.; Sokmen S.; Bisgin T.; Egeli T.; Yildirim Y.; Safak T.; Celik K.; Yilmaz E.M.; Kirnap M.; Demirkiran A.E.; Sekerci U.U.; Karacan E.; Bilgic E.; Ozmen M.M.; Guldogan C.E.; Gundogdu E.; Moran M.; Erol T.; Dincer H.A.; Kirimtay B.; Yilmaz S.; Cennet O.; Yildiz A.; Sahin C.; Akyol C.; Koc M.A.; Ersoz S.; Turhan A.; Konca C.; Tezcaner T.; Erkent M.; Aydin O.; Avci T.; Altiner S.; Osmanov I.; Emral A.C.; Cetinkaya G.; Lapsekili E.; Sakca M.; Cimen S.; Ozen D.; Kozan E.B.; Dogan L.; Haberal E.; Kayhan O.; Aksel B.; Karabacak H.; Azili C.; Yazici F.; Apaydin M.; Kaya I.O.; Cetinkaya E.; Akin T.; Gunes G.; Turap H.; Aslan D.; Demirbag A.E.; Bolukbasi B.; Karaca B.E.; Ozturk E.; Ozeller E.; Kayacan G.S.; Borcek A.O.; Ece I.; Yormaz S.; Colak B.; Calisir A.; Sahin M.; Arslan K.; Hasirci I.; Ulutas M.E.; Metin S.H.; Gultekin F.A.; Ozkan Z.; Ilhan O.; Gundogdu T.; Liman R.K.; Kanat B.H.; Aydin A.; Sungurtekin U.; Ozgen U.; Aykota M.R.; Altintoprak F.; Gonullu E.; Cakmak G.; Dulger U.C.; Mantoglu B.; Demir H.; Akin E.; Eroz E.; Nazli O.; Dere O.; Dadasoglu M.A.; Kara E.; Tutcu S.; Solak I.; Gencer I.; Dalkiran A.; Sevinc B.; Karahan O.; Damburaci N.; Sari E.; Akay T.; Calta A.F.; Ozdemir A.; Ohri N.; Ermis I.; Bozbiyik O.; Ozdemir M.; Goktepe B.; Demir B.; Kilincarslan O.; Gunduz U.R.; Olcum M.; Dincer O.I.; Cakir R.C.; Dinc B.; Sahin E.; Uludag E.; Arslan Y.; Posteki G.; Oktay A.; Tatar O.C.; Guler S.A.; Utkan N.Z.; Tayar S.; Copelci Y.; Kartal M.; Kalayci T.; Yeni M.; Buyukkasap A.C.; Vural S.; Kesicioglu T.; Aydin I.; Gulmez M.; Saracoglu C.; Topcu O.; Kurt A.; Soylu S.; Kurt B.; Serin M.; Basceken S.I.; Gundes E.; Savda M.; Balkan A.Z.A.; Yildiz M.N.; Uzunkoy A.; Karaca E.; Berkan A.; Isik A.; Yildiz Y.A.; Ergul Z.; Yasar N.F.; Badak B.; Ozen A.; Velipasaoglu M.; Ure I.
    Background: Appendicitis is the most prevalent surgical emergency. The negative appendicectomy rate and diagnostic uncertainty are important concerns. This study aimed to assess the effectiveness of current appendicitis risk prediction models in patients with acute right iliac fossa pain. Methods: A nationwide prospective observational study was conducted, including all consecutive adult patients who presented with right iliac fossa pain. Diagnostic, clinical and negative appendicectomy rate data were recorded. The Alvarado score, Appendicitis Inflammatory Response (AIR), Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) and Adult Appendicitis Score systems were calculated with collected data to classify patients into risk categories. Diagnostic value and categorization performance were evaluated, with use of risk category-based metrics including 'true positive rate' (percentage of appendicitis patients in the highest risk category), 'failure rate' (percentage of patients with appendicitis in the lowest risk category) and 'categorization resolution' (true positive rate/failure rate). Results: A total of 3358 patients from 84 centres were included. Female patients were less likely to undergo surgery than men (71.5% versus 82.5% respectively; relative risk 0.866, 95% c.i. 0.834 to 0.901, P < 0.001); with a three-fold higher negative appendicectomy rate (11.3% versus 4.1% respectively; relative risk 2.744, 95% c.i. 2.047 to 3.677, P < 0.001). Ultrasonography was utilized in 56.8% and computed tomography in 75.2% of all patients. The Adult Appendicitis Score had the best diagnostic performance for the whole population; however, only RIPASA was significant in men. All scoring systems were successful in females patients, but Adult Appendicitis Score had the highest area under the receiver operating characteristic curve value. The RIPASA and the Adult Appendicitis Score had the best categorization resolution values, complemented by their exceedingly low failure rates in both male and female patients. Alvarado and AIR had extremely high failure rates in men. Conclusion: The negative appendicectomy rate was low overall, but women had an almost three-fold higher negative appendicectomy rate despite lower likelihood to undergo surgery. The overuse of imaging tests, best exemplified by the 75.2% frequency of patients undergoing computed tomography, may lead to increased costs. Risk-scoring systems such as RIPASA and Adult Appendicitis Score appear to be superior to Alvarado and AIR. © 2024 The Author(s). Published by Oxford University Press on behalf of BJS Foundation Ltd.