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  • Küçük Resim
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    Comparison of likert and PI-RADS v2 scoring in the diagnosis of prostate cancer
    (2018) Inan, Ibrahim; Aktan, Ahmet; Ozkanli, Sidika Seyma; Yildirim, Asif; Aslan, Ahmet; Senturk Gucel, Senem; Erturk, Sukru Mehmet
    Aim: We aimed to compare the inter- and intra-observer variability and diagnostic performance of PI-RADS v2 and Likert scoring in the evaluation of prostate cancer on multiparametric prostate MR imaging. Material and Methods: MRI findings of 53 patients who had histopathologic diagnosis of prostate cancer and 51 patients who had one or more negative transrectal ultrasound guided prostate biopsy were evaluated retrospectively. The images were assessed by three independent observers blinded to histopathologic results of the patients. Intra-observer and inter-observer variability were evaluated by Cohen’s Kappa coefficient for all possible pairs of observers. ROC curve analysis was used to determine AUC to evaluate diagnostic performance of Likert and PI-RADS v2 scoring with a 1.5T MR in the diagnosis of prostate cancer. Results: Kappa values for 4 or higher PI-RADS v2 scores were calculated and κ=0.59-0.71 for intra-observer and κ=0.48-0.67 for inter-observer variability were obtained. κ=0.54-0.69 for intra-observer and κ=0.42-0.75 for inter-observer reliability were obtained for 4 or higher Likert scoring. AUC was 72% for PI-RADS v2 scores and was 75.9% for Likert scores for determining Gleason 6 or higher prostate cancers. There was not a statistically significant difference in the comparison of Likert and PI-RADS v2 ROC curves. Conclusion: PI-RADS v2 has no significant superiority compared to Likert scoring in intra-observer and inter-observer reliability. Likert and PI-RADS v2 scoring has no difference in the terms of diagnostic capability of prostate cancers.
  • Küçük Resim Yok
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    Kuru Kayısı Yetiştiren İşletmelerin Etkinliklerinin Agroekolojik Bölgeler Düzeyinde Değişimi ve Bu Değişime Risk Faktörünün Etkisi
    (2017) Gündüz, Orhan; Bayramoğlu, Zeki; Aslan, Ahmet; Ceyhan, Vedat; Türk, Süheyla; Ağızan, Kemalettin
    Sadece Türkiye’nin değil dünyanın da en büyük kayısı üretim bölgesi olan Malatya’da kuru kayısı üreten işletmeler birçok risk ve belirsizlikle karşı karşıyadır. İşletmeler, risklerle başa çıkmak için yoğun girdi kullanmakta ve bu da işletmelerde rasyonel kaynak kullanımını bozucu etki yapmaktadır. Sonuçta etkinlik ve verimlilik adına önemli sorunlarla karşılaşılmaktadır. Risk, üretim etkinliğini belirleyen temel unsurlardan bir tanesi olmasına rağmen, Malatya ilinde ve hatta Türkiye’de yürütülen çalışmalarda tarımsal riskler ve etkinlik konusunun bir arada değerlendirilmediği görülmektedir. Araştırmanın ana amacı, Malatya ilinde kuru kayısı üreten tarım işletmelerinin etkinliklerini agroekolojik alt bölgeler itibariyle ve riskli şartlarda ölçülmesi ve üretim etkinliğini artırıcı politika ve stratejilerin geliştirilmesidir. Araştırmada, altı farklı alt agroekolojik bölgeden tabakalı tesadüfi örnekleme yöntemiyle seçilmiş işletmelerden iki yıl arka arkaya gerçekleştirilmiş anket çalışması yoluyla toplanan panel veriler kullanılmıştır. Agroekolojik bölgeler itibariyle kayısı işletmelerinde etkinlik skorlarında ki değişim, “Stokastik Metafrontier” yöntemi ile tahmin edilmiştir. Üreticilerin risk karşıtlığı katsayıları “Eşit olasılıklı eşdeğer bedel” yöntemiyle belirlenmiştir. Üreticilerin riske karşı tutumları üzerine risk kaynaklarının, riske karşı geliştirilen stratejilerin ve diğer özelliklerin etkisi sıralı logit, risk yönetimi stratejilerini etkileyen faktörler multivariate probit model ile belirlenmiştir. Araştırmada, işletmelerde yıllık faaliyet sonuçlarının yıllar itibariyle değiştiği, beşinci bölge hariç bütün bölgelerde ilk yıl kayısı veriminin ikinci yıla göre düşük olduğu belirlenmiştir. İşletmeler için en önemli risk kaynağı, ilkbahar donları iken en etkin risk stratejisi ise kamu destekleri olarak görülmektedir. İşletmeler kendi bölgeleri içerisinde daha yüksek etkinlik skoruna sahip iken, metafrontiere göre etkinlikleri düşmektedir. Kendi bölge etkinliklerini girdi kullanımını azaltarak yükseltebilecek iken, metafrontiere göre metateknolojik açık (TGR) yani potansiyel üretim sınırına oldukça uzaktırlar. İşletmelerin TGR düzeyi sadece üretimde kullanılan teknikle izah edilememekte, bu açığa sosyoekonomik değişkenlerle birlikte risk tutumları ve risk kaynakları ile risk stratejileri de neden olmaktadır. Üreticilerin riskini azaltmak adına uygulanan kamu politikalarının üreticilerin ve yörenin sahip olduğu özellikler dikkate alınmadan bütüncül bir yaklaşımla geliştirilmiş olduğundan sorunların çözümü zorlaşmaktadır. Üreticilerin gönüllü olarak katıldıkları ve kamu ile birlikte paydaşların dâhil olduğu aktivite ve yeniliklerin yayımı önemli görülmektedir.
  • Küçük Resim
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    Short and long term results of the Karydakis flap versus the Limberg flap for treating pilonidal sinus disease a prospective randomized study
    (The American Journal of Surgery, 2011) Ateş, Mustafa; Dirican, Abuzer; Saraç, Mehmet; Aslan, Ahmet; Çolak, Cemil
    BACKGROUND: Pilonidal sinus is a common disease that mostly affects young people. Although various surgical techniques have been described for treating sacrococcygeal pilonidal disease (SPD), controversy still exists as to the best surgical technique. The purpose of this study was to compare the efficiency and short-term and long-term results of the Karydakis flap with that of the Limberg flap for treating SPD. METHODS: In this prospective randomized study, 269 patients with SPD were recruited to undergo either the Karydakis flap (n 135) or the Limberg flap (n 134) procedure between September 2004 and September 2008. RESULTS: The mean operative time for the Karydakis group (42.32 8.64 minutes) was shorter than that for the Limberg group (50.14 6.96 minutes) (P .01). The complication rate for the Karydakis group (n 15 [11.1%]) was lower than that for the Limberg group (n 28 [20.8%]) (P .029). The visual analogue scale score for postoperative pain at the operation site on the 30th day was lower in the Karydakis group than in the Limberg group (2.22 1.01 vs 3.23 1.14, P .01). The visual analogue scale score for satisfaction with the cosmetic appearance of the scars in the Karydakis group was 7.08 1.75, whereas it was 3.16 1.40 in the Limberg group at the 3rd month (P .01). Length of hospital stay was significantly shorter in the Karydakis group than in the Limberg group (3.40 .94 vs 3.8 1.19 days, P .03). Only 4 patients in the Karydakis group developed recurrence (3%), whereas 9 patients (6.9%) did so in the Limberg group (P .151). CONCLUSIONS: The Karydakis flap procedure should be chosen instead of the Limberg flap for treating uncomplicated SPD because of its lower postoperative complication rate, lower pain scores, shorter operation time and length of hospital stay, and good cosmetic satisfaction. However, no differences existed between the 2 surgical procedures in terms of recurrence prevention.
  • Küçük Resim
    Öğe
    Short and long term results of the Karydakis flap versus the Limberg flap for treating pilonidal sinus disease a prospective randomized study
    (The American Journal of Surgery, 2011) Ateş, Mustafa; Dirican, Abuzer; Saraç, Mehmet; Aslan, Ahmet; Çolak, Cemil
    BACKGROUND: Pilonidal sinus is a common disease that mostly affects young people. Although various surgical techniques have been described for treating sacrococcygeal pilonidal disease (SPD), controversy still exists as to the best surgical technique. The purpose of this study was to compare the efficiency and short-term and long-term results of the Karydakis flap with that of the Limberg flap for treating SPD. METHODS: In this prospective randomized study, 269 patients with SPD were recruited to undergo either the Karydakis flap (n 135) or the Limberg flap (n 134) procedure between September 2004 and September 2008. RESULTS: The mean operative time for the Karydakis group (42.32 8.64 minutes) was shorter than that for the Limberg group (50.14 6.96 minutes) (P .01). The complication rate for the Karydakis group (n 15 [11.1%]) was lower than that for the Limberg group (n 28 [20.8%]) (P .029). The visual analogue scale score for postoperative pain at the operation site on the 30th day was lower in the Karydakis group than in the Limberg group (2.22 1.01 vs 3.23 1.14, P .01). The visual analogue scale score for satisfaction with the cosmetic appearance of the scars in the Karydakis group was 7.08 1.75, whereas it was 3.16 1.40 in the Limberg group at the 3rd month (P .01). Length of hospital stay was significantly shorter in the Karydakis group than in the Limberg group (3.40 .94 vs 3.8 1.19 days, P .03). Only 4 patients in the Karydakis group developed recurrence (3%), whereas 9 patients (6.9%) did so in the Limberg group (P .151). CONCLUSIONS: The Karydakis flap procedure should be chosen instead of the Limberg flap for treating uncomplicated SPD because of its lower postoperative complication rate, lower pain scores, shorter operation time and length of hospital stay, and good cosmetic satisfaction. However, no differences existed between the 2 surgical procedures in terms of recurrence prevention. © 2011 Elsevier Inc. All rights reserved.
  • Küçük Resim Yok
    Öğe
    Short and long-term results of the Karydakis flap versus the Limberg flap for treating pilonidal sinus disease: a prospective randomized study
    (Excerpta Medica Inc-Elsevier Science Inc, 2011) Ates, Mustafa; Dirican, Abuzer; Sarac, Mehmet; Aslan, Ahmet; Colak, Cemil
    BACKGROUND: Pilonidal sinus is a common disease that mostly affects young people. Although various surgical techniques have been described for treating sacrococcygeal pilonidal disease (SPD), controversy still exists as to the best surgical technique. The purpose of this study was to compare the efficiency and short-term and long-term results of the Karydakis flap with that of the Limberg flap for treating SPD. METHODS: In this prospective randomized study, 269 patients with SPD were recruited to undergo either the Karydakis flap (n = 135) or the Limberg flap (n = 134) procedure between September 2004 and September 2008. RESULTS: The mean operative time for the Karydakis group (42.32 +/- 8.64 minutes) was shorter than that for the Limberg group (50.14 +/- 6.96 minutes) (P = .01). The complication rate for the Karydakis group (n = 15 [11.1%]) was lower than that for the Limberg group (n = 28 [20.8%]) (P = .029). The visual analogue scale score for postoperative pain at the operation site on the 30th day was lower in the Karydakis group than in the Limberg group (2.22 +/- 1.01 vs 3.23 +/- 1.14, P = .01). The visual analogue scale score for satisfaction with the cosmetic appearance of the scars in the Karydakis group was 7.08 +/- 1.75, whereas it was 3.16 +/- 1.40 in the Limberg group at the 3rd month (P = .01). Length of hospital stay was significantly shorter in the Karydakis group than in the Limberg group (3.40 +/- .94 vs 3.8 +/- 1.19 days, P = .03). Only 4 patients in the Karydakis group developed recurrence (3%), whereas 9 patients (6.9%) did so in the Limberg group (P = .151). CONCLUSIONS: The Karydakis flap procedure should be chosen instead of the Limberg flap for treating uncomplicated SPD because of its lower postoperative complication rate, lower pain scores, shorter operation time and length of hospital stay, and good cosmetic satisfaction. However, no differences existed between the 2 surgical procedures in terms of recurrence prevention. (C) 2011 Elsevier Inc. All rights reserved.