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Öğe Comparison of classifications of seizures: A preliminary study with 28 participants and 48 seizures(2005) Baykan B.; Ertas N.K.; Ertas M.; Aktekin B.; Saygi S.; Gokyigit A.; Akyol A.; Serdaroglu A.; Bilir E.; Yigit A.; Mungen B.; Bulut S.; Genc B.O.; Bingol C.A.; Turkdogan D.; Agan K.; Arman F.; Gurses C.; Bebek N.; Akhan G.; Bozdemir H.; Aslan K.; Gul G.; Altin U.; Ozisik H.I.; Misirli H.; Aydogdu I.; Arac N.; Bora I.; Taskapilioglu O.; Cengiz N.; Deriocioglu N.; Erdinc O.; Velioglu S.K.Purpose: Our aim was to compare three available seizure classifications (SCs), namely, the international classification of epileptic seizures published in 1981 (ICES; Epilepsia 1981;22:489-50); the semiological seizure classification (SSC) by H. Lüders, J. Acharya, C. Baumgartner, et al. (Epilepsia 1998;39:1006-13; Acta Neurol Scand 1999;99:137-41); and the proposal of a new diagnostic scheme for seizures (PDSS) by J. Engel, Jr. (Epilepsia 2001;42:796-803) published in 2001. The three SCs were compared with respect to diagnostic success rates, usefulness, and consistency by a large group of neurologists in this preliminary study. Methods: After a training period, 28 blindfed participants with different levels of experience with epilepsy classified videos or written descriptions of 48 randomly selected seizures according to the three SCs. Definite diagnoses of the seizures were established based on all clinical, ictal/interictal EEG, and MRI data. All the participants answered a questionnaire concerning their preferences for SCs after the study. Results: The overall diagnostic success rates were 81.4% for ICES, 80.5% for PDSS, and 87.5%, for SSC. Various parameters concerning experience with epilepsy affected success rates positively, without reaching statistical significance, whereas experience with epilepsy surgery appeared to be a parameter significantly affecting the success rate in all SCs. In reliability analysis, Cronbach's ? was 0.94 for ICES, 0.88 for PDSS, and 0.70 for SSC, all showing good agreement in the group. Nineteen reviewers chose SSC, eight chose ICES, and one chose PDSS as their preference in the questionnaire, completed after the end of the study. Conclusion: The results of this preliminary study demonstrate that with proper training, physicians treating epilepsy patients can handle new SCs, and emphasize the need for revision of the current classification. © 2005 Elsevier Inc. All rights reserved.Öğe Diagnostic and treatment reproducibility of cervical intraepithelial neoplasia/squamous intraepithelial lesion and factors affecting the diagnosis(Federation of Turkish Pathology Societies, 2017) Sağlam A.; Usubütün A.; Dolgun A.; Mutter G.L.; Coşkun Salman M.; Kurtulan O.; Akyol A.; Özkan E.A.; Baykara S.; Bülbül D.; Calay Z.; Eren F.; Gümürdülü D.; Haberal N.; İlvan Ş.; Karavelı Ş.; Koyuncuoğlu M.; Müezzınoğlu B.; Müftüoğlu K.H.; Özen Ö.; Özdemır N.; Peşterelı E.; Ulukuş Ç.; Zekİoğlu O.Objective: Inter-observer differences in the diagnosis of HPV related cervical lesions are problematic and response of gynecologists to these diagnostic entities is non-standardized. This study evaluated the diagnostic reproducibility of “cervical intraepithelial neoplasia” (CIN) and “squamous intraepithelial lesion” (SIL) diagnoses. Material and Method: 19 pathologists evaluated 66 cases once using H&E slides and once with immunohistochemical studies (p16, Ki-67 and Pro-ExC). Management response to diagnoses was evaluated amongst 12 gynecologists. Pathologists and gynecologists were also given a questionnaire about how additional information like smear results and age modify diagnosis and management. Results: We show moderate interobserver diagnostic reproducibility amongst pathologists. The overall kappa value was 0.50 and 0.59 using the CIN and SIL classifications respectively. Impact of immunohistochemical evaluation on interpretation of cases differed and there was lack of statistically significant improvement of interobserver diagnostic reproducibility with the addition of immunohistochemistry. We saw that choice of treatment methods amongst gynecologists varied and overall concordance was only fair to moderate. The CIN2 diagnostic category was seen to have the lowest percentage agreement amongst both pathologists and gynecologists. We showed that pathologists had diagnostic “styles” and gynecologists had management “styles”. Conclusion: In summary each pathologist had different diagnostic tendencies which were affected not only by histopathology and marker studies, but also by the patient management tendencies of the gynecologist that the pathologist worked with. The two-tiered modified Bethesda system improved diagnostic agreement. We concluded that immunohistochemistry should be used only to resolve problems in select cases and not for every case. © 2017, Federation of Turkish Pathology Societies. All rights reserved.Öğe The factors affecting sleep quality in type 2 diabetes patients(Kuwait Medical Association, 2019) Tavsanli N.G.; Sivrikaya S.K.; Menekli T.; Akyol A.Objective: Research was planned with the aim of determining the sleep quality of individuals with type 2 diabetes and the factors affecting this. Design: Descriptive and cross-sectional study Setting: Endocrinology Department of the Internal Medicine Section of Ege University Medical Faculty Hospital, Manisa Celal Bayar University Hafsa Sultan Hospital, and Balıkesir University Medical Faculty Hospital Subjects: The research was conducted between May 2014 and February 2015 on 366 individuals with type 2 diabetes. Intervention: Non-interventional Main outcome measure: The sleep quality of individuals with type 2 diabetes and the factors affecting this Results: The total Pittsburgh Sleep Quality Index (PSQI) scores of individuals who had had diabetes for 1-4 years and 5-9 years were found to be significantly higher than the scores of those who had had diabetes for less than one year or more than ten years (f = 10.85, p = 0.000). The total PSQI scores of individuals using oral anti diabetic (OAD) and insulin diabetes treatment were significantly higher than the scores of patients receiving only diet treatment or OAD + insulin (f = 3.03, p = 0.029). A significant relationship was found between the HbA1c of the individuals in the study with type 2 diabetes and their total PSQI scores (p <0.01). Conclusion: It can be said that such socio-demographic characteristics as age, gender, income, duration of diabetes and diabetes treatment, and metabolic values such as the glycated haemoglobin (Hemoglobin A1c-HbA1c), fasting blood glucose and body mass index negatively affect sleep quality. © 2019, Kuwait Medical Association. All rights reserved.Öğe Oral Health and Oral Mucosa as A Graft Material for Urinary System: A Narrative Review(Springer Science and Business Media B.V., 2024) Akyol A.; Akyol İ.; Ergün K.E.; Buduneli N.Purpose of Review: This review aims to investigate the significance of oral examination and dental care in the context of buccal mucosal graft urethroplasty (BMGU) and related surgical interventions. Recent Findings: The available literature indicates that the possible effects of general oral health assessment and treatment of oral health-related diseases on buccal mucosal graft urethroplasty results have not been clearly elucidated yet. Summary: Urethral stricture disease poses a significant challenge in urology, necessitating meticulous management strategies. The success of BMGU may be influenced by the oral health status of the donor tissue. Recent publications highlighted a correlation between oral health problems and histological changes in the buccal mucosa, potentially impacting operative outcomes. Factors such as gingival status, periodontal health, and smoking habits may also affect graft success. Therefore, preoperative dental assessment and treatment could enhance the efficacy of BMGU by addressing oral health issues and optimising tissue condition. © The Author(s), under exclusive licence to Springer Nature Switzerland AG 2024.Öğe Reproducibility of endometrial intraepithelial neoplasia diagnosis is good, but influenced by the diagnostic style of pathologists(2012) Usubutun A.; Mutter G.L.; Saglam A.; Dolgun A.; Ozkan E.A.; Ince T.; Akyol A.; Bulbul H.D.; Calay Z.; Eren F.; Gumurdulu D.; Haberal A.N.; Ilvan S.; Karaveli S.; Koyuncuoglu M.; Muezzinoglu B.; Muftuoglu K.H.; Ozdemir N.; Ozen O.; Baykara S.; Pestereli E.; Ulukus E.C.; Zekioglu O.Endometrial intraepithelial neoplasia (EIN) applies specific diagnostic criteria to designate a monoclonal endometrial preinvasive glandular proliferation known from previous studies to confer a 45-fold increased risk for endometrial cancer. In this international study we estimate accuracy and precision of EIN diagnosis among 20 reviewing pathologists in different practice environments, and with differing levels of experience and training. Sixty-two endometrial biopsies diagnosed as benign, EIN, or adenocarcinoma by consensus of two expert subspecialty pathologists were used as a reference comparison to assess diagnostic accuracy of 20 reviewing pathologists. Interobserver reproducibility among the 20 reviewers provided a measure of diagnostic precision. Before evaluating cases, observers were self-trained by reviewing published textbook and/or online EIN diagnostic guidelines. Demographics of the reviewing pathologists, and their impressions regarding implementation of EIN terminology were recorded. Seventy-nine percent of the 20 reviewing pathologists' diagnoses were exactly concordant with the expert consensus (accuracy). The interobserver weighted ? values of 3-class EIN scheme (benign, EIN, carcinoma) diagnoses between expert consensus and each of reviewing pathologists averaged 0.72 (reproducibility, or precision). Reviewing pathologists demonstrated one of three diagnostic styles, which varied in the repertoire of diagnoses commonly used, and their nonrandom response to potentially confounding diagnostic features such as endometrial polyp, altered differentiation, background hormonal effects, and technically poor preparations. EIN diagnostic strategies can be learned and implemented from standard teaching materials with a high degree of reproducibility, but is impacted by the personal diagnostic style of each pathologist in responding to potential diagnostic confounders. © 2012 USCAP, Inc. All rights reserved.
