Basri Cakiroglu

To evaluate decision-relevant content completeness, patient-oriented communication, and source transparency of YouTube videos on robotic surgery for endometriosis. Cross-sectional content analysis. Publicly accessible YouTube content identified through six English- and Turkish-language search strings in September 2026; the retained records document search dates for only a subset. Seventy-six fully accessible videos explicitly addressing robotic surgery for endometriosis, selected from 101 unique records after exclusion of inaccessible videos and records without confirmed eligibility. No clinical intervention. Two reviewers independently coded eligible videos using the study checklist and resolved differences by consensus; reviewer-specific ratings were not retained. In a post hoc strict recoding of the indication/patient-selection domain from retained video/page notes, 18 videos (23.7%) qualified; a broad surgery/candidacy reference was present in 73 (96.1%). The recalculated median DRCCI was 1 of 9 (IQR, 0-2); under a sensitivity rule counting any broad reference, the median was 2 (IQR, 1-3). Deep endometriosis and organ involvement were discussed in 29 (38.2%) and 25 (32.9%) videos; non-surgical options, comparison with laparoscopy, risks, fertility/ovarian reserve, recurrence, and multidisciplinary care were present in 5 (6.6%), 6 (7.9%), 7 (9.2%), 14 (18.4%), 2 (2.6%), and 5 (6.6%), respectively. Selected decision-relevant topics were infrequently present in this exploratory sample of public videos. Because intended audience and purpose were not classified, these findings do not establish that all videos were intended for patient counseling or that omissions affected viewers.

Background/Objectives: Rotavirus vaccines have been available in Türkiye as self-financed products since 2006, but nationally representative uptake data and long-term data on their association with laboratory-confirmed rotavirus gastroenteritis remain limited. We evaluated calendar-period variation in the association between documented complete rotavirus vaccination and laboratory-confirmed rotavirus gastroenteritis among children younger than 5 years. Methods: This retrospective test-negative study included children aged 0–59 months who underwent qualitative stool rotavirus antigen testing during clinically evaluated acute gastroenteritis at a tertiary hospital between January 2015 and June 2026. Cases were rotavirus-positive episodes and controls were rotavirus-negative episodes. The institutional vaccination registry identified documented completion of either the two-dose Rotarix or three-dose RotaTeq schedule before testing, it did not separately identify partial schedules. Cluster-robust logistic regression adjusted for age group, sex, treatment setting, calendar year, and test month. Results are reported as odds ratios (ORs) with 95% confidence intervals (CIs). Results: The analysis included 2788 episodes among 2242 children: 534 rotavirus-positive cases and 2254 test-negative controls. Documented complete vaccination was recorded in 81 cases (15.2%) and 539 controls (23.9%). The adjusted OR for rotavirus positivity was 0.47 (95% CI, 0.36–0.62) for episodes with documented complete vaccination versus episodes with no documented complete series. Period-specific adjusted ORs were 0.85 (95% CI, 0.56–1.29) in 2015–2019, 0.64 (95% CI, 0.20–2.06) in 2020–2021, and 0.22 (95% CI, 0.13–0.38) in 2022–2026; between-period heterogeneity was significant (Q = 15.36; p < 0.001). The adjusted OR among hospitalized episodes was 0.42 (95% CI, 0.27–0.66). Among documented complete schedules, 448 episodes involved Rotarix and 172 involved RotaTeq; product-specific analyses were exploratory. Conclusions: The observed association varied substantially by calendar period; therefore, the pooled OR should not be interpreted as a stable national measure of vaccine performance. Within this tested clinical population, documented complete vaccination was associated with lower odds of laboratory-confirmed rotavirus gastroenteritis, including in the hospitalized test-negative analysis. Because the comparison group may have included partially vaccinated children, these findings are not conventional vaccine-effectiveness estimates. Nationally representative surveillance with complete dose-level vaccination histories is needed.

Objectıve: The coronavirus disease 2019 pandemic and associated non-pharmaceutical interventions, including school closure, mask use, and social distancing, substantially altered the epidemiology of pediatric respiratory infections. However, their impact on pediatric Group A Streptococcus pharyngitis remains incompletely understood. This study evaluated temporal trends in Group A Streptococcus positivity across the coronavirus disease 2019 era and factors independently associated with Group A Streptococcus positivity. Methods: In this retrospective cohort study, pediatric patients aged 0–18 years presenting with suspected acute tonsillopharyngitis at a tertiary pediatric outpatient clinic between October 2018 and December 2025 were evaluated. Group A Streptococcus positivity was defined based on a positive rapid antigen detection test and/or positive throat culture for Streptococcus pyogenes . Patients were categorized into pre-pandemic (October 2018 to February 2020), pandemic (March 2020 to May 2023), and post-pandemic (June 2023 to December 2025) periods. Group A Streptococcus positivity rates were compared using chi-square tests, and multivariable logistic regression adjusted for epidemiological period, age, sex, and diagnostic method was performed. Results: In total, 24,166 deduplicated clinical episodes were included. Group A Streptococcus positivity increased significantly across the three epidemiological periods, from 19.7% in the pre-pandemic period to 28.4% during the pandemic and 35.1% in the post-pandemic period ( p < 0.001). Compared with the pandemic period (reference category), the post-pandemic period was independently associated with higher odds of Group A Streptococcus positivity (odds ratio, 1.37; 95% confidence interval, 1.29–1.46; p < 0.001), whereas the pre-pandemic period was associated with lower odds (odds ratio, 0.66; 95% confidence interval, 0.61–0.71; p < 0.001). Increasing age (odds ratio, 1.02; 95% confidence interval, 1.01–1.03; p < 0.001) and male sex (odds ratio, 1.08; 95% confidence interval, 1.02–1.14; p = 0.005) were also independently associated with Group A Streptococcus positivity. Conclusions: Group A Streptococcus positivity increased progressively across the coronavirus disease 2019 era. These trends likely reflect combined effects of healthcare utilization, diagnostic testing practices, age distribution, and transmission dynamics rather than a single explanatory mechanism. Continued epidemiological surveillance is needed to better understand pediatric Group A Streptococcus pharyngitis.

Background/Objectives: Rotavirus vaccination reduces severe childhood gastroenteritis, but real-world effectiveness may vary across settings and calendar periods. We estimated the effectiveness of documented complete rotavirus vaccination against laboratory-confirmed rotavirus gastroenteritis and rotavirus-associated hospitalization among children younger than 5 years in Türkiye. Methods: This retrospective test-negative study included children aged 0–59 months who underwent stool rotavirus testing for clinically evaluated acute gastroenteritis at a tertiary hospital between January 2015 and June 2026. Tests occurring within 14 days in the same child were combined into one episode. Cases were rotavirus-positive episodes and controls were rotavirus-negative episodes. Complete vaccination was defined by an institutional record showing completion of the full schedule before the index test. Cluster-robust logistic regression adjusted for age group, sex, treatment setting, calendar year, and test month. Vaccine effectiveness (VE) was calculated as (1−adjusted odds ratio)×100%. Results: The analysis included 2,788 episodes among 2,242 children: 534 rotavirus-positive cases and 2,254 test-negative controls. Complete vaccination was documented in 81 cases (15.2%) and 539 controls (23.9%). Crude VE was 43.1% (95% confidence interval [CI], 26.2%–56.1%). Adjusted VE against laboratory-confirmed rotavirus gastroenteritis was 52.8% (95% CI, 37.6%–64.3%; P<0.001). Among hospitalized episodes, adjusted VE was 57.8% (95% CI, 33.5%–73.2%; P<0.001). Estimates were stable when vaccination completion was required at least 14 days before testing, when only the first episode per child was retained, and with 7- or 30-day episode definitions. Effectiveness varied markedly by calendar period: 15.3% (95% CI, −28.7% to 44.3%) in 2015–2019 and 77.7% (95% CI, 62.3%–86.8%) in 2022–2026. Conclusions: Documented complete rotavirus vaccination was associated with substantially lower odds of laboratory-confirmed rotavirus gastroenteritis and rotavirus-associated hospitalization. The marked period-specific variation indicates that the pooled estimate should be interpreted with attention to changes in epidemiology, testing, healthcare utilization, and residual confounding across the COVID-19 era.

To evaluate the quality, reliability, source characteristics, and content completeness of YouTube videos related to pediatric nocturnal enuresis and to ide

Background The COVID-19 pandemic coincided with substantial changes in respiratory virus circulation, healthcare utilization, and diagnostic testing. Although population-level influenza activity declined markedly in many settings during periods of stringent public health restrictions, patterns among children undergoing clinical testing remain less clearly understood. This study compared pediatric influenza test positivity across pre-pandemic, restriction-dominant pandemic, and post-restriction periods. Methods This retrospective cohort study included 18,035 children who underwent influenza A/B antigen testing at the Department of Pediatrics, Hisar Intercontinental Hospital, Istanbul, Türkiye, between January 2018 and May 2023. The study period was divided into the pre-pandemic (January 2018-February 2020), restriction-dominant pandemic (March 2020-June 2021), and post-restriction (July 2021-May 2023) periods. Influenza A and B antigens were detected in nasopharyngeal swab specimens using the GenBody Influenza A/B Ag rapid immunochromatographic assay. Tests performed for the same patient within 14 days were considered part of the same illness episode, and only the first eligible test was included. Influenza test positivity was compared across periods and according to age, sex, influenza type, and seasonality. Multivariable logistic regression was used to evaluate factors independently associated with influenza positivity. Results Of the 18,035 children, 6,691 were tested during the pre-pandemic period, 3,375 during the restriction-dominant period, and 7,969 during the post-restriction period. Influenza was detected in 1,699 (25.4%), 969 (28.7%), and 1,937 (24.3%) children, respectively (P<0.001). Although the proportion of positive tests was highest during the restriction-dominant period, both the testing volume and absolute number of detected cases were lower than before the pandemic. Influenza A positivity increased from 17.1% during the restriction-dominant period to 20.0% after restrictions were relaxed, whereas influenza B positivity declined from 11.6% to 4.4%. Seasonal positivity also varied substantially across the study periods. After adjustment for demographic characteristics, the epidemiological period remained independently associated with influenza test positivity. Conclusions Temporal changes in pediatric influenza test positivity coincided with changes in COVID-19 public health measures. The higher positivity among tested children during the restriction-dominant period occurred in the context of substantially reduced testing and should not be interpreted as increased population-level influenza circulation. Changes in healthcare utilization, testing behavior, and the composition of the tested population should be considered when interpreting these findings.

Background: Male infertility has been associated with various environmental, physiological, and genetic factors. In recent years, the widespread use of mobile phones has raised concerns regarding exposure to electromagnetic radiation (EMR). EMR emitted from mobile devices may adversely affect male reproductive function by inducing oxidative stress and impairing spermatogenesis. Objective: This study aimed to evaluate the potential protective effects of vitamin E and N-acetylcysteine (NAC) against EMR-induced testicular damage in rats. Methods: A total of 35 adult male Wistar rats were randomly divided into five groups ( n = 7 per group): control, EMR exposure, EMR + NAC, EMR + vitamin E, and EMR + NAC + vitamin E. Rats were exposed to EMR generated by a mobile phone operating in the GSM frequency band (900/1800 MHz) in active call mode, positioned at a fixed distance of 15 cm from the cages, for 3 h daily over 28 days. The specific absorption rate (SAR) was based on manufacturer-reported values. Biochemical analyses were performed to assess total antioxidant capacity (TAC), glutathione peroxidase (GPX), superoxide dismutase (SOD), and malondialdehyde (MDA) levels. Data distribution was evaluated using the Shapiro–Wilk test, and group comparisons were conducted using the Kruskal–Wallis test with appropriate post-hoc analyses. Results: Significant differences were observed among groups in terms of total antioxidant capacity (TAC) ( p < 0.001). TAC levels were reduced in the EMR-only group compared to controls, whereas antioxidant supplementation (NAC and/or vitamin E) resulted in increased TAC levels. Post-hoc analyses demonstrated significant improvements in TAC in treatment groups compared to both control and EMR-only groups. However, no statistically significant differences were observed among groups for GPX, SOD, and MDA levels ( p > 0.05). Conclusion: N-acetylcysteine (NAC) and vitamin E may exert partial protective effects against EMR-induced oxidative alterations in rat testes, particularly as reflected by improvements in total antioxidant capacity. However, given that other oxidative stress markers did not demonstrate statistically significant differences, these findings should be interpreted with caution. Further experimental and clinical studies with larger sample sizes and detailed histopathological evaluation are required to better elucidate the potential therapeutic role and clinical relevance of these antioxidant agents.

Objective: To systematically compare thulium fiber laser enucleation of the prostate (ThuFLEP) with holmium laser enucleation of the prostate (HoLEP) in terms of efficacy, safety, and perioperative outcomes in men undergoing surgical treatment for benign prostatic hyperplasia (BPH). Materials and methods: This systematic review and meta-analysis was conducted according to the PRISMA 2020 guidelines and registered in PROSPERO (CRD420251057100). PubMed, Scopus, Web of Science, EMBASE, and Google Scholar were searched up to March 2025 for randomized controlled trials and comparative observational studies that evaluated ThuFLEP versus HoLEP. The primary outcomes were perioperative parameters (operative time, catheterization duration, and length of hospital stay) and functional outcomes (International Prostate Symptom Score (IPSS) and maximum urinary flow rate (Qmax)). Secondary outcomes included blood loss, transfusion rate, and postoperative complications graded using the Clavien–Dindo classification. Results: Twelve studies comprising 1248 patients (624 ThuFLEP and 624 HoLEP) met the inclusion criteria. Both techniques yielded comparable functional improvements, with no meaningful differences in the postoperative IPSS, Qmax, or post-void residual volume. ThuFLEP showed perioperative advantages, including a shorter operative time (mean difference (MD) −12.4 min; 95% CI −20.1 to −4.7), shorter catheterization duration (MD −0.58 days; 95% CI −0.81 to −0.35), and shorter hospital stay (MD −0.73 days; 95% CI −1.02 to −0.44). Bleeding-related outcomes favored ThuFLEP, with lower estimated blood loss and fewer transfusions. Overall postoperative complication rates and high-grade complications (Clavien–Dindo ⩾ III) were similar between the groups. Conclusions: ThuFLEP provides functional outcomes equivalent to those of HoLEP while offering improved perioperative efficiency and favorable bleeding-related outcomes. Both procedures appear to be safe and effective for treating BPH. Further large multicenter randomized trials with long-term follow-up are needed to confirm durability and evaluate cost-effectiveness.

Beyond Standard Culture: Diagnostic Value of Ureaplasma and Chlamydia in Women with UTI Symptoms - Medeniyet Medical Journal