Correlation between oral health-related quality of life (OHQoL) and oral disorders in a Turkish patient population

Objectives: The purpose of the present study is to determine the nature of the complaints that bring patients to our clinic and to what degree these complaints affect their quality of life (QoL). We also aimed to determine any associations between gender, education or harmful habits and each patient?s oral health-related quality of life (OHQoL). Methods: A total of 1090 patients, consisting of 651 females (59.7 %) and 439 males (40.3 %), were included in this study. Of these patients, 220 constituted healthy controls. Two patient-centered outcome measures, the 14 item OHIP-14 and the 16 item OHQoL-UK measures were used. Results: Most of the patients presented with toothache and caries (50.1 %), 11.2 % had suffered tooth loss and had denture needs, 9.2 % had periodontal problems, 1.8 % had temporomandibular joint (TMJ) disorders, 3.8 % had buried third molars, 2.4 % had orthodontic and aesthetic disorders, 1.3 % had suffered injury due to trauma, and 20.2 % came only for control checkups. OHQoL was best in the control group and the worst in patients who had suffered trauma. In addition, we noted correlations between gender, education and harmful habits, and that of the patient?s oral health-related quality of life. Conclusion: According to our results, OHQoL is associated with the oral complaints of patients. Furthermore, OHQoL may not only be associated with the oral health status of patients, but factors such as gender, education and harmful habits may also play a role

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Rationale and Design of the Turkish Sleep Apnea Database - TURKAPNE: A National, Multicenter, Observational, Prospective Cohort Study

OBJECTIVES: The primary aim of The Turkish Sleep Apnea Database (TURKAPNE) study is to generate a cross-sectional nationwide database for defining the clinical and polysomnographic characteristics of the patients with obstructive sleep apnea (OSA) in Turkey

Rationale and Design of the Turkish Sleep Apnea Database - TURKAPNE: A National, Multicenter, Observational, Prospective Cohort Study

WOS: 000439590300008PubMed ID: 30083405OBJECTIVES: The primary aim of The Turkish Sleep Apnea Database (TURKAPNE) study is to generate a cross-sectional nationwide database for defining the clinical and polysomnographic characteristics of the patients with obstructive sleep apnea (OSA) in Turkey. MATERIALS AND METHODS: In this ongoing project, all consecutive adults with suspected OSA are recruited from the sleep centers of the university and research hospitals in Turkey. Information on anthropometric data, educational status, driving license, smoking habits, alcohol use, comorbidities, drug use, questionnaires, polysomnographic, and/or cardiorespiratory polygraphic findings are recorded in a systematized Web-based report form. Blood glucose, lipids and other biochemical markers, lung function, and echocardiography measurements are optionally included. Follow-up data regarding treatment modality and compliance is assessed. Cross-sectional and longitudinal associations between OSA phenotypes and metabolic, pulmonary, and cardiovascular comorbidities as well as traffic accidents, and the impact of treatment will be further explored. We target a total sample of 10,000 participants. RESULTS: The study was registered with ClinicalTrials.gov (NCT02784977) in May 2016 and the first patient was recruited in October 2017. A total of 1911 participants from 19 centers have been enrolled in the study by May 31, 2018. CONCLUSION: The TURKAPNE study will contribute to a better understanding of the health-related burden of OSA phenotypes and its association with the comorbidities and adverse outcomes, including traffic accidents in Turkey. The results may also contribute to a more personalized approach and better management of varying OSA phenotypes with concomitant disorders.Turkish Thoracic SocietyThe foundation and infrastructure of the database was supported by grants from the Turkish Thoracic Society with no influence on the design of the study, the analysis of the data, the data collection, drafting of the manuscript, or the decision to publish

Management of Priapism: Results of a Nationwide Survey and Comparison with International Guidelines

Objective: The aim of this study is to evaluate current urologic practice regarding the management of priapism in Turkey and compare with international guidelines. Methods: Urologists and urology residents were invited to an online survey consisting of 30 multiple-choice questions on priapism-related clinical practices that were considered most important and relevant to practices by using Google Forms. Results: Total number of responses was 340. Respondents reported that they recorded a detailed patient’s medical history and physical examination findings (n = 340, 100%) and laboratory testing, which includes corporal blood gas analysis (n = 323, 95%). Participants announced that they performed Doppler ultrasound for 1/4 cases (n = 106, 31%), but 22% of the participants (n = 75) replied that they performed in >75% of cases. Participants (n = 311, 91%) responded that the first-line treatment of ischemic priapism is decompression of the corpus cavernosum. Moreover, most respondents (n = 320, 94%) stated that sympathomimetic injection drugs should be applied as the second step. About three-quarters of respondents (n = 247, 73%) indicated adrenaline as their drug of choice. Phosphodiesterase type 5 inhibitors seems to be the most preferred drug for stuttering priapism (n = 141, 41%). Participants (n = 284, 84%) replied that corpora-glanular shunts should be preferred as the first. A large number of participants (n = 239, 70%) declared that magnetic resonance imaging can be performed in cases with delayed (>24 hours) priapism to diagnose corporal necrosis. Most of the participants (84%) responded that penile prosthesis should be preferred to shunts in cases with delayed (>48 hours) priapism. Conclusion: It would be appropriate to improve the training offered by professional associations and to give more training time to the management of priapism during residency

Stoma-free survival after anastomotic leak following rectal cancer resection: worldwide cohort of 2470 patients

Background: The optimal treatment of anastomotic leak after rectal cancer resection is unclear. This worldwide cohort study aimed to provide an overview of four treatment strategies applied. Methods: Patients from 216 centres and 45 countries with anastomotic leak after rectal cancer resection between 2014 and 2018 were included. Treatment was categorized as salvage surgery, faecal diversion with passive or active (vacuum) drainage, and no primary/secondary faecal diversion. The primary outcome was 1-year stoma-free survival. In addition, passive and active drainage were compared using propensity score matching (2: 1). Results: Of 2470 evaluable patients, 388 (16.0 per cent) underwent salvage surgery, 1524 (62.0 per cent) passive drainage, 278 (11.0 per cent) active drainage, and 280 (11.0 per cent) had no faecal diversion. One-year stoma-free survival rates were 13.7, 48.3, 48.2, and 65.4 per cent respectively. Propensity score matching resulted in 556 patients with passive and 278 with active drainage. There was no statistically significant difference between these groups in 1-year stoma-free survival (OR 0.95, 95 per cent c.i. 0.66 to 1.33), with a risk difference of -1.1 (95 per cent c.i. -9.0 to 7.0) per cent. After active drainage, more patients required secondary salvage surgery (OR 2.32, 1.49 to 3.59), prolonged hospital admission (an additional 6 (95 per cent c.i. 2 to 10) days), and ICU admission (OR 1.41, 1.02 to 1.94). Mean duration of leak healing did not differ significantly (an additional 12 (-28 to 52) days). Conclusion: Primary salvage surgery or omission of faecal diversion likely correspond to the most severe and least severe leaks respectively. In patients with diverted leaks, stoma-free survival did not differ statistically between passive and active drainage, although the increased risk of secondary salvage surgery and ICU admission suggests residual confounding

Stoma-free Survival After Rectal Cancer Resection With Anastomotic Leakage: Development and Validation of a Prediction Model in a Large International Cohort.

Objective:To develop and validate a prediction model (STOMA score) for 1-year stoma-free survival in patients with rectal cancer (RC) with anastomotic leakage (AL).Background:AL after RC resection often results in a permanent stoma.Methods:This international retrospective cohort study (TENTACLE-Rectum) encompassed 216 participating centres and included patients who developed AL after RC surgery between 2014 and 2018. Clinically relevant predictors for 1-year stoma-free survival were included in uni and multivariable logistic regression models. The STOMA score was developed and internally validated in a cohort of patients operated between 2014 and 2017, with subsequent temporal validation in a 2018 cohort. The discriminative power and calibration of the models' performance were evaluated.Results:This study included 2499 patients with AL, 1954 in the development cohort and 545 in the validation cohort. Baseline characteristics were comparable. One-year stoma-free survival was 45.0% in the development cohort and 43.7% in the validation cohort. The following predictors were included in the STOMA score: sex, age, American Society of Anestesiologist classification, body mass index, clinical M-disease, neoadjuvant therapy, abdominal and transanal approach, primary defunctioning stoma, multivisceral resection, clinical setting in which AL was diagnosed, postoperative day of AL diagnosis, abdominal contamination, anastomotic defect circumference, bowel wall ischemia, anastomotic fistula, retraction, and reactivation leakage. The STOMA score showed good discrimination and calibration (c-index: 0.71, 95% CI: 0.66-0.76).Conclusions:The STOMA score consists of 18 clinically relevant factors and estimates the individual risk for 1-year stoma-free survival in patients with AL after RC surgery, which may improve patient counseling and give guidance when analyzing the efficacy of different treatment strategies in future studies