Acıbadem University Atakent Hospital

Background and Objectives: It is crucial to determine physical findings and outcome measures that affect functional status of the patients, and the impact levels of these parameters on patients. Therefore, the aim of this study was to investigate the determinant and predictive effect of pain levels, shoulder range of motion (ROM) values, disability and health-related quality of life factors on functional status in individuals with partial-thickness rotator cuff tears (PRCT). Materials and Methods: Firstly, the functional status of 45 patients (mean age: 50.78 ± 5.28 years; 29 female) with PRCT, then activity and night pain levels with Numeric Pain Rating Scale, active flexion, abduction and external rotation of the shoulder ROM values with goniometer, disability level with Quick Disabilities of Arm, Shoulder & Hand Questionnaire, and health-related quality of life levels with Short Form-12 were evaluated and recorded. Results: It was detected that all determinants whose effect on functionality was evaluated with a multiple regression model explained 76% of the variance, and this effect level was statistically significant (R square = 0.760, adjusted R square = 0.707, F = 14.272, p < 0.001). Detailed evaluation showed that flexion and external rotation ROM values (respectively; β = 0.54, p < 0.001; β = 0.38, p = 0.001) and disability level (β = 0.44, p < 0.001) had statistically significant determinant effects on functional status. No statistically significant results which could be correlated with functional status were found for activity and night pain, abduction ROM value, and health-related quality of life domains (p > 0.05). Conclusions: Shoulder flexion and external rotation ROMs and disability level were found to have a predictive effect on the functional status in individuals with PRCT. It is noteworthy that more subjective and patient-reported findings and outcome measures such as pain and health-related quality of life had no predictive effect on functionality. By determining the level of these effects, results were reached that can shed light on the literature by guiding the development of reliable assessment algorithms.

Abstract Background: De novo metastatic breast cancer (MBC) presents distinct clinical challenges and accounts for a small proportion of all breast cancer cases. While extensive data exist for female patients, the characteristics and outcomes of male patients with de novo MBC remain poorly defined. Comparing clinicopathological features and prognoses between male and female patients may help improve personalized management strategies for this rare subgroup. In this study, we compared the clinicopathological features and prognoses of male and female patients diagnosed with de novo metastatic breast cancer. Method: This retrospective study utilized data from the Surveillance, Epidemiology, and End Results (SEER) database, including male and female patients diagnosed with de novo metastatic breast cancer, between 2000 and 2021. Demographic and clinicopathological variables were collected to compare baseline characteristics. Survival outcomes were assessed using Kaplan-Meier analysis, and multivariate Cox regression was performed to identify independent prognostic factors. Statistical analyses were conducted using SPSS version 30.0. Results: A total of 60,590 patients met the study criteria. Of these patients, 713 (1.2%) were male. 56.1% were under 65 years of age. Pathological subtypes were HR+/HER2- (61.2%), HR+/HER2+ (15.9%), HR-/HER2- (14.3%), and HR-/HER2+ (8.6%). All patients had de novo metastatic disease. Metastatic sites were bone (64.2%), lung (30%), distant lymph node (27%), liver (24.2%), brain (7.3%), and other (18%). At the time of diagnosis, statistically significant differences were detected in patient groups in terms of age (p&amp;lt;0.001), marital status (p&amp;lt;0.001), origin (p&amp;lt;0.001), race (p&amp;lt;0.001), histologic type (p&amp;lt;0.001), breast cancer subtype (p&amp;lt;0.001), liver metastasis (p&amp;lt;0.001), lung metastasis (p&amp;lt;0.001) 5-year survival of de novo metastatic female breast cancer patients was found to be better than male patients (31.4% vs. 25.6%, p = 0.036). Conclusions: Male breast cancer is quite rare. The clinicopathological features and metastatic spread of male and female patients at diagnosis differ. Female patients were found to have a better survival rate. Citation Format: I. Dogan, A. Azizy, I. D. Subası, I. Yıldız, A. Arican, S. Yücel, O. Dülgeroğlu, M. Bozkurt, C. Uras. Comparison of Clinicopathological Features and Prognoses in Male and Female Patients with Denovo Metastatic Breast Cancer [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS1-09-11.

Aim: We aimed to compare the aesthetic results and safety profile of bipolar coagulation of muscle during blepharoplasty with those of blepharoplasty with muscle resection. Materials and Methods: This retrospective study included patients who underwent isolated upper eyelid blepharoplasty. The patients were divided into two groups according to the blepharoplasty technique: patients who had muscle resection (Group A) and patients who had muscle contraction with bipolar cautery (Group B). The data were obtained from patient files and photograph archives. The photographs of the patients were evaluated by two independent plastic surgeons. The Visual Analysis Scale/Score (VAS) was used to evaluate the safety profile, And the Global Aesthetic Improvement Scale (GAI) was used to evaluate the aesthetic results. The scores were compared between the two groups. Results: The mean VAS scores of Group A were 5.21 for edema, 4.95 for bruising, 0.91 for scar, 0.67 for fold loss, and 0.86 for asymmetry. Same scores for Group B were 5.43 for edema, 4.83 for bruising, 0.87 for scar, 0.63 for fold loss, and 0.79 for asymmetry. The mean GAI scores were 3.82 at 3 months and 3.76 at 12 months for Group A, and 4.19 at 3 months and 4.12 at 12 months for Group B. There was no statistically significant difference between the groups for VAS (p&gt;0.05), but there was a statistically significant difference for GAI (p

Isolated tears of the pectoralis minor (PMi) are rare and often misdiagnosed as pectoralis major or costochondral injuries. Since the first report in 2004, only eleven cases have been described in the English-language literature, all involving the myotendinous junction or coracoid insertion. A tear at the costal origin has not previously been reported. A 46-year-old male developed acute anterior chest pain after pulling a heavy hospital bed. Physical examination revealed focal tenderness over the third to fifth ribs and pain with resisted internal rotation. Magnetic resonance imaging demonstrated a partial tear of the pectoralis minor at its costal origin with associated rib bone marrow edema, while the coracoid insertion and pectoralis major were intact. The patient was treated nonoperatively with analgesics and a structured physiotherapy program emphasizing scapular stabilization, resulting in complete symptom resolution within six weeks. A structured search of PubMed and Scopus identified eleven previously reported cases of isolated PMi tear published between 2004 and 2021. Most injuries occurred in contact or overhead athletes and involved the myotendinous or insertional region. All cases were managed conservatively with favorable clinical outcomes. This case represents the first documented costal origin tear of the pectoralis minor, associated with rib bone marrow edema following a low-energy, non-sporting mechanism. The findings expand the anatomical spectrum of PMi injuries and highlight the importance of considering this diagnosis in patients with anterior chest wall pain and an intact pectoralis major. MRI is essential for accurate localization of the lesion and exclusion of concomitant injury. Conservative management remains an effective treatment strategy.

This multicenter observational study aimed to retrospectively evaluate the mid-term clinical outcomes of the mini-crush technique (MCT) and double kissing culotte technique (DKCT) in patients with coronary bifurcation lesions (CBLs). This large-scale, multicenter study ( n = 8) included patients with CBLs who underwent percutaneous coronary intervention with either MCT or DKCT. The primary endpoint was defined as major adverse cardiac events (MACE), which include cardiac death, target vessel myocardial infarction, or clinically driven target lesion revascularization. A total of 728 patients [male: 584 (80.2%), mean age: 60.93 ± 10.46 years] were included. The initial revascularization strategy was MCT in 476 (65.4%) cases and DKCT in 252 (34.6%) cases. The number of balloons used (6.30 ± 1.84 vs. 5.43 ± 1.99, P < 0.001) and procedure time (65.10 ± 20.34 vs. 61.30 ± 18.48 min, P = 0.020) were significantly higher in the DKCT group. In multivariate Cox regression analysis, risk-adjusted mid-term MACE [hazard ratio (HR): 0.645, (95% confidence interval: 0.395-1.053), P = 0.079] did not differ in the MCT group compared to the DKCT group. Additionally, chronic kidney disease (HR = 2.434, P < 0.001), high SYNTAX score (HR = 1.085, P < 0.001), final kissing balloon inflation (HR = 0.110, P < 0.001), presence of nonfatal intraprocedural complications (HR = 5.818, P < 0.001), and high total cholesterol level (HR = 1.007, P = 0.005) were found to be independent predictors of MACE. This multicenter registry demonstrates that in patients with CBLs, the risk-adjusted MACE rate was similar between both techniques, with a nonsignificant trend favoring MCT at mid-term follow-up.

The comparison of outcomes of mini-crush (MCT) versus double kissing crush (DKC) techniques for complex left main bifurcation (LMB) lesions is still lacking. This investigation aimed to assess the long-term outcomes of patients who underwent MCT or DKC for LMB disease. From 2014 to 2024, patients who underwent percutaneous coronary intervention for complex LMB lesions were retrospectively collected. The primary end point was major adverse cardiac events as the combination of cardiac death, target vessel myocardial infarction, or clinically driven target lesion revascularization during follow-up. The secondary end point was measured as major adverse cardiovascular and cerebral events including all-cause death, target vessel revascularization, target vessel myocardial infarction, stent thrombosis, and stroke. This large-scale multicenter (n=13) observational study included a total of 531 consecutive patients (men: 405 [76.3%], mean age: 63.16±11.26 years) with complex LMB lesions who underwent percutaneous coronary intervention. The initial revascularization strategy was MCT in 313 (59%) patients and DKC in 218 (41%) patients. The number of balloons used (5.91±1.53 versus 6.72±1.70, P<0.001) and procedure time (66.60±24.20 versus 72.97±19.97 minutes, P<0.001) were notably lower in the MCT group. In the overall population, the long-term major adverse cardiac events (hazard ratio [HR], 0.704; P=0.169) and major adverse cardiovascular and cerebral events (HR, 0.660; P=0.079) did not differ in individuals with complex LMB lesions treated with MCT and DKC. Other end points were also comparable between the 2 groups. In complex LMB lesions, risk-adjusted major adverse cardiac events and major adverse cardiovascular and cerebral events rates were comparable between both techniques, with a nonsignificant trend favoring DKC at long-term follow-up. URL: https://www.clinicaltrials.gov; Unique Identifier: NCT06546748.

Local recurrence and distant metastasis remain a concern in advanced rectal cancer, with up to 10% and 20%-30% of patients suffering local and distal progression, respectively. Radiomics refers to a novel technology that extracts and analyses quantitative imaging features from images, which can be subsequently used to develop and test clinical models predictive of outcomes. We aim to develop and test an MRI-based radiomics nomogram predictive of disease recurrence in patients with T4 rectal cancer. We conducted a multi-institutional retrospective analysis of 55 patients with T4 rectal cancer treated with neoadjuvant chemoradiotherapy followed by exenterative surgery. Radiomic features were extracted from pre-treatment T2-weighted MRI scans and used to construct predictive models. The top-performing radiomic signatures were identified, and internal validation with 1000 bootstrap samples was performed to calculate optimism-corrected performance measures. Two radiomic signatures were identified as strong predictors of post-operative disease recurrence. The best-performing model achieved an optimism-corrected AUC of 0.75, demonstrating good discriminative ability. Calibration plots showed a satisfactory fit of the predictions to the actual rates, and decision curve analyses confirmed the positive net benefit of the models. The MRI-based radiomics nomogram provides a promising tool for predicting disease recurrence in T4 rectal cancer patients post-exenteration. This model could improve risk stratification and guide more personalized treatment strategies. Further studies with larger cohorts and external validation are needed to confirm these findings and enhance the model's generalizability.

The optimal goal in the management of refractory/relapsed classical Hodgkin lymphoma (R/R-cHL) is to obtain minimal disease status before stem cell transplantation (SCT). The efficiency of BEGEV (bendamustin, gemcitabine, vinorelbine) regimen is well-established as first-line salvage therapy in earlier studies. The search for novel treatment continues for patients with limited options in later lines. This study aimed to evaluate the efficacy of BEGEV regimen in heavily pretreated, platinum-resistant, R/R-cHL. In this single-center retrospective trial, patients diagnosed with R/R-cHL between 2018 and 2023 were analyzed. Patients who received BEGEV in third- or fourth-line treatment were eligible. Patient's demographic characteristics, pathology results, treatment and survival outcomes were recorded. Overall survival (OS), objective response rate (ORR), progression free survival (PFS) and toxicity were analyzed. A total of 31 patients were included in this study. 27 (87.2%) patients were treated with BEGEV in the 3rd line and 4 (12.8%) patients were treated in the 4th line. The results show an ORR of 90.3%, with 54.9% achieving complete response. The median PFS and OS after the BEGEV regimen was 20.2 (range 15-23.6) and 23.2 (range 15.4-40.8) months, respectively. The regimen demonstrated acceptable toxicity, with the most common severe adverse events being neutropenia and thrombocytopenia. SCT was successfully performed in 100% of the patients after BEGEV treatment. Our findings suggest that BEGEV is a viable and effective treatment option for heavily pretreated, platinum-resistant R/R-cHL patients, particularly in regions with limited access to novel therapies.