Medical Park Hospitals Group, which has been active in the health care sector since 1995, offers service in various provinces of Turkey with more than 6,000 doctors and employees, 17 hospitals in total. Medical Park is the biggest hospital group in Turkey.The hospital chain was founded by Muharrem Usta, who currently chairs the company. The company owned two hospitals in Istanbul in 2005. In 2006, he initially sold 30% of the company shares to Sancak family. This partnership enabled a rapid growth of the company that led to establishment of 13 hospitals with 2,000 beds within three years. By the end of 2009, 40% of the company shares were sold to the third biggest US-American global asset management firm The Carlyle Group. With this new partnership, the number of hospitals reached 17 with 2,771 beds in total that placed the company on first rank of its kind in Turkey. In March 2013, it was reported that the Carlyle Group sold its shares at Medical Park to the largest US-American private equity investment firm Texas Pacific Group.
To apply online surveying to access Obstetrics and Gynecology residents and consultants’ knowledge of, attitudes toward, practice behaviors, and self-confidence levels of caring for lesbian, gay, bisexual, and transgender (LGBT) patients in Turkey. In a prospective survey-based study conducted using an online survey platform, 867 eligible obstetrics and gynecology residents and consultants working at various hospitals in Istanbul, Turkey, identified from a hospital database, were emailed a link to the survey between January 15 and February 21, 2023. 189 OB/GYNs (55 consultants and 134 residents) completed the survey with a response rate of 21.8
To investigate the impact of gluten-free diet adherence on bone mineral density and growth in children with celiac disease.This retrospective cross-sectional study reviewed the medical records of 75 pediatric patients diagnosed with celiac disease. Data on adherence to a gluten-free diet, bone mineral density assessed by dual-energy X-ray absorptiometry, anthropometric measurements, and laboratory parameters were collected. Bone mineral density was evaluated using Z-scores, and low bone mass for age was defined as a bone mineral density Z-score of<-2 according to International Society for Clinical Densitometry pediatric guidelines.Of the 75 patients, 26 (34.7%) patients were men and 49 (65.3%) patients were women; 48 (64%) patients adhered to the diet and 27 (36%) patients did not. Most patients (96%) had normal bone mineral density Z-scores, while 3 (4%) patients had low bone mass for age. The mean height was 141.09±19.34 cm and the mean weight was 37.50±14.95 kg. Growth failure was observed in 10.6% for height, 21.3% for weight, and 5.3% for both. No significant association was observed between diet adherence and sex, bone mineral density findings, growth failure, or most laboratory parameters. Ferritin levels were significantly higher in adherent patients, and positive correlations were observed between diet adherence and hemoglobin and ferritin levels.Adherence to a gluten-free diet showed a trend toward higher bone mineral density Z-scores but without statistically significant differences. The low prevalence of low bone mass for age may limit the detection of differences between groups. Prospective longitudinal studies are needed to clarify the long-term impact of dietary adherence on bone health in pediatric celiac disease.
Abstract Background and aims Aphasia after acute stroke is a frequent and disabling condition, impairing communication and quality of life. We investigated whether tablet-assisted Speech and Language Therapy (SLT) using the Neolexon application is superior to standard SLT in acute stroke patients. Methods In this open-label, randomized, controlled clinical trial, patients with acute post-stroke aphasia were recruited from one stroke center and two neurorehabilitation clinics in Germany. Participants were stratified by aphasia severity and randomized to tablet-assisted SLT (n = 53) or standard SLT (n = 51), initiated during inpatient care and continued in rehabilitation (30 minutes/Day). The primary outcome was the change in the Bielefelder Aphasia Screening (BIAS) percentile rank from baseline to 90 days. Secondary outcomes included frequency and duration of self-training. Results From 07/2021 to September 4, 2024,097 patients were screened and 104 randomized (mean age 74.4 ± 11.2 years; 51.9% female). No significant difference in BIAS change was found at 90 days (18 vs. 14). The trial was stopped early for futility. The intervention group engaged in self-directed training more frequently (37.7% vs. 21.6%) and trained longer (10 vs. 4 hours). Subgroup analyses showed benefits of tablet-assisted SLT in patients with mild (β = 15.51; 95% CI -1.67 to 32.69) and moderate aphasia (β = 23.58; 95% CI -4.48 to 51.65), and those with a NIHSS of less than 5 (β = 21.69; 95% CI 5.54-37.84). Conclusions Although underpowered to demonstrate overall superiority, tablet-assisted SLT showed potential benefits in patients with mild to moderate aphasia and less severe strokes in the acute setting. Conflict of interest K.L. was employed as a project lead at Limedix GmbH during part of the study period. Limedix is the manufacturer of the Neolexon application evaluated in this study. This relationship had no influence on the study design, data collection, data analysis, or interpretation of the results. P.Y. received funding for travel or speaker honoraria from Idorsia, Sanofi, Amicus, Löwenstein Medical, Bioprojet and Mementor outside of this study. P.Y. is supported by the Dr. Werner und Raphael Müller Narcolepsy Foundation. K.F. received grants from the University of Tübingen (AKF and Sigrid-Örgel Stiftung) and speakers’ honoraria/consulting fees from AstraZeneca and BMS/Pfizer, all not related to this work. L.K. received funding for travel or speaker honoraria from Alexion, AstraZeneca, Bayer Vital, Boehringer Ingelheim, Bristol-Myers Squibb, Daiichi Sankyo, Lilly and Pfizer outside of this study.
Background: Focused shockwave therapy (fSWT) has now taken its place in the algorithm for the treatment of vascular erectile dysfunction (ED) in current guidelines. Radial wave therapy (rWT) has started to be applied with the same indication in recent years and positive results have been reported. We aimed to compare the long-term effectiveness of fSWT and rWT in ED. Methods: A two-center study enrolled 200 patients aged 40 to 70 years with ED complaints. Patients were non-randomly allocated to either fSWT or rWT groups based on the clinic they visited. Results: After 3 months, the mean International Index of Erectile Function (IIEF) score for patients in the fSWT group was significantly higher compared with the baseline (13 +/- 2.9 vs. 20.4 +/- 4.7, p < 0.001), and the same trend was observed at 1 year (13 +/- 2.9 vs. 18.1 +/- 4.9, p < 0.001). Similarly, in the rWT group, the mean IIEF score was significantly higher at 3 months (13.1 +/- 3 vs. 22.8 +/- 4.6, p < 0.001) and 1 year (13.1 +/- 3 vs. 19.4 +/- 4.9, p < 0.001) compared with the baseline. However, there was no significant difference in the mean IIEF score changes between the two groups at both 3 months and 1 year. The proportion of patients giving a positive response to the Sexual Encounter Profile-2 (SEP-2) question was 81% at 3 months and 63.2% at 1 year in the fSWT group, and 88.9% at 3 months and 71.6% at 1 year in the rWT group, with no significant difference between the groups. Conclusions: Both fSWT and rWT are effective treatments for vascular-related ED, showing comparable efficacy in improving IIEF scores. Clinical Trial Registration: The study was retrospectively registered with https://www.isrctn.com/ as: ISRCTN14000407.
Primary hemophagocytic lymphohistiocytosis (p-HLH) can be cured with allogeneic haematopoietic stem cell transplantation (allo-HSCT). It remains unclear whether HSCT outcomes are affected by the presence of different genetic mutations. We used data obtained from children who underwent allo-HSCT for HLH to examine the effects of genetic mutations on HSCT outcomes. Data from 153 paediatric patients in 18 paediatric stem cell centres were retrospectively evaluated. Patients were divided into four groups: 1) with PRF1 mutation (n = 46), 2) with UNC13D mutation (n = 38), 3) with STX11/STXBP2 mutation (n = 25) and 4) with Griscelli syndrome type 2/ Chediak–Higashi syndrome (GS2/CHS) diagnosis (n = 44). Statistical analysis showed no difference between the subgroups in terms of engraftment, VOD, acute GVHD, chronic GVHD, TRM, OS and EFS rates. The most important factor affecting OS and EFS in all genetic subgroups was remission status before HSCT. The 5-year EFS values for children with mutations in PRF1, UNC13D, STX11/STXBP2 and GS2/CHS were 71%, 66.6%, 74% and 66.7, respectively (log-rank >0.05). However, with prospective studies covering more patients, and creating different genetic subgroups by performing more detailed genetic analyses, special approaches for different genetic subgroups can be revealed in the future.
