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    A google trends™ analysis of bladder cancer: determining awareness campaign success, and patients’ needs in clinical management
    (Asian Pacific Organization for Cancer Prevention, 2021) Demirci, Aykut; Özgür, Berat Cem
    Objective: We aimed to determine the interest and changing trends over time in the diagnosis and treatment of bladder cancer and its awareness campaign by examining the Google Trends application as an indicator of people’s interest globally. Methods: Using the Google Trends application, we determined the yearly and country-based relative search volumes of the term “bladder tumor” and of the methods used in the diagnosis and treatment of bladder cancer in the period from January 2004 to December 2019. We compared the median relative search volumes found in the period 2004-2011 (Period 1) with those found in the period 2012-2019 (Period 2). Results: We found that the median relative search volume for bladder cancer decreased in period 2 and this was parallel to the decrease in the incidence rates in North America and Australia (p<0.001). We found that the bladder cancer awareness month did not cause an increase in the online interest (p>0.05). We found that the median relative search volumes of diagnostic cystoscopy and cytology were higher than those of molecular markers and imaging methods in line with guidelines (p<0.001). Also, TURBT was the most sought-term among treatment methods with increasing popularity in the second period (p<0.001). Conclusion: People use the internet intensively to search for information about bladder cancer. We think that several types of web-based applications such as “Google Trends” can help determine the behavioural patterns and tendencies of bladder cancer patients and affect the clinical decision-making processes, as well as readily determining the impact of cancer awareness campaigns to bring about an increased awareness in the society for the recognition of the importance of an early diagnosis.
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    Chronic prostatitis developing due to candida infection: A case diagnosed 20 years later and review of up-to-date literature
    (Elsevier, 2018) Demirci, Aykut; Bozlak, Nurten; Türkel, Selçuk
    Chronic prostatitis is a disease which adversely affects the quality of life of patients and does not respond adequately to treatments. In this case, we will present an immunocompetent patient who had chronic prostatitis due to candida infection and who did not benefit from treatments and was not diagnosed for a long time in the light of the up-to-date literature.
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    Comparison between the success of prostate and breast cancer awareness campaigns over "Google Trends" in Turkey
    (Galenos Yayıncılık, 2021) Demirci, Aykut; Sağnak, Azmi Levent
    Objective: This study aimed to compare the success of breast and prostate cancer awareness campaigns using the search rates on the internet as an indicator of the public's interest in the subject. Materials and Methods: The periodic median search rates of the "breast cancer" and "prostate cancer" terms searched between January 2010 and December 2019 annually, 2010-2014 (first period), and 2015-2019 (second period) were compared over Google Trends (TM). The effect of the awareness campaigns and isolated rises (an increase of at least 25%) in the normal trend were evaluated. Results: It was observed that the median search rates for both cancer types increased in the second period (p<0.05). When trends were compared before and after the awareness months annually, an increase above the normal trend was detected for breast cancer (p<0.001). However, this increase was not observed in prostate cancer (p>0.05). Moreover, we found that the isolated rises for both types of cancer coincided with celebrity-related news covered in the media. Conclusion: Although breast cancer awareness was created in the society, it was determined that the situation was not the same for prostate cancer. More studies are needed to enlighten the public on prostate cancer, and Google Trends (TM) may be an important tool that can assist the follow-up on this subject.
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    Comparison of hormone profile and systemic inflammation in patients presenting with sexual dysfunction: Which is important
    (Ediciones Doyma, S.L., 2021) Demirci, Aykut; Özgür, Berat Cem; Tuncer, Sibel Çiğdem
    Introduction: Erectile dysfunction (ED) is the inability to achieve or maintain erection sufficient for satisfactory sexual performance. Although the definition is well known, there are controversial issues about the effects of hormones and inflammation on ED. Objectives: We aimed to compare the clinical value of the hormonal and inflammation parameters in sexual dysfunction. Materials and methods: A total of 152 patients diagnosed with erectile dysfunction between September 2018 and March 2019 and 101 healthy males were included in this prospective study as case group and control group, respectively. The 152 patients were divided into three groups based on their total International Index of Erectile Function (IIEF) scores: (I) severe ED, (II) mild-moderate ED and (III) mild ED. All groups were compared in terms of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and total testosterone (TT), estradiol, prolactin, testosterone-to-estradiol ratio and 25 (OH) vitamin D. Results: Patient and control groups differed significantly in term of NLR, PLR, prolactin and vitamin D (p < 0.001, p = 0.004, p = 0.002, p < 0.001, p < 0.001, respectively). NLR was more significant in determining the severity of ED (p < 0.001). It was observed that libido score (the total score of IIEF items #11 and #12) was negatively associated with prolactin and NLR (p < 0.001, p = 0.023, respectively), was positively associated with vitamin D and TT (p < 0.001, p = 0.02, respectively), and was lower in severe ED patients. Conclusions: Although more clinical studies are needed, we think that our findings may be useful on these controversial issues of ED.
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    COVID-19 effect on perioperative findings of flexible/semi-rigid ureterorenoscopic lithotripsy: A match-pair analysis
    (SAGE, 2023) Demirci, Aykut; Hızlı, Fatih; Başar, Halil
    If not treated on time with proper management options, urolithiasis cause serious morphologic and functional alterations in the involved renal units. Like many other pathologies, the diagnosis, treatment, and follow-up principles of patients with urinary stones have been negatively affected by the unestimated changes in the healthcare systems dealing intensively with COVID-19 patients. In this present study, we aimed to evaluate and present the possible effects of COVID-19 infection on the ureterorenoscopic stone treatment.
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    The effect of using tadalafil 5 mg/day on neutrophil-lymphocyte and platelet-lymphocyte ratios in mild-medium and severe erectile dysfunction patients; and comparison of clinical response
    (Wiley, 2019) Demirci, Aykut; Özgür, Berat Cem
    To examine the relation between NLR (neutrophil-lymphocyte ratio) and PLR (platelet-lymphocyte ratio) rates and the severity of ED (erectile dysfunction) and the effect of tadalafil 5 mg/day on these, a total of 143 patients were retrospectively evaluated. Sixty-three patients with ED who came for follow-up examinations in the 1st month of the treatment were included as the study group, and 80 men who were not diagnosed with ED were as the control group. The age and Charlson Comorbidity Indexes (CCI) of the study and control groups were compared with the IIEF 5, NLR and PLR values before and after the treatment. The mean age and median CCI were higher in the severe ED group (p < 0.05). The mean NLR and PLR values were lower in the control group (p < 0.001). In the study group, the NLR and PLR values decreased with the increase in the IIEF 5 scores (p < 0.001). The ROC curve was significant for the NLR and PLR scores (AUC = 0.779, [95% CI: 0.698-0.860]; AUC = 0.754, [95% CI: 0.670-0.838] p < 0.001). Although more prospective and randomized studies are needed, the systemic inflammation decreases and the clinical symptoms improve in patients who use tadalafil 5 mg/day.
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    The prognostic effect of immunohistochemical staining rates in patients with non-muscle-invasive bladder cancer
    (Wolters Kluwer Medknow Publications, 2023) Demirci, Aykut; Ordu, Melike
    Context: Despite the follow-up protocols developed in non-muscle-invasive bladder cancer patients, progression and recurrence could not be prevented. Aims: We aimed to investigate whether proteins such as OCT-4, CD47, p53, Ki-67, and Survivin, which increase in bladder cancer cells, can be used as prognostic markers for patients with non-muscle-invasive bladder cancer. Settings and Design: The study included a total of 89 patients with newly diagnosed non-muscle-invasive bladder cancer between January 2015 and December 2020. Materials and Methods: Levels of OCT-4, CD47, p53, Kİ-67, and Survivin proteins in cancer cells were determined with a semi-quantitative immunohistochemical experiment. Pathological data and survival rates were compared according to the staining rates. Statistical Analysis Used: Data obtained in the study were analyzed statistically with SPSS 22.0 (SPSS, Chicago, IL, USA). Results: The mean age of the patients was 64.25 ± 9.91 years, and the median follow-up period was 55 months. Recurrence rate was determined to be 36% (n = 32), and the rate of progression at 40.4% (n = 36). The staining rates were stronger for each marker in the progression group and advanced-stage tumors (p < 0.001). The findings of the multivariate analysis carried out as part of the study showed that older age and higher tumor stage were independent risk factors for recurrence-free survival (HR = 1.048 and 7.074, respectively; P = 0.02). Also, higher tumor stages, diameters, and grades were associated with reduced progression-free survival (HR = 0.105, 0.395, 0.225, respectively; P < 0.05). Conclusions: Although immunohistochemical staining rates are promising, it is more appropriate to use tumor characteristics when assessing survival rate in patients with non-muscle-invasive bladder cancer.
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    Whether adding vitamin D to tadalafil 5 mg treatment Is useful in patients with erectile dysfunction and vitamin D deficiency?
    (Karger Publishers, 2021) Demirci, Aykut; Cakan, Murat; Topcuoğlu, Murat
    Introduction: Numerous factors such as endothelial disease and hormonal disorder cause the development of erectile dysfunction (ED). However, the relationship between vitamin D deficiency (VDD) and ED is unclear. Moreover, the benefit of vitamin D replacement on ED patients with VDD is uncertain. As far as we know, there is no study yet in the literature regarding the addition of vitamin D to phosphodiesterase type 5 inhibitors in the treatment of ED patients with VDD. In this study, we investigated whether adding vitamin D to daily tadalafil treatment would be beneficial in ED patients with VDD. Methods: A total of 111 patients with VDD accompanying ED were retrospectively evaluated between January 2016 and December 2019. Patients were divided into 2 groups according to the treatment they received. Group 1 (n = 58) was treated with daily oral tadalafil 5 mg, while group 2 (n = 53) received oral tadalafil 5 mg and 4,000 IU vitamin D3. Total International Index of Erectile Function-15 (IIEF-15) scores and vitamin D levels of the groups were compared at the end of the study. Results: The mean vitamin D level was increased statistically significant in group 2, but no difference was seen in group 1 (p < 0.001 and p > 0.05, respectively). There was a significant increase in median erectile function, orgasmic function, sexual desire, sexual satisfaction, and overall satisfaction scores in both groups (p < 0.001). However, the increase in median erectile function and sexual desire scores was significantly higher in group 2 compared to group 1 at the end of the study (p = 0.01 and p < 0.001, respectively). Conclusion: We found that adding vitamin D to 5 mg oral daily tadalafil treatment may have an additional positive effect on erectile function and sexual desire in ED patients with VDD.