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  Abstract 4367615: The Cardiovascular Paradox of Gout Prophylaxis: A Systematic Review and Meta-analysis

  (Ovid Technologies (Wolters Kluwer Health), 2025-11-04)

  Ibrahim Kuyucu

  ;

  Omer Faruk Canavar

  ;

  Riza Deha Dogruer

  ;

  Azra Dila Altin

  ;

  Recep Aktas

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  Introduction: Colchicine and NSAIDs are commonly used as flare prophylaxis during urate-lowering therapy (ULT) in gout, a chronic inflammatory condition linked to elevated cardiovascular risk. Oxidative stress and endothelial dysfunction may contribute to major adverse cardiovascular events (MACE). Although colchicine shows cardioprotective effects in non-gout populations and NSAIDs remain widely used despite risks, their effect on MACE in gout patients is unclear. Research Question: Does flare prophylaxis with colchicine or NSAIDs alter the cardiovascular risk profile in patients with gout initiating ULT therapy? Methods: This review followed PRISMA guidelines and was registered in PROSPERO (CRD420251017700). MEDLINE, EMBASE, and CENTRAL were searched through April 2025 for studies of gout patients initiating ULT with flare prophylaxis using colchicine, NSAIDs, or no prophylaxis. Studies involving non-gout crystal arthropathies, isolated hyperuricemia, or prophylaxis without ULT were excluded. The primary outcome was MACE, defined as a composite of all-cause mortality, myocardial infarction, stroke, and coronary revascularization. Log-transformed hazard ratios (HRs) were pooled using a random-effects meta-analysis. Results: Five studies from the UK, US, and Canada were included: three retrospective cohorts, one observational reanalysis of an RCT, and one target trial emulation. To avoid duplication with Cipolletta et al., only the CPRD GOLD subset was extracted from Roddy et al. Across four studies, 148,345 gout patients were included, with Singh et al. reporting 10,195 person-years of follow-up. Among them, 37,168 (25.1%) received colchicine and 19,461 (13.1%) received NSAIDs. Colchicine prophylaxis was not significantly associated with MACE risk compared to no prophylaxis [log(HR) = 0.005; 95% CI: -0.21 to 0.22, Figure 1]. NSAIDs also showed no significant difference [log(HR) = 0.19; 95% CI: -0.18 to 0.57, Figure 2]. Risk was similar between colchicine and NSAID groups [log(HR) = -0.02; 95% CI: -0.32 to 0.28, Figure 3]. Conclusion: Our meta-analysis found that flare prophylaxis with colchicine or NSAIDs did not reduce cardiovascular event risk in gout patients. These findings may contradict recent evidence of colchicine’s cardioprotective effects compared to NSAIDs. Further studies are needed to guide cardiovascular risk management in this high-risk population.

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  Item type:Publication, Access status: Metadata only ,

  Refined Adjustment with Rotational Septal Extension Graft in Rhinoplasty for Tip Rotation and Projection

  (SAGE Publications, 2023-09-01)

  Erkan Soylu

  ;

  Alper Yenigun

  ;

  Orhan Ozturan

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  YENİGÜN, ALPER

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  ÖZTURAN, ORHAN

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  Background: Precise adjustment of tip rotation and projection harmonious with nasal dorsum is important in rhinoplasty. The use of septal extension graft for rotation and projection enhancement has been the most reliable surgical technique recently. It is also an efficient graft to increase the tip projection effectively and permanently. Objective: The aim of this study is to demonstrate the ability to adjust tip rotation and projection with the use of rotational septal extension graft in accordance with the needs of the patient. Materials and Methods: Rotational septal extension graft was applied in 21 patients who underwent rhinoplasty. It is fixed with a dental needle to provide desired projection to the caudal septum. In this way, the rotation of the graft pivoting around the needle in caudal or dorsal direction can allow precise adjustment. In the position where rotation and projection are evaluated appropriate, the graft is fixed with sutures. They were followed in average 12 months (between 6 and 18 months). Results: Eight of these patients were revision cases and 13 were primary cases. The targeted rotation and projection results were achieved in all patients. All patients had satisfactory aesthetic results. Conclusions: Rotational septal extension graft allows effective rotation adjustment as well as adequate projection and can be rotated in the desired direction around the dental needle. No competing financial interests exist. No funding was received for this article. Runtime of video: 1 mins 13 secs

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  Item type:Publication, Access status: Metadata only ,

  Effect of Home-Based Regular Exercise Training Program in Females with Asthma: A Randomized Controlled Trial

  (Elsevier BV, 2024-01-01)

  Ayse Sena Manzak Dursun

  ;

  Semiramis Ozyilmaz

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  Pinar Atagun Guney

  ;

  Aysegul Yabaci Tak

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  DURSUN, AYŞE ESRA

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  WCN24-369 End-stage kidney disease care for migrants: a European survey

  (Elsevier BV, 2024-04-01)

  Liz Lightstone

  ;

  Ewa Pawlowicz-Szlarska

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  Gaetan Alfano

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  H.Van Craenenbroeck Amaryllis

  ;

  Alice Doreille

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  Item type:Publication, Access status: Open Access ,

  Evaluating incidental findings in cervical mri scans: The prevalence and clinical relevance of incidental findings

  (Galenos Yayinevi, 2025-01-17)

  Nevin Köremezli Keskin

  ;

  Mehmet Denizhan Yurtluk

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  Merve Başdemirci

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  Onur Başdemirci

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  Abdullah Emren Taçyıldız

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  Objective: This study aims to examine the frequency, types, and clinical significance of incidental findings in cervical magnetic resonance imaging (MRI) scans and their implications for patient care. Materials and Methods: A total of 331 cervical MRI scans were reviewed retrospectively at Karabük University Research and Teaching Hospital between April 2022 and April 2023. Patients presenting with arm and neck pain or symptoms suggesting abnormalities of the cervical spine were included; those whose images were affected by artifacts were excluded. Incidental findings were recorded and categorized according to their type, location, and potential clinical significance. Results: Our cohort consisted of 221 female patients (69%) and 101 male patients (31%), amounting to a total of 322 patient records. Loss of cervical lordosis (71%) and cervical disc herniation (92%) were the most prevalent findings in the cervical spine. Additional findings included syringomyelia, cerebellar tonsillar herniation, and empty sella. After being diagnosed with thyroid cancer, one patient received appropriate care. The distribution of incidental findings by gender was not statistically significant. This study highlights the frequency and variety of incidental findings in cervical MRI scans, along with their possible clinical significance. The findings are consistent with earlier studies, highlighting the necessity of carefully analyzing these results to detect potentially fatal disorders. Conclusion: It is crucial not to overlook incidental abnormalities in cervical MRI scans for the early identification of clinically relevant disorders. Future research should concentrate on creating uniform protocols for handling incidental results to successfully balance clinical benefits and resource consumption.

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