{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T12:48:24Z","timestamp":1770814104623,"version":"3.50.1"},"reference-count":41,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2022,11,1]],"date-time":"2022-11-01T00:00:00Z","timestamp":1667260800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2022,11,1]],"date-time":"2022-11-01T00:00:00Z","timestamp":1667260800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Endocrine"],"DOI":"10.1007\/s12020-022-03241-2","type":"journal-article","created":{"date-parts":[[2022,11,1]],"date-time":"2022-11-01T16:02:41Z","timestamp":1667318561000},"page":"545-553","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Giant growth hormone-secreting pituitary adenomas from the endocrinologist\u2019s perspective"],"prefix":"10.1007","volume":"79","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4462-6393","authenticated-orcid":false,"given":"Bahadir","family":"Koylu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9072-5683","authenticated-orcid":false,"given":"Busra","family":"Firlatan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6740-6708","authenticated-orcid":false,"given":"Suleyman Nahit","family":"Sendur","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7781-944X","authenticated-orcid":false,"given":"Seda Hanife","family":"Oguz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0513-1750","authenticated-orcid":false,"given":"Selcuk","family":"Dagdelen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1377-9394","authenticated-orcid":false,"given":"Tomris","family":"Erbas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,11,1]]},"reference":[{"issue":"1","key":"3241_CR1","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1007\/s11102-016-0772-8","volume":"20","author":"L Vilar","year":"2017","unstructured":"L. Vilar, C.F. Vilar, R. Lyra, R. Lyra, L.A. Naves, Acromegaly: clinical features at diagnosis. Pituitary 20(1), 22\u201332 (2017).","journal-title":"Pituitary"},{"issue":"6","key":"3241_CR2","doi-asserted-by":"publisher","first-page":"707","DOI":"10.1530\/EJE-14-1117","volume":"172","author":"I Shimon","year":"2015","unstructured":"I. Shimon, R.S. Jallad, M. Fleseriu, C.G. Yedinak, Y. Greenman, M.D. Bronstein, Giant GH-secreting pituitary adenomas: management of rare and aggressive pituitary tumors. Eur. J. Endocrinol. 172(6), 707\u2013713 (2015).","journal-title":"Eur. J. Endocrinol."},{"issue":"3","key":"3241_CR3","doi-asserted-by":"publisher","first-page":"431","DOI":"10.1007\/s11102-014-0574-9","volume":"18","author":"E Fernandez-Rodriguez","year":"2015","unstructured":"E. Fernandez-Rodriguez, F.F. Casanueva, I. Bernabeu, Update on prognostic factors in acromegaly: is a risk score possible? Pituitary 18(3), 431\u2013440 (2015).","journal-title":"Pituitary"},{"issue":"24","key":"3241_CR4","doi-asserted-by":"publisher","first-page":"2558","DOI":"10.1056\/NEJMra062453","volume":"355","author":"S Melmed","year":"2006","unstructured":"S. Melmed, Medical progress: Acromegaly. N. Engl. J. Med. 355(24), 2558\u20132573 (2006).","journal-title":"N. Engl. J. Med."},{"issue":"3","key":"3241_CR5","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1007\/s12020-018-1645-x","volume":"61","author":"P Iglesias","year":"2018","unstructured":"P. Iglesias, V. Rodriguez Berrocal, J.J. Diez, Giant pituitary adenoma: histological types, clinical features and therapeutic approaches. Endocrine 61(3), 407\u2013421 (2018).","journal-title":"Endocrine"},{"issue":"7","key":"3241_CR6","doi-asserted-by":"publisher","first-page":"3141","DOI":"10.1210\/jc.2009-2670","volume":"95","author":"A Giustina","year":"2010","unstructured":"A. Giustina, P. Chanson, M.D. Bronstein, A. Klibanski, S. Lamberts, F.F. Casanueva et al. A consensus on criteria for cure of acromegaly. J. Clin. Endocrinol. Metab. 95(7), 3141\u20133148 (2010).","journal-title":"J. Clin. Endocrinol. Metab."},{"issue":"5","key":"3241_CR7","first-page":"E1154","volume":"56","author":"A Sidhaye","year":"2005","unstructured":"A. Sidhaye, P. Burger, D. Rigamonti, R. Salvatori, Giant somatotrophinoma without acromegalic features: more \u201cquiet\u201d than \u201csilent\u201d: case report. Neurosurgery 56(5), E1154 (2005).","journal-title":"Neurosurgery"},{"key":"3241_CR8","doi-asserted-by":"crossref","unstructured":"Ravikiran M., Bhansali A., Dutta P., Singh P., Mukherjee K.K., Walia R. Giant somatotropinoma. BMJ Case Rep. 2009 (2009).","DOI":"10.1136\/bcr.01.2009.1483"},{"issue":"1","key":"3241_CR9","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1111\/j.1440-1673.1996.tb00355.x","volume":"40","author":"TP Ip","year":"1996","unstructured":"T.P. Ip, F.L. Chan, A.W. Kung, K.S. Lam, Giant growth-hormone secreting pituitary tumour with extracranial extension. Australas. Radiol. 40(1), 88\u201390 (1996).","journal-title":"Australas. Radiol."},{"issue":"2","key":"3241_CR10","first-page":"122","volume":"43","author":"R Cahyanur","year":"2011","unstructured":"R. Cahyanur, W. Setyawan, D.G. Sudrajat, S. Setyowati, D. Purnamasari, P. Soewondo, Diagnosis and management of acromegaly: giant invasive adenoma. Acta Med. Indonesiana 43(2), 122\u2013128 (2011).","journal-title":"Acta Med. Indonesiana"},{"issue":"2","key":"3241_CR11","doi-asserted-by":"publisher","first-page":"214","DOI":"10.2174\/1871530318666180807160712","volume":"19","author":"F Dicuonzo","year":"2019","unstructured":"F. Dicuonzo, S. Purciariello, A. De Marco, E. Guastamacchia, V. Triggiani, Inoperable giant growth hormone-secreting pituitary adenoma: radiological aspects, clinical management and pregnancy outcome. Endocr., Metab. Immune Disord. Drug Targets 19(2), 214\u2013220 (2019).","journal-title":"Endocr., Metab. Immune Disord. Drug Targets"},{"key":"3241_CR12","doi-asserted-by":"publisher","first-page":"544","DOI":"10.1016\/j.wneu.2018.11.069","volume":"122","author":"F Penner","year":"2019","unstructured":"F. Penner, N. Prencipe, V. Pennacchietti, P. Pacca, V. Cambria, D. Garbossa et al. Super giant growth hormone-secreting pituitary adenoma in young woman: from ventricles to nose. World Neurosurg. 122, 544\u2013548 (2019).","journal-title":"World Neurosurg."},{"issue":"3","key":"3241_CR13","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1530\/eje.1.01863","volume":"152","author":"P Nomikos","year":"2005","unstructured":"P. Nomikos, M. Buchfelder, R. Fahlbusch, The outcome of surgery in 668 patients with acromegaly using current criteria of biochemical \u2018cure\u2019. Eur. J. Endocrinol. 152(3), 379\u2013387 (2005).","journal-title":"Eur. J. Endocrinol."},{"issue":"1","key":"3241_CR14","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s11102-017-0836-4","volume":"21","author":"Y Nagata","year":"2018","unstructured":"Y. Nagata, N. Inoshita, N. Fukuhara, M. Yamaguchi-Okada, H. Nishioka, T. Iwata et al. Growth hormone-producing pituitary adenomas in childhood and young adulthood: clinical features and outcomes. Pituitary 21(1), 1\u20139 (2018).","journal-title":"Pituitary"},{"issue":"1","key":"3241_CR15","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1038\/s41572-019-0071-6","volume":"5","author":"A Colao","year":"2019","unstructured":"A. Colao, L.F.S. Grasso, A. Giustina, S. Melmed, P. Chanson, A.M. Pereira et al. Acromegaly. Nat. Rev. Dis. Prim. 5(1), 20 (2019).","journal-title":"Nat. Rev. Dis. Prim."},{"issue":"2","key":"3241_CR16","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1111\/j.1365-2265.1992.tb02304.x","volume":"37","author":"AJ van der Lely","year":"1992","unstructured":"A.J. van der Lely, A.G. Harris, S.W. Lamberts, The sensitivity of growth hormone secretion to medical treatment in acromegalic patients: influence of age and sex. Clin. Endocrinol. 37(2), 181\u2013185 (1992).","journal-title":"Clin. Endocrinol."},{"issue":"3","key":"3241_CR17","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1023\/A:1015314906972","volume":"4","author":"PU Freda","year":"2001","unstructured":"P.U. Freda, R.E. Landman, R.E. Sundeen, K.D. Post, Gender and age in the biochemical assessment of cure of acromegaly. Pituitary 4(3), 163\u2013171 (2001).","journal-title":"Pituitary"},{"key":"3241_CR18","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1016\/j.clineuro.2018.02.001","volume":"167","author":"L Lv","year":"2018","unstructured":"L. Lv, Y. Hu, S. Yin, M. Wang, P. Zhou, N. Zhang et al. Clinically aggressive phenotype: a clinicopathological case series of atypical pituitary adenomas. Clin. Neurol. Neurosurg. 167, 93\u201398 (2018).","journal-title":"Clin. Neurol. Neurosurg."},{"key":"3241_CR19","doi-asserted-by":"publisher","first-page":"e802","DOI":"10.1016\/j.wneu.2019.08.004","volume":"132","author":"N Fallah","year":"2019","unstructured":"N. Fallah, M. Taghvaei, S. Sadaghiani, S.M. Sadrhosseini, F. Esfahanian, M. Zeinalizadeh, Surgical outcome of endoscopic endonasal surgery of large and giant pituitary adenomas: an institutional experience from the Middle East. World Neurosurg. 132, e802\u2013e811 (2019).","journal-title":"World Neurosurg."},{"issue":"4","key":"3241_CR20","doi-asserted-by":"publisher","first-page":"483","DOI":"10.1007\/s11102-012-0444-2","volume":"16","author":"N Cinar","year":"2013","unstructured":"N. Cinar, Y. Tekinel, S. Dagdelen, H. Oruckaptan, F. Soylemezoglu, T. Erbas, Cavernous sinus invasion might be a risk factor for apoplexy. Pituitary 16(4), 483\u2013489 (2013).","journal-title":"Pituitary"},{"issue":"7","key":"3241_CR21","doi-asserted-by":"publisher","first-page":"423","DOI":"10.1038\/nrendo.2014.64","volume":"10","author":"A Di Ieva","year":"2014","unstructured":"A. Di Ieva, F. Rotondo, L.V. Syro, M.D. Cusimano, K. Kovacs, Aggressive pituitary adenomas\u2013diagnosis and emerging treatments. Nat. Rev. Endocrinol. 10(7), 423\u2013435 (2014).","journal-title":"Nat. Rev. Endocrinol."},{"issue":"2","key":"3241_CR22","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1530\/eje.1.01968","volume":"153","author":"GM Besser","year":"2005","unstructured":"G.M. Besser, P. Burman, A.F. Daly, Predictors and rates of treatment-resistant tumor growth in acromegaly. Eur. J. Endocrinol. 153(2), 187\u2013193 (2005).","journal-title":"Eur. J. Endocrinol."},{"issue":"4","key":"3241_CR23","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1507\/endocrj1954.39.355","volume":"39","author":"H Bando","year":"1992","unstructured":"H. Bando, T. Sano, T. Ohshima, C.Y. Zhang, R. Yamasaki, K. Matsumoto et al. Differences in pathological findings and growth hormone responses in patients with growth hormone-producing pituitary adenoma. Endocrinol japonica 39(4), 355\u2013363 (1992).","journal-title":"Endocrinol japonica"},{"issue":"1","key":"3241_CR24","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1007\/s11102-016-0748-8","volume":"20","author":"LV Syro","year":"2017","unstructured":"L.V. Syro, F. Rotondo, C.A. Serna, L.D. Ortiz, K. Kovacs, Pathology of GH-producing pituitary adenomas and GH cell hyperplasia of the pituitary. Pituitary 20(1), 84\u201392 (2017).","journal-title":"Pituitary"},{"issue":"3","key":"3241_CR25","first-page":"267","volume":"17","author":"S Chiloiro","year":"2014","unstructured":"S. Chiloiro, A. Bianchi, F. Doglietto, C. de Waure, A. Giampietro, A. Fusco et al. Radically resected pituitary adenomas: prognostic role of Ki 67 labeling index in a monocentric retrospective series and literature review. Pituitary 17(3), 267\u2013276 (2014).","journal-title":"Pituitary"},{"issue":"5","key":"3241_CR26","doi-asserted-by":"publisher","first-page":"758","DOI":"10.1016\/j.humpath.2007.10.004","volume":"39","author":"R Gejman","year":"2008","unstructured":"R. Gejman, B. Swearingen, E.T. Hedley-Whyte, Role of Ki-67 proliferation index and p53 expression in predicting progression of pituitary adenomas. Hum. Pathol. 39(5), 758\u2013766 (2008).","journal-title":"Hum. Pathol."},{"key":"3241_CR27","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1159\/000094315","volume":"35","author":"MD Bronstein","year":"2006","unstructured":"M.D. Bronstein, Acromegaly: molecular expression of somatostatin receptor subtypes and treatment outcome. Front. Horm. Res. 35, 129\u2013134 (2006).","journal-title":"Front. Horm. Res."},{"issue":"3","key":"3241_CR28","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1007\/s11102-015-0684-z","volume":"19","author":"A Colao","year":"2016","unstructured":"A. Colao, R.S. Auriemma, R. Pivonello, L. Kasuki, M.R. Gadelha, Interpreting biochemical control response rates with first-generation somatostatin analogues in acromegaly. Pituitary 19(3), 235\u2013247 (2016).","journal-title":"Pituitary"},{"issue":"1","key":"3241_CR29","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1007\/s11102-016-0737-y","volume":"20","author":"DS Lim","year":"2017","unstructured":"D.S. Lim, M. Fleseriu, The role of combination medical therapy in the treatment of acromegaly. Pituitary 20(1), 136\u2013148 (2017).","journal-title":"Pituitary"},{"issue":"11","key":"3241_CR30","doi-asserted-by":"publisher","first-page":"5194","DOI":"10.1210\/jcem.86.11.7986","volume":"86","author":"M Losa","year":"2001","unstructured":"M. Losa, E. Ciccarelli, P. Mortini, R. Barzaghi, D. Gaia, G. Faccani et al. Effects of octreotide treatment on the proliferation and apoptotic index of GH-secreting pituitary adenomas. J. Clin. Endocrinol. Metab. 86(11), 5194\u20135200 (2001).","journal-title":"J. Clin. Endocrinol. Metab."},{"issue":"1","key":"3241_CR31","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1210\/jc.2014-2468","volume":"100","author":"D Cuevas-Ramos","year":"2015","unstructured":"D. Cuevas-Ramos, J.D. Carmichael, O. Cooper, V.S. Bonert, A. Gertych, A.N. Mamelak et al. A structural and functional acromegaly classification. J. Clin. Endocrinol. Metab. 100(1), 122\u2013131 (2015).","journal-title":"J. Clin. Endocrinol. Metab."},{"issue":"11","key":"3241_CR32","doi-asserted-by":"publisher","first-page":"6290","DOI":"10.1210\/jc.2005-0998","volume":"90","author":"S Bhayana","year":"2005","unstructured":"S. Bhayana, G.L. Booth, S.L. Asa, K. Kovacs, S. Ezzat, The implication of somatotroph adenoma phenotype to somatostatin analog responsiveness in acromegaly. J. Clin. Endocrinol. Metab. 90(11), 6290\u20136295 (2005).","journal-title":"J. Clin. Endocrinol. Metab."},{"issue":"5","key":"3241_CR33","doi-asserted-by":"publisher","first-page":"1327","DOI":"10.1210\/jc.2010-2443","volume":"96","author":"L Sandret","year":"2011","unstructured":"L. Sandret, P. Maison, P. Chanson, Place of cabergoline in acromegaly: a meta-analysis. J. Clin. Endocrinol. Metab. 96(5), 1327\u20131335 (2011).","journal-title":"J. Clin. Endocrinol. Metab."},{"issue":"2","key":"3241_CR34","doi-asserted-by":"publisher","first-page":"R57","DOI":"10.1530\/EJE-19-0124","volume":"181","author":"J Bollerslev","year":"2019","unstructured":"J. Bollerslev, A. Heck, N.C. Olarescu, Management of endocrine disease: Individualised management of acromegaly. Eur. J. Endocrinol. 181(2), R57\u2013R71 (2019).","journal-title":"Eur. J. Endocrinol."},{"issue":"2","key":"3241_CR35","doi-asserted-by":"publisher","first-page":"448","DOI":"10.1007\/s12020-018-1690-5","volume":"62","author":"I Shimon","year":"2018","unstructured":"I. Shimon, Z. Adnan, A. Gorshtein, L. Baraf, N. Saba Khazen, M. Gershinsky et al. Efficacy and safety of long-acting pasireotide in patients with somatostatin-resistant acromegaly: a multicenter study. Endocrine 62(2), 448\u2013455 (2018).","journal-title":"Endocrine"},{"key":"3241_CR36","doi-asserted-by":"crossref","unstructured":"Amarawardena W., Liyanarachchi K.D., Newell-Price J. D. C., Ross R. J. M., Iacovazzo D., Debono M. Pasireotide: successful treatment of a sparsely granulated tumour in a resistant case of acromegaly. Endocrinol. Diabetes Metab. Case Rep. 2017 (2017).","DOI":"10.1530\/EDM-17-0067"},{"issue":"10","key":"3241_CR37","doi-asserted-by":"publisher","first-page":"3644","DOI":"10.1210\/jc.2014-2032","volume":"99","author":"SJ Neggers","year":"2014","unstructured":"S.J. Neggers, S.E. Franck, F.W. de Rooij, A.H. Dallenga, R.M. Poublon, R.A. Feelders et al. Long-term efficacy and safety of pegvisomant in combination with long-acting somatostatin analogs in acromegaly. J. Clin. Endocrinol. Metab. 99(10), 3644\u20133652 (2014).","journal-title":"J. Clin. Endocrinol. Metab."},{"issue":"6","key":"3241_CR38","doi-asserted-by":"publisher","first-page":"769","DOI":"10.1111\/j.1365-2265.2012.04381.x","volume":"76","author":"G Raverot","year":"2012","unstructured":"G. Raverot, F. Castinetti, E. Jouanneau, I. Morange, D. Figarella-Branger, H. Dufour et al. Pituitary carcinomas and aggressive pituitary tumours: merits and pitfalls of temozolomide treatment. Clin. Endocrinol. 76(6), 769\u2013775 (2012).","journal-title":"Clin. Endocrinol."},{"issue":"1","key":"3241_CR39","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1210\/jc.2007-1191","volume":"93","author":"OM Dekkers","year":"2008","unstructured":"O.M. Dekkers, N.R. Biermasz, A.M. Pereira, J.A. Romijn, J.P. Vandenbroucke, Mortality in acromegaly: a metaanalysis. J. Clin. Endocrinol. Metab. 93(1), 61\u201367 (2008).","journal-title":"J. Clin. Endocrinol. Metab."},{"issue":"4","key":"3241_CR40","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1038\/nrendo.2014.21","volume":"10","author":"A Giustina","year":"2014","unstructured":"A. Giustina, P. Chanson, D. Kleinberg, M.D. Bronstein, D.R. Clemmons, A. Klibanski et al. Expert consensus document: a consensus on the medical treatment of acromegaly. Nat. Rev. Endocrinol. 10(4), 243\u2013248 (2014).","journal-title":"Nat. Rev. Endocrinol."},{"issue":"4","key":"3241_CR41","first-page":"411","volume":"8","author":"S Galoiu","year":"2015","unstructured":"S. Galoiu, C. Poiana, Current therapies and mortality in acromegaly. J. Med. Life 8(4), 411\u2013415 (2015).","journal-title":"J. Med. Life"}],"container-title":["Endocrine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12020-022-03241-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s12020-022-03241-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12020-022-03241-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,6]],"date-time":"2023-03-06T16:13:56Z","timestamp":1678119236000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s12020-022-03241-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,1]]},"references-count":41,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,3]]}},"alternative-id":["3241"],"URL":"https:\/\/doi.org\/10.1007\/s12020-022-03241-2","relation":{},"ISSN":["1559-0100"],"issn-type":[{"value":"1559-0100","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,1]]},"assertion":[{"value":"10 July 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 October 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 November 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"The authors declared no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study was performed in line with the principles of the Declaration of Helsinki and approved by Hacettepe University Ethics Committee (Approval ID: GO 18\/973-06).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}}]}}