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The effect of boost radiotherapy on local control in ductal carcinoma in-situ of the breast: Retrospective single-center experience with literature review
No full textPurpose: We aimed to investigate factors related to local recurrence and especially the effects of additional radiotherapy (RT) boost after whole breast radiation therapy (WBRT) on local recurrence in ductal carcinoma in situ (DCIS) patients undergoing breast-conserving surgery (BCS). Methods: In this retrospective analysis, 197 patients treated for DCIS between 1998-2018 were evaluated. Patients with microinvasion, intracystic in situ cancer, undergoing mastectomy, less than 12 months of follow-up, and missing information were excluded. Results: The median age was 50 years (28-78). The median follow-up time was 97 months (12-257). Local recurrence occurred in eight patients (4%), six of them were invasive and two were DCIS. Systemic metastasis was present in a patient who recurred as invasive cancer. Contralateral breast cancer developed in nine patients (4.5%). Boost radiation was given to patients 143 (72.6%). Local recurrence developed in two patients (3.7%) without boost and six patients (4.2%) with boost; there was no significant difference in local recurrence free survival between patients with and without boost radiation (p=0.94). The factors affecting significantly local recurrence were age, tumor diameter, and surgical margin width (≤ 2 mm) in univariate analysis, but only tumor diameter and surgical margin width (≤ 2 mm) in multivariate analysis. Conclusion: Surgical margin width and tumor diameter were independently associated with local recurrence. In contrast, patient age, RT boost, hormonotherapy use, and poor histological features were not significantly associated with local recurrence. © 2021 Zerbinis Publications. All rights reserved
Short-Term Changes in Chronic Neck Pain After the Use of Elastic Adhesive Tape
No full textObjectives: The aim of the study was to examine the short-term changes of elastic adhesive tape application on pain intensity and the range of motion (ROM), cervical region proprioception sense, and cervical flexor endurance of patients with chronic neck pain. Methods: Thirty-four patients (male: 26, female: 8) between ages 20 and 55 with chronic neck pain having the complaints for at least 6 months were included in the study. Demographic information, pain intensity, cervical ROM, cervical flexor endurance, and cervical proprioception sense of the patients were evaluated. Results were examined 2 times. The first evaluation was conducted prior to elastic adhesive tape application and the second one was conducted 24 hours after the procedure. Results: The mean age of the patients was 39.56 ± 17.09 years, average height was 165.65 ± 9.83 cm, average weight was 71.44 ± 15.79 kg, and average body mass index was 26.24 ± 6.62. A statistically significant difference was found between the measurement results of pain intensity, ROM of the joint in flexion, extension, right and left rotation, and cervical flexor endurance before and 24 hours after the application of elastic adhesive tape (P <.05). When the proprioception sense was examined, there was a significant difference between the results before elastic adhesive tape application and 24 hours after the same application in deviation angles except for right rotation (P <.05). Conclusion: The results of this study revealed short-term changes following the use of elastic adhesive tape on cervical flexor endurance, pain, and cervical proprioception sense for patients with chronic pain. © 202
The Restorative Effect of Gallic Acid on the Experimental Sciatic Nerve Damage Model
No full textObjective : Peripheral nerve injuries occur mostly as a result of mechanical trauma. Due to the microvascular deterioration in peripheral nerve damage, it becomes challenging to remove free oxygen radicals. Gallic acid is a powerful antioxidant with anti-inf-lammatory effects and a free radical scavenger. The purpose of the study is to show that gallic acid contributes to the restorative effect in mechanical nerve damage, considering its antioxidant and anti-inflammatory effects. Methods : Thirty male Sprague Dawley albino mature rats were included in the study. Ten of them constituted the control group, 10 out of 20 rats for which sciatic nerve damage was caused, constituted the saline group, and 10 formed the gallic acid group. Post-treatment motor functions, histological, immunohistochemical, and biochemical parameters of the rats were evaluated. Results : Compared to the surgery+saline group, lower compound muscle action potential (CMAP) latency, higher CMAP amplitu-de, and higher inclined plane test values were found in the surgery+gallic acid group. Similarly, a higher nerve growth factor (NGF) percentage, a higher number of axons, and a lower percentage of fibrosis scores were observed in the surgery+gallic acid group. Fi-nally, lower tissue malondialdehyde (MDA) and higher heat shock protein-70 (HSP-70) values were determined in the surgery+gallic acid group. Conclusion : Gallic acid positively affects peripheral nerve injury healing due to its anti-inflammatory and antioxidant effects. It has been thought that gallic acid can be used as a supportive treatment in peripheral nerve damage
Fibroblast Growth Factor Receptor-4 Expression in Pituitary Adenomas is Associated with Aggressive Tumor Features
No full textPurpose To investigate the relationship of Fibroblast Growth Factor Receptor-4 (FGFR-4) expression with radiologic, pathologic, and clinical parameters in pituitary adenomas. Methods Among 307 patients who underwent pituitary surgery for a pituitary adenoma between 2000 and 2015, we included 161 patients (53 gonadotroph, 26 corticotroph, 25 null cell, 22 lactotroph, 13 somatotroph, 8 adenomas with unusual combination, 7 Pit-1 positive adenomas, and 7 lactosomatotroph) based on availability of pathology specimens. Patients' radiologic, pathologic, and clinical parameters were determined. FGFR-4 immunostaining was evaluated using a semi-quantitative histologic score (H-score). Results The mean follow-up period was 61 (IQR=32-84) months. The median H-scores for FGFR-4 were higher in patients without remission, those with residual lesion, and T2-hyperintense adenoma (p0.05). There was no significant difference (p>0.05) when the H-score and Ki-67 levels were assessed in terms of sex, sellar-dural invasion, Knosp and a grading system for superior, inferior, parasellar, anterior and posterior tumor extension Classification, tumor function or presence of poor subtype. Adenomas with Ki-67 expression ?3% had higher FGFR4 expression levels than those with <3% expression (p=0.002). There was a weak positive correlation between H-score and Ki-67 (p=0.011; r=0.201). Conclusions Higher levels of FGFR-4 in pituitary adenomas could be use a marker for more aggressive tumor behavior. © 2021 American Medical Association. All rights reserved
Assessment score for the diagnosis of a case with pleuroparenchymal fibroelastosis
No full textIdiopathic pleuropulmonary fibroelastosis is an extremely rare lung disease characterized by the combination of fibrosis of the visceral pleura and the fibroelastotic changes transcending in the subpleural lung parenchyma that predominantly affects the upper lobes with accompanying volume loss. It is mostly idiopathic while infection, autoimmunity, bone marrow or lung transplantation and genetic predisposition may be associated with the development of PPFE. The disease is exceptionally rare as approximately ninety cases have been reported in the literature currently. A 35-year-old female presented with exertional dyspnea, dry cough and weight loss. Physical examination demonstrated platythorax, suprasternal notch deepening and fine rales over the upper lobes. Blood count, serum biochemistry, autoimmunity and serologic markers for collagen vascular diseases were within normal limits. Arterial blood gases demonstrated a low pO2 (48 mm Hg) and a high pCO2 (54 mm Hg) values. Chest x-ray showed bilateral parenchymal fibrotic lesions, left pneumothorax, bronchiectasis in the middle and pleural thickening in the upper lung zones while HRCT revealed bilateral apical pleural thickening, traction bronchiectasis, subpleural reticulations, ground-glass opacities and honeycombing in the upper lobes. Bronchoscopy, BAL cytology, smear and culture did not reveal any pathologic findings. Relevant with the clinical, laboratory, radiologic manifestations and the differential diagnosis with other interstitial lung diseases, PPFE was the final diagnosis. The aim of this case report was to present the clinical manifestations of our case. The second crucial objective was to establish a diagnostic scoring system relevant with the literature and the clinical manifestations of the patient
Effect of Lipid Emulsion on the Improvement of Renal Damage in Colist-in-Induced Nephrotoxicity
No full textBackground: Colistin utilization has gradually increased worldwide with the rising of multidrug-resistant (MDR) gram-negative bacilli despite its nephrotoxicity. Lipid emulsion (LE) is widely used for the toxic overdose treatment of various drugs. Objective: The aim of the present study is to evaluate the effect of lipid emulsion on the improvement of renal damage in colistin-induced nephrotoxicity with an experimental Sprague Dawley rat model. Methods: Twenty-four male Sprague Dawley rats were initially assigned to 2 random groups. Sixteen rats were given a single dose of 20 mg/kg colistin, and eight rats received no medication (control group). Sixteen rats that were administered colistin were sub-divided into 2 groups. Group 1/LE rats (n = 8) were given 20 ml/kg solution of lipid emulsion, and group 2/S rats (n = 8) were given 20 ml/kg/day (i.p.) of 0.9% NaCl saline; both were administered for 10 days. Then tubular injury was evaluated histopathologically. Serum levels of blood urea nitrogen (BUN), Kidney Injury Molecule-1 (KIM-1), and creatinine were measured. Besides, malondialdehyde (MDA) levels were determined in tissue samples for the assessment of lipid peroxidation. Results: The mean percent of tubular epithelial cell injury and tubular dilatation was found significantly higher in group 2/S than in control and group 1/LE (p < 0.0001 and < 0.001; respectively). KIM-1 and MDA levels were also statistically higher in group 2/S than in control and group 1/LE. (p < 0.0001 and < 0.0001; respectively). Additionally, serum BUN and creatinine levels of group 2/S were significantly greater than control and group 1/LE (p < 0.0001 and < 0.0001; respectively). Conclusion: In this present study, we determined that colistin-induced proximal tubular damage was decreased histopathologically and serologically by the effect of lipid emulsion. Thus, our findings may guide future studies on the clinical use of colistin, particularly in MDR positive intensive care infections
Comparison of early and long-term follow-up results of percutaneous mitral balloon valvuloplasty and mitral valve replacement
No full textBACKGROUND: Percutaneous mitral balloon valvuloplasty and mitral valve replacement have been the treatment options for mitral stenosis for several years, however, studies that compare these two modalities are very rare in the literature. ObjectIve: In this article, we aim to investigate the comparison of clinical results of percutaneous mitral balloon valvuloplasty and mitral valve replacement. Methods: 527 patients with rheumatic mitral stenosis, treated with percutaneous mitral balloon valvuloplasty or mitral valve replacement (276 patients with percutaneous mitral balloon valvuloplasty and 251 patients with mitral valve replacement) from 1991 to 2012 were evaluated. The demographic characteristics, clinical, echocardiographic and catheterization data of patients were evaluated retrospectively. The results of early and late clinical follow-up of patients after percutaneous mitral balloon valvuloplasty and mitral valve replacement were also evaluated. Results: The mean follow-up time of the percutaneous mitral balloon valvuloplasty group was 4.7 years and, for the mitral valve replacement-group, it was 5.45 years. The hospital stay of the percutaneous mitral balloon valvuloplasty group was shorter than that of the mitral valve replacement group (2.02 days vs 10.62 days, p<0.001). The hospital mortality rate of percutaneous mitral balloon valvuloplasty and mitral valve replacement were 0% and 2% respectively (p=0.024). In the percutaneous mitral balloon valvuloplasty group, early postprocedural success rate was 92.1%. The event-free survival of percutaneous mitral balloon valvuloplasty and mitral valve replacement was found to be similar. While reintervention was higher in percutaneous mitral balloon valvuloplasty-group (p<0.001), mortality rate was higher in mitral valve replacement-group (p<0.001). Conclusion: Percutaneous mitral balloon valvuloplasty seems to be more advantageous than mitral valve replacement due to low mortality rates, easy application of the procedure and no need for general anesthesia
An Experimental Study: Benefits of Digoxin on Hepatotoxicity Induced by Methotrexate Treatment
No full textPurpose. The aim of the study is to examine the possible therapeutic effects of a known cardiac glycoside, digoxin, on a rat model of MTX-induced hepatotoxicity. Methods. The study was conducted on twenty-four male rats. While eighteen rats received a single dose of 20 mg/kg MTX to obtain an injured liver model, six rats constituted the control group. Also, the eighteen liver toxicity model created rats were equally divided into two groups, one of which received digoxin 0.1 mg/kg/day digoxin (Group 1) and the other group (Group 2) was given saline (% 0.9NaCl) with a dose of 1 ml/kg/day for ten days. Following the trial, the rats were sacrificed to harvest blood and liver tissue samples to determine blood and tissue MDA, serum ALT, plasma TNF-alpha, TGF-beta, IL-6, IL-1-Beta, and PTX3 levels. Results. MTX's structural and functional hepatotoxicity was observable and evidenced by relatively worse histopathological scores and increased biochemical marker levels. Digoxin treatment significantly reduced the liver enzyme ALT, plasma TNF-alpha, TGF-beta, PTX3, and MDA levels and decreased histological changes in the liver tissue with MTX-induced hepatotoxicity in the rat model. Conclusion. We suggest that digoxin has an anti-inflammatory and antihepatotoxic effect on the MTX-induced liver injury model
Public health experts have the highest impact on citizens’ compliance with COVID-19 prevention recommendations
No full textIntroduction: In this study, we investigated the sources of information that have had the highest impact on Kosovans’ compliance with preventive measures against COVID-19. Methods: We recruited 744 participants, aged 18-35, to participate in this cross-sectional survey between 27th April and 5th May 2020, utilising an online questionnaire. Results: Our findings show that public health experts had the greatest influence in persuading citizens to obey the recommendations, with 63.2% (470) compliance, followed by family members, with 18% (134), and health workers, with 10.2% (76). Conclusion: Our study has shown that public health experts have had the greatest impact on Kosovo citizens, persuading them to follow recommendations designed to prevent the spread of COVID-19. © 2021 Tahirbegolli et al
The prevalence of anosmia among patients with COVID-19 in Istanbul, Turkey: A cross-sectional study
No full textObjective: Coronavirus disease 2019 (COVID-19) is a new disease entity that appeared in late 2019. In this study, we aimed to determine the prevalence of loss of smell and/or taste among patients who tested positive for COVID-19 and identify demographic and clinical differences between patients with and without anosmia/dysgeusia. Methods: The study was performed in a referral center for COVID-19 in Istanbul, Turkey between the months of April and July 2020. The responses from a set of questions in regard to loss of sense of smell and/or taste were collected. None of these patients were exposed to any further examination or testing related to their senses of smell and/or taste. The data in regard to the patients being tested as well as their demographic information and co-morbidities associated with their condition were collected. Results: Twenty patients (10 male, 10 females, mean age 43.3 years) out of 86 patients (49 male, 37 female, median age 49.5 years), who tested positive for COVID-19, declared a loss of smell and/or taste. Nineteen patients (19/20, 95%) had a full recovery, and one (1/20, 5%) had partial recovery at the end of two weeks. Conclusion: Our results indicate that 23.3% of patients who tested positive with reverse transcription-polymerase chain reaction testing for COVID-19 had loss of sense of smell to a certain extent