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Centralization of mammography reporting with mobile trucks: Turkish experience
Get PDFScreening via mammography is a complex process to be implemented. Objective: To report the initial results and the effectiveness of newly implemented Turkey's population based breast cancer screening program performed for 40–69 years old women; and effectiveness of the newly implemented out-sourcing mobile trucks and national central report center. The study is conducted prospectively in one year (March 2016–March 2017) in all 81 provinces of Turkey. Mammography images were transferred via on-line web based system to the central reporting center. BI-RADS Scores and KETEM models (Mobile vs. Stationary) were the parameters were compared. In total mammography images of 414.802 patients were transferred from 155 KETEMs to the central reporting center. From these patients; 95.872 (23,1%) were aged between 40 and 44. Among all images, 21.999 (5,3%) were BI-RADS 0-4-5, 391.123 (94,3%) were BI-RADS 1–2. Totally recall rate of the national reporting center was 5.3%. Number of patients screened per day were significantly higher in out-sourcing mobile trucks compared to stationary KETEMs (31.8 vs. 8.9; p < 0.05). This is the first and the largest breast cancer screening study which results of a population based mammography screening for 40–69 years old women are evaluated at the same time with the evaluation of the efficacy of newly implemented centralized reporting center and the mobile screening trucks in comparison with stationary cancer screening centers. According to the initial results; Turkey's newly implemented population based breast cancer screening system seems to be feasible and effective. © 2018 The Author
Hareket korkusu nedenleri ölçeğinin (kinesiophopia causes scale) türkçe uyarlamasının geçerlik ve güvenilirliği
No full textÇalışmanın amacı; Türkçe konuşan geriatrik bireylerde, HKNÖ’nin Türkçe uyarlaması ve kültürel adaptasyonunu sağlayarak, geçerlik ve güvenilirliğini ölçmektir. Çalışmamıza, 65-80 yaş arası, kooperasyon ve anlamaya engel olabilecek herhangi bir mental problemi olmayan ve araştırmaya gönüllü olarak katılan 103 sağlıklı geriatrik birey (yaş ortalaması:71.09±4.45 yıl, vücut kütle indeksi:27.08 ±4.4 kg/m2) dahil edildi. Bireylere Türkçe çevirisi yapılan HKNÖ ile kriter geçerliğini belirlemek amacıyla Tampa Kinezyofobi Ölçeği (TKÖ) uygulandı. Ölçeğin güvenilirliğinin göstergesi olan zamana göre değişmezliği test etmek için 48 saat sonra, HKNÖ ikinci kez uygulandı. Ankette yer alan tüm sorular arası iç tutarlılık değeri 0.863 olarak bulundu. Biyolojik alt boyutta yer alan sorular arası Cronbach’s α katsayısı 0.913, Psikolojik alt boyutta 0.797 olarak bulundu. Biyolojik parametre alt boyutlarının (morfolojik, harekete geçmek için bireysel ihtiyaç, enerji kaynakları, biyolojik dürtülerin gücü) Cronbach’s α 0.800 ve üstü iken, psikolojik parametre alt boyutlarının (kendini kabul etme, motor yatkınlığın öz değerlendirmesi, vücut bakımı) iç tutarlılık değeri sırasıyla 0.834, 0.790, 0.642 bulundu. TKÖ ve HKNÖ alt boyut puanları arasındaki korelasyonlar incelendiğinde TKÖ toplam puanı ile HKNÖ toplam puanı, biyolojik ve psikolojik alt boyutları arasında istatistiksel olarak anlamlı, pozitif yönde korelasyon belirlendi (p<0.05). Sonuç olarak, yetişkinde motor inaktivitenin ve hareket korkusunun sebeplerinin belirlenmesi amacıyla geliştirilmiş ve şimdiye kadar başka herhangi bir dilde adaptasyonu yapılmamış olan HKNÖ’nün, Türk geriatrik bireylerde geçerli ve güvenilir bir anket olduğunu ayrıca farklı hastalıklarda, daha büyük örneklemlerde ve yaş gruplarında incelenmesi gerektiğini düşünmekteyiz.
The aim of this study is to provide the Turkish adaptation and cultural adaptation of KCS in Turkish-speaking geriatric individuals and to measure their reliability and validity. Our study included 103 healthy geriatric individuals (the average age: 71.09±4.45 years, body mass index: 27.08±4.4 kg/m2) the aged of 65-80 years, who had no mental problems that could interfere with cooperation and understanding and who volunteered to participate in the study. Tampa Scale of Kinesiophobia (TSK) was applied in order to determine the validity of the criterion with the KCS translated into Turkish. After 48 hours of testing for variability, which is an indicator of the reliability of the scale, KCS was applied for the second time. The internal consistency value of the questionnaire was 0.863. The Cronbach’s α coefficient was 0.913 among the questions in the biological sub-dimension, and 0.797 in the psychological sub-dimension. While the biological parameters sub-dimensions (morphologic, individual need for stimulation, energetic substrates, power of biological drives) have Cronbach's α coefficient of 0.800 and above, the internal consistency of psychological parameter sub-dimensions (self-acceptance, self-assessment of motor susceptibility, body care) is respectively 0.834, 0.790, 0.642. When the correlations between TSK and KCS subscale scores were examined, there was a statistically significant positive correlation between total score of TSK and total score of KCS biological and psychological subscales (p<0.05). As a result, we think that the KCS questionnaire, which has been developed in order to determine the causes of motor inactivity and fear of movement in adults, is a valid and reliable survey in Turkish geriatric individuals and should be examined in different diseases and age groups
Effects of volume-controlled equal ratio ventilation with recruitment maneuver and positive end-expiratory pressure in laparoscopic sleeve gastrectomy: a prospective, randomized, controlled trial
No full textBackground/aim: We compared the effects of volume-controlled equal ratio ventilation (VC-ERV) and volume-controlled conventional ratio ventilation (VC-CRV) on oxygenation, ventilation, respiratory mechanics, and hemodynamic status during mechanical ventilation with recruitment maneuver (RM) and positive end-expiratory pressure (PEEP) in patients undergoing laparoscopic sleeve gastrectomy.
Materials and methods: A total of 111 patients scheduled for laparoscopic sleeve gastrectomy were randomized to ventilation with inspiratory to expiratory ratio of 1:1 (Group VC-ERV) or 1:2 (Group VC-CRV) following tracheal intubation. RM (40 cmH2O, 15 s) and PEEP (10 cmH2O) were administered to all patients. Arterial blood gas samples were taken and peak airway pressure (Ppeak), mean airway pressure (Pmean), dynamic compliance (Cdyn), mean arterial pressure, heart rate, SpO2, and EtCO2 were recorded at 4 time points. Postoperative respiratory complications were recorded.
Results: Oxygenation, ventilation, Pmean levels, and hemodynamic variables were similar in both groups. VC-ERV significantly decreased Ppeak and increased Cdyn compared to VC-CRV at all time points of the operation (P < 0.05). No pulmonary complication was observed in any patients.
Condusion: VC-ERV provides significantly lower Ppeak and higher Cdyn with similar oxygenation, ventilation, hemodynamic parameters, and Pmean levels when compared to VC-CRV during mechanical ventilation with RM and PEEP in laparoscopic sleeve gastrectomy
The Wide Open Windows of Cholera Street: On the Light and Sound Leaking Through/To the Private Space
No full textInspired by the subaltern studies the purpose of this article is to examine how the dichotomy of private/public in Metin Kacan's Agir Roman Novel is reproduced on the axis of the visual language used by Mustafa Altioklar's cinematic adaptation Cholera Street. The article is interested in the peculiar choice of slang usage and reads this as an invitation to blur the borders of private/public space that modern life demands to keep separate. In this sense, Cholera Street can also be regarded as a brilliant piece of social commentary, offering a vivid peek into the life of the "other" trapped in the peripheral neighborhood. This article unravels further how Cholera Street through visual film grammar and various metaphors sends strong critical messages about the silence of subalterns who often lack the means to speak for themselves and how the violation of privacy turns out to be a challenging act against the dominant order
Bilateral Asymmetric Rhegmatogenous Retinal Detachment in a Patient with Stickler Syndrome
No full textHere we present the long-term anatomical and visual outcomes of bilateral asymmetric rhegmatogenous retinal detachment repair in a patient with Stickler syndrome. A 17-year-old girl presented with decreased visual acuity in both eyes for more than one year. Her best-corrected visual acuity (BCVA) was 0.1 in the right eye and 0.05 in the left eye. Slit-lamp anterior segment examination revealed subcapsular cataract in both eyes. Fundus examination showed bilateral rhegmatogenous retinal detachment, chronic retinal detachment accompanied by multiple retinal holes, tears and membranous fibrillary vitreous in the peripheral retina. Grade C2 proliferative vitreoretinopathy was observed in the left eye. Scleral buckling surgery was performed initially for both eyes. After the primary surgical procedure, retinal reattachment was achieved in the right eye and the left eye underwent phacoemulsification, intraocular lens implantation, pars plana vitrectomy (PPV), and silicone oil injection. After these surgical procedures retinal reattachment was achieved in the left eye. Silicone oil removal was performed six months after PPV surgery. After surgical treatment, BCVA was 0.6 in the right eye at the end of the 3.5-year follow-up period. After silicone oil removal, BCVA reached 0.2 in the left eye after 36 months of follow-up and retinal reattachment was achieved in both eyes. Scleral buckling surgery and PPV are effective and confidential methods for the treatment of chronic retinal detachment cases in Stickler syndrome
FREQUENCY OF POLYPHARMACY AND RISK FACTORS IN THE ELDERLYIN BURDUR
No full textIntroduction: Polypharmacy is common among the elderly. This study aimed to determine the frequency of polypharmacy and the risk factors in the elderly.
Materials and Method: This cross-sectional study will be analysed in three stages (polypharmacy, drug characteristics and drug interaction). Herein, the first stage (polypharmacy) was conducted at Burdur city centre and the connected villages. A total of 400 of 11,360 subjects aged >= 65 years who were registered with family physicians in Burdur city centre were selected using a systematic sampling method. A questionnaire of 30 questions about socio-demographic variables and rational drug use was distributed among the subjects. Subsequently, the subjects were asked to bring their own drugs from home that they were actively using or not currently using, and their drug-using behaviour was analysed via specific questions.
Results: The average number of different drugs possessed by the subjects at home was approximately 6 (5.95 +/- 4.30). A total of 64.9% of the drugs were used regularly, 21.3% were used occasionally and 13.8% were previously used but not currently used. The median number +/- standard deviation of the drugs that were used regularly, used occasionally and previously used but not currently used was 3.86 +/- 3.36, 1.27 +/- 1.75 and 0.82 +/- 1.82, respectively. According to the results of multivariate analysis, the presence of diabetes, hypertension, respiratory system or cardiovascular (except hypertension) diseases, visual impairment or hearing disorders significantly increased the total drug use (p<0.05).
Conclusion: Chronic diseases and living in the city centre are the main risk factors leading to polypharmacy. Therefore, interventions must be undertaken by monitoring and reducing chronic diseases and providing training on rational drug use in the provincial centres
Systematic identification of cancer-specific MHC-binding peptides with RAVEN
No full textImmunotherapy can revolutionize anti-cancer therapy if specific targets are available. Immunogenic peptides encoded by cancer-specific genes (CSGs) may enable targeted immunotherapy, even of oligo-mutated cancers, which lack neo-antigens generated by protein-coding missense mutations. Here, we describe an algorithm and user-friendly software named RAVEN (Rich Analysis of Variable gene Expressions in Numerous tissues) that automatizes the systematic and fast identification of CSG-encoded peptides highly affine to Major Histocompatibility Complexes (MHC) starting from transcriptome data. We applied RAVEN to a dataset assembled from 2,678 simultaneously normalized gene expression microarrays comprising 50 tumor entities, with a focus on oligo-mutated pediatric cancers, and 71 normal tissue types. RAVEN performed a transcriptome-wide scan in each cancer entity for gender-specific CSGs, and identified several established CSGs, but also many novel candidates potentially suitable for targeting multiple cancer types. The specific expression of the most promising CSGs was validated in cancer cell lines and in a comprehensive tissue-microarray. Subsequently, RAVEN identified likely immunogenic CSG-encoded peptides by predicting their affinity to MHCs and excluded sequence identity to abundantly expressed proteins by interrogating the UniProt protein-database. The predicted affinity of selected peptides was validated in T2-cell peptide-binding assays in which many showed binding-kinetics like a very immunogenic influenza control peptide. Collectively, we provide an exquisitely curated catalogue of cancer-specific and highly MHC-affine peptides across 50 cancer types, and a freely available software (https://github.com/JSGerke/RAVENsoftware) to easily apply our algorithm to any gene expression dataset. We anticipate that our peptide libraries and software constitute a rich resource to advance anti-cancer immunotherapy
The effect of bleomycin embolization on symptomatic improvement and hemangioma size among patients with giant liver hemangiomas
No full text3D evaluation of the effect of disinfectants on dimensional accuracy and stability of two elastomeric impression materials
No full textThe aim of this study was to determine and compare the dimensional changes of polyether and vinyl polyether siloxane impression materials under immersion disinfection with two different disinfectants in three time periods. Impressions were obtained from an edentulous master model. Sodium hypochlorite (5.25%) and glutaraldehyde (2%) were used for disinfection and measurements were done 30 min later after making impression before disinfection, after required disinfection period (10 min), and after 24 h storage at room temperature. Impressions were scanned using 3D scanner with 10 microns accuracy and 3D software was used to evaluate the dimensional changes with superimpositioning. Positive and negative deviations were calculated and compared with master model. There was no significant difference between two elastomeric impression materials (p>0.05). It was concluded that dimensional accuracy and stability of two impression materials were excellent and similar
Cloacogenic Adenocarcinoma of the Vulva: A Case Report and Review of the Literature
No full textPrimary adenocarcinoma of the vulva, unrelated to the native glands of perineum is an extremely rare neoplasm. Despite awareness of this lesion for over 40 years, the origin is not beyond speculation. The most reasonable hypothesis is based on the remnants of cloacal differentiation during early days of life. Here we report the case of a 60-year-old patient with a vulvar mass, who underwent partial vulvectomy and bilateral regional lymph node dissection. The tumor was composed of papillary and complex glandular structures and exhibited diffuse positivity for cytokeratin 20 and polyclonal CEA, CDX2, and focal positivity with cytokeratin 7. Unlike the indolent behavior of this malignant neoplasm according to the literature, we found two metastatic inguinal lymph nodes. She did not receive adjuvant therapy and is still alive, free of disease 38 months after surgery. We present different aspects of vulvar adenocarcinomas with a case report