İstanbul Sağlık ve Teknoloji Üniversitesi Kurumsal Akademik Arşivi
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Psychooncology: The physical, psychological, social, and behavioral aspects of cancer
No full textPsychooncology is a specialized field that focuses on the interplay between the psychological, social, and behavioral aspects of cancer, with the goal of enhancing the quality of life for both patients and their families. This chapter delves into the diverse roles played by psychooncology in cancer care, particularly in providing psychosocial support throughout the various stages of the disease. A key focus is on the distinct role of the psychooncologist, who blends multiple therapeutic techniques and works closely with oncologists to address the complex psychological challenges faced by cancer patients. The Cancer Empowerment Model is introduced, offering a holistic approach to improving patients’ psychological wellbeing by fostering resilience and adaptive coping mechanisms. The chapter also explores the significance of culturally sensitive care, emphasizing how interventions must be tailored to a patient’s personal values, cultural background, and family dynamics. Furthermore, the chapter highlights the concept of posttraumatic growth (PTG) and discusses strategies to promote cancer empowerment, helping patients find strength during their treatment. In addition, it examines how digital tools, including teletherapy and AI-driven assessments, are transforming psychooncology, improving accessibility to care and enabling more precise, personalized interventions. This chapter offers a comprehensive exploration of psychooncology, its current practices, and its future directions
Early fibrinogen replacement based on shock index and lactate levels in massive postpartum hemorrhage: A retrospective cohort study
No full textBackground - Massive postpartum hemorrhage (PPH) remains a major cause of maternal morbidity and mortality worldwide. Timely fibrinogen replacement is critical in hemostatic resuscitation, yet laboratory delays may hinder early intervention. This study evaluates the clinical outcomes of early fibrinogen concentrate administration in massive PPH using a protocol based on shock index and serum lactate levels rather than laboratory-confirmed hypofibrinogenemia. Materials and methods - This retrospective cohort study included 103 PPH patients treated at a tertiary hospital in Istanbul, Turkey, between 2016 and 2020. Patients were divided into four groups based on fibrinogen dose: Group I (4 g), and Group IV (non-massive PPH, no fibrinogen). A predefined protocol guided early fibrinogen administration based on clinical indicators. Fibrinogen was administered without awaiting lab confirmation. Results - Group III had the highest estimated blood loss (2,600±500 mL) and Group IV the lowest (600±150 mL; p<0.001). ICU admission was significantly lower in Group III (23.8%) than in Group I (62.1%; p=0.020). Group III patients also had fewer secondary surgical interventions and reduced transfusion requirements compared to Groups I and II. No thromboembolic events or mortality were observed in any group. Discussion - Early fibrinogen replacement based on shock index and lactate levels appears feasible and beneficial in managing massive PPH. This approach was associated with improved hemostatic control, reduced ICU admissions, and fewer surgical interventions. Prospective studies are warranted to further assess this strategy’s safety, efficacy, and cost-effectiveness
Impact of extraction solvents on total antioxidant capacity of barberry (berberis crataegina) plant
No full textDefense mechanisms involving antioxidant molecules play a key role in neutralizing free radicals formed in the human body. It is important to determine the content of these molecules, which have become important in human nutrition in recent years, in consumed foods. This study aims to determine the total antioxidant capacity of the barberry (Berberis Crataegina) plant, which is consumed in many regions of Turkiye. For this purpose, firstly, barberry plant samples were collected from Mersin in summer season, the extracts were prepared with different solvents and CERAC method was used to determine the total antioxidant capacities of the samples. The highest value of total antioxidant capacity was obtained by 80 % (v/v) methanol solution for flesh part of the fruit. Total phenolic compound and total antioxidant capacities of the flesh part of barberry samples were calculated as 1.954 mmol gallic acid (GA) g-1 and 1.288 mmol Tr (TR) g-1, by Folin-Ciocalteu method and Cerium Reducing Antioxidant Capacity Assay (CERAC), respectively
Interpersonal conflicts in nursing through the lens of senior nursing students: A qualitative study
No full textBackground Unmanaged interpersonal conflicts emerge as significant obstacles for the nursing team during daily duties. Observations and discussions with nursing undergraduate students determined the need to explore their perspectives on conflict management in greater depth. Objective To investigate the perspectives of senior undergraduate nursing students on conflicts experienced by nurses during clinical practice, as well as the strategies employed to manage these conflicts. Design This is a qualitative descriptive study. Participants The study involved written interviews with 31 senior undergraduate nursing students from a university in Istanbul, Turkey. Methods Data were collected between November 23, 2023, and December 4, 2023. Thematic analysis was used. Results Four themes emerged: (1) Causes of conflicts, (2) Methods for resolving conflicts, (3) Nurse managers' approaches, and (4) Student learning through observation. The themes were organized under 13 sub-themes: ineffective communication, absence of a singular goal, misunderstanding in role boundaries, and lack of professionalism (first theme); transparent communication, absolute loss, integration, and softening (second theme); autonomy in conflict resolution and seeking other professionals to manage conflicts (third theme); positive side of the conflict, negative side of the conflict, and how I would act if I were the nurse manager (fourth theme). Conclusions Nursing students know that staff nurses and nurse managers play crucial roles in conflict management. Communication issues were identified as significant causes of conflicts. Open communication and the active involvement of nurse managers were determined as essential for effective conflict resolution. Positive outcomes of conflicts included changes in attitudes; however, conflicts were also acknowledged as contributors to workplace stress. The study underscores the importance of equipping nurses with conflict resolution skills through practical educational approaches
Evaluation of the effects of different root control techniques on molar mesialization in clear aligner treatments – a finite element analysis study
No full textBu araştırmanın temel amacı, şeffaf plak tedavisinde farklı power arm uzunluklarının (6, 8 ve 10 mm) ve farklı ataşman yerleşimlerinin, birinci molar dişin mezial yönlü hareketi sırasında meydana gelen diş yer değiştirmesi, von Mises gerilme dağılımları, periodontal ligament (PDL) üzerindeki gerilme düzeyleri ve şeffaf plak deformasyonları üzerindeki olası etkilerini analiz etmektir. Bu amaçla, toplamda altı adet farklı sonlu eleman modeli geliştirilmiştir. Hazırlanan modellerde şeffaf plak kalınlığı 0,75 mm, PDL kalınlığı ise 0,25 mm olarak tanımlanmıştır. Modeller üzerinde uygulanan kuvvetler; 0,2 mm şeffaf plak aktivasyonu ile 200 gram büyüklüğünde elastik kuvvetten oluşmaktadır. Tüm sayısal analizler, Altair OptiStruct yazılımı kullanılarak doğrusal olmayan statik çözümleme yöntemi ile yürütülmüştür. Elde edilen von Mises gerilme değerleri megapascal (MPa), yer değiştirme değerleri ise milimetre (mm) biriminde değerlendirilmiştir. Altı farklı senaryoda, power arm yükseklikleri 6, 8, 10 mm olacak şekilde planlanmış ve ataşman pozisyonları bukkalde veya palatinalde olacak şekilde tasarlanmıştır. Ataşmanın palatinalde olduğu senaryolarda bukkalde power arm için buton kesileri açılmıştır. Ataşmanın bukkalde olduğu senaryolarda power arm ataşmanla birlikte uygulanmıştır. Elde edilen sonuçlarda power arm ve palatinalde ataşman modellerinde kısa power arm yüksekliklerinde (6, 8 mm) devrilme miktarı artmış, uzun power arm yüksekliğinde ise daha fazla gövdesel hareket tespit edilmiştir. Ataşman ile power arm kullanıldığı senaryolarda ise hareket miktarının daha az olduğu ancak daha kontrollü hareket sağlandığı saptanmıştır. Sonlu elemanlar analizi ile yapılan çalışmalar, ağız ortamını ve klinik sonuçları tam olarak yansıtmadığından, bu sonuçların klinik çalışmalarla desteklenmesi gerekmektedir.The primary objective of this study is to analyze the potential effects of varying power arm lengths (6, 8, and 10 mm), button placement, and attachment positioning on tooth displacement, von Mises stress distributions, periodontal ligament (PDL) stress levels, and aligner deformation during the mesial movement of the first molar in clear aligner therapy. For this purpose, six distinct finite element models were developed. In the constructed models, the aligner thickness was defined as 0.75 mm and the PDL thickness as 0.25 mm. The applied forces consisted of a 0,2 mm aligner activation combined with an elastic force of 200 grams. All numerical analyses were performed using Altair OptiStruct software through a nonlinear static solution method. The obtained von Mises stress values were evaluated in megapascals (MPa), while the displacement values were measured in millimeters (mm). Across the six scenarios, the power arm lengths were designed as 6, 8, and 10 mm, with attachments positioned either buccally or palatally. In scenarios where the attachment was placed palatally, button slots were created on the buccal side for the power arm. Conversely, when the attachment was positioned buccally, the power arm was applied in combination with the attachment. The results demonstrated that in palatal attachment models, shorter power arms (6 and 8 mm) increased tipping movements, whereas longer power arm (10 mm) facilitated more bodily movement. In scenarios where power arms were used together with attachments, the extent of movement was reduced, but the achieved tooth movement was more controlled. Since finite element analyses cannot fully replicate intraoral conditions or clinical outcomes, the findings of this study should be further validated through clinical research
Logistical requirements for high-resolution anoscopy: Pre-procedure preparation and materials – A video vignette
No full textHigh-resolution anoscopy (HRA) is a diagnostic procedure that in-volves examining the anus, anal canal and perianal region with amicroscope, utilizing 5% acetic acid and Lugol's solution to detectabnormal epithelial changes and early precursors of anal cancer.Vital stains cause epithelial and vascular changes that distinguishnormal tissue from lesions, aiding in clinical decision-making forbiopsy
Hyperthermic intraperitoneal chemotherapy in epithelial ovarian cancer
No full textOver kanseri periton yüzeyine hem primer hem de nüks olgularda tutmaktadır. Bundan dolayı özellikle periton yüzeyini hedef alan terapötik yaklaşımlardan biri olan Hipertermik İntraperitoneal Kemoterapi (HIPCE) literatürde tartışılan önemli bir tedavi modalitesidir. Bugün için over kanserinin standart tedavisinde etkin bir sitoredüksiyon veplatin bazlı kemoterapi standart yerini korumaktadır. HIPEC ile ilgili tartışma devam etmektedir. Eldeki veriler HIPEC'in Neoadjuvan Kemoterapi (NACT) sonrası İnterval Debulking Cerrahisi (IDS) sağkalımı artırdığı yönündedir. Primer ve Nüks cerrahisinde sağkalımı arttırdığına dair çalışmalar olsa da standart bir yaklaşım değildir.Ovarian cancer involves the peritoneal surface in both primary and recurrent cases. Therefore, Hyperthermic Intraperitoneal Chemotherapy (HIPEC), a therapeutic approach specifically targeting the peritoneal surface, is an important treatment modality discussed in the literature. Currently, optimal cytoreduction and platinum-based chemotherapy remain the standard treatment for ovarian cancer. The debate over HIPEC continues. Available data suggest that HIPEC improves survival when used following Neoadjuvant Chemotherapy (NACT) during Interval Debulking Surgery (IDS). While some studies indicate that it enhances survival in both primary and recurrent surgeries, it is not yet a standardized approach
Clinical characteristics of peripheral joint disease in axial and peripheral spondyloarthritis: Findings from a multicentre cross sectional study
No full textPeripheral joint disease (PJD) is the most common peripheral manifestation in spondyloarthritis (SpA) patients. This study aimed to determine PJD characteristics and associated factors in patients with axial SpA (AxSpA) and peripheral SpA (pSpA). This cross-sectional and multicenter study involved 13 different rheumatology and physical medicine & reha bilitation clinics, and patients diagnosed with axSpA or pSpA were included in the study. PJD was defined as the ‘ever’ related to SpA according to the physician. Multivariable analyses were conducted to identify factors associated with PJD. A total of 394 patients were enrolled in the study (57.6% male, mean age 40.8 years), of whom 359 (91.1%) were clas sified as AxSpA and 35 (8.9%) as pSpA. Peripheral arthritis was reported in 118 patients (29.9%), comprising 85 (72%) with AxSpA and 33 (28%) with pSpA. Among the whole population with PJD, the main joint involvement pattern was monoarticular (33.9%, n=40) and oligoarticular (49.2%, n=58). The rate of predominantly lower limb and large joint involvement was approximately 60% (n=68) and the major course of PJD was transient (42.4%, n=50) and intermit tent (40.7%, n=48). pSpA patients had a higher rate of persistent (33.3% vs. 14.3%, p=0.021) and progressive arthritis (15.2% vs. 1.2%, p=0.007). The coexistence of PJD with other peripheral involvement and extra-articular manifestations excluding psoriasis was widespread. Dactylitis, enthesitis, and high CRP level were positively associated with PJD; on the contrary, ever alcohol intake, presence of sacroiliitis on MRI, and family history for SpA were negatively associated. PJD was accompanied by both other peripheral involvements and extra-articular manifestations, excluding psoriasis and the course of PJD was more persistent in pSpA patients. This undoubtedly contributes to an increased disease burden
HL23‐5 ve HL23‐6 7075‐T6 alüminyum HI‐LOK vidalı pinler için çekme ve kesme test fikstürlerinin tasarımı ve sonlu elemanlar analizi
No full textÖz: Bu çalışmada, havacılık ve savunma uygulamalarında kullanılan HL23-5 ve HL23-6 tipi 7075-T6 alüminyum vidalı pinlerin çekme ve kesme testlerine yönelik özel test fikstürlerinin tasarımı ve sayısal doğrulaması ele alınmıştır. Pinlerin geometrik kısıtları nedeniyle evrensel test makinelerinde doğrudan test edilememesi, fikstür tasarımını zorunlu kılmaktadır. Bu kapsamda geliştirilen fikstürler SolidWorks ortamında modellenmiş; Toolox 33, AISI 304 ve AISI 4140 malzemeleri kullanılarak ANSYS 2025 akademik sürümünde sonlu elemanlar analizleri gerçekleştirilmiştir. Çekme ve kesme yükleme koşullarını kapsayan analizlerde gerilme dağılımları, deformasyonlar ve emniyet katsayıları karşılaştırılmıştır. Elde edilen sonuçlar doğrultusunda, deneysel testler için en uygun fikstür geometrisi ve malzeme seçimi belirlenmiş; çalışmanın küçük çaplı havacılık tipi vidalı pinlerin mekanik karakterizasyonu için güvenilir ve tekrarlanabilir bir test altyapısı sunması hedeflenmiştir
Developments in pharmacotherapy for the preservation of ovarian function during cancer treatment
No full textIntroduction: Cancer is one of the major causes of human death, and anti-cancer therapy often results in premature ovarian failure and infertility, depending on factors such as age, initial ovarian reserve, and chemotherapy type and dose. Fertility preservation procedures, such as oocyte, embryo, and ovarian cortex cryopreservation, can help women achieve pregnancy after cancer treatment. However, the development of pharmacological therapies to protect ovarian function during chemotherapy would represent a significant advancement. Areas covered: We searched the published articles in PubMed up to December 2024, containing key words '"chemotherapy",' 'cancer,' '"ovarian protection",' '"pharmacological therapy",' '"ovarian reserve"' and '"fertility".' Chemotherapeutic agents act via various mechanisms in the human ovary, including direct DNA damage leading to oocyte apoptosis, as well as damage to ovarian stroma and microvascular architecture. In recent years, numerous protective agents have emerged, showing promise in protecting ovaries from chemotherapy-induced damage. However, most studies have relied on animal models, and only a limited number have directly tested these agents in human ovarian tissue. At present, no pharmacological treatment has been conclusively proven effective for preserving fertility. Expert opinion: A comprehensive understanding of the mechanisms underlying chemotherapy-induced ovarian damage is critical for the development of efficient and targeted pharmacological therapies.This work was supported by the National Institutes of Health (NICHD RO1HD053112)