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What Has Changed in Patients Aged 65 and over Diagnosed with Breast Cancer during the COVID-19 Pandemic: A Single-Center Experience
No full textIntroduction: The COVID-19 pandemic has a worldwide negative impact on healthcare systems. This study aims to determine how the diagnosis, clinicopathological features, and treatment approaches of patients with breast cancer (BC) diagnosed at >= 65 years old were affected during the pandemic. This survey has shown that patients, especially the elderly, had to postpone their BC health problems or delay their routine controls due to the risk of COVID-19 transmission, high mortality rates due to comorbidity, and restrictions. Materials and Methods: The medical records of 153 patients with BC diagnosed at >= 65 years old before (January-December 2019group A, n = 61) and during (March 2020-May 2021group B, n = 92) the COVID-19 pandemic were retrospectively analyzed. In addition, clinicopathological features of patients, including age, admission form, clinical stage, tumor (T) size-grade-histology-subtype, lymph node involvement, surgery type, and treatment protocols, were evaluated. Results: Patients mostly applied for screening purposes were included in group A and patients who frequently applied for diagnostic purposes due to their existing BC or other complaints were included in group B (p = 0.009). Group B patients had a higher clinical stage (p = 0.026) and had commonly larger (p = 0.020) and high-grade (p = 0.001) Ts. Thus, mastectomy and neoadjuvant systemic therapy were more commonly performed in group B (p = 0.041 and p = 0.005). Conclusion: The survey showed significant changes in BC diagnosis and treatment protocols for patients diagnosed at >= 65 years old during the COVID-19 pandemic. Postponing screening and delaying treatment leads to more advanced BC stages in elderly patients. (C) 2022 S. Karger AG, Basel4AUG385-3901
THE EFFICACY AND SAFETY OF TRANSCRANIAL MAGNETIC STIMULATION IN TREATMENT-RESISTANT BIPOLAR DEPRESSION
No full textBackround: The aim of the current study is to investigate the efficacy and safety of Transcranial magnetic stimulation (TMS) treatment, a non-invasive brain stimulation technique, on depressive symptoms in treatment-resistant bipolar depression (TRBD). Subjects and methods: The study included 29 patients between the ages of 18-65, with bipolar disorder depressive episode according to DSM-5 and with the decision of non-response to treatment according to the Canadian Mood and Anxiety Treatment Network (CANMAT). Patients were divided into two groups double-blind-randomly, 20 sessions of TMS and 20 sessions of sham TMS were applied crossover. Hamilton Depression Rating Scale (HAM-D), Beck Depression Inventory (BDI), Young Mania Rating Scale (YMRS) and TMS Side Effect Questionnaire were applied to the patients before the treatment, at the 2nd week which is the crossover phase, and at the end of the treatment at 4th week. Results: In both groups, the severity of depression was decreased significantly according to HAM-D and BDI scores after the procedure. As well as active stimulation, some positive placebo effects were observed with sham stimulation. But the decreases seen in HAM-D and BDI scores and response to the treatment were higher during the weeks when the groups received active stimulation (respectively p=0.000, p=0.001, p=0.005). At the end of the study, according to HAM-D, 55.7\% of the patients showed response to the treatment, 24.13\% partial response. According to BDI, 41.37\% of the patients showed response to the treatment, and 31.03\% partial response. No associations were found between TMS response and sociodemographic - clinical features, or type of the disease (p>0.05). During the study, no serious adverse effects such as seizures or manic / hypomanic switches were observed. Conclusions: The results of our study showed that TMS treatment is an effective and safe treatment for patients with treatment-resistant bipolar depression.2236-2443
Zinc finger protein 384 (ZNF384) impact on childhood mixed phenotype acute leukemia and B-cell precursor acute lymphoblastic leukemia
No full textB-cell precursor acute lymphoblastic leukemia (BCP-ALL) is a heterogeneous malignancy and consists of several genetic abnormalities. Some of these abnormalities are used in clinics for risk calculation and treatment decisions. Patients with ZNF384 rearrangements had a distinct expression profile regardless of their diagnosis, BCP-ALL or mixed phenotype acute leukemia (MPAL) and defined as a new subtype of ALL. In this study, we screened 42 MPAL and 91 BCP-ALL patients for the most common ZNF384 fusionsZNF384::TCF3, ZNF384::EP300 and ZNF384::TAF15 by using PCR. We identified ZNF384 fusions in 9.5\% of MPAL and 7.6\% of BCP-ALL. A novel breakpoint was identified in ZNF384::TCF3 fusion in one BCP-ALL patient. T-myeloid MPAL patients showed significantly lower ZNF384 expression compared to lymphoid groups. Patients with ZNF384r had intermediate survival rates based on other subtypes. Prognostic and patient-specific treatment evaluation of ZNF384 fusions in both ALL and MPAL might help to improve risk characterization of patients.12OCT 152931-29396
Study of epidemiological behaviour of malaria and its control in the Purulia district of West Bengal, India (2016-2020)
No full textPurulia is a malaria-prone district in West Bengal, India, with approximately half of the blocks defined as malaria endemic. We analyzed the malaria case in each block of the Purulia district from January 1, 2016, to December 31, 2020. As per the API, 20 blocks of Purulia were assigned to four different categories (0-3) and mapped using ArcGIS software. An exponential decay model was fitted to forecast the trend of malaria cases for each block of Purulia (2021-2025). There was a sharp decrease in total malaria cases and API from 2016 to 2020 due to the mass distribution of LLINs. The majority of cases (72.63\%) were found in >= 15-year age group. Males were more prone to malaria (60.09\%). Malaria was highly prevalent among Scheduled Tribes (48.44\%). Six blocks were reported in Category 3 (high risk) and none in Category 0 (no risk) in 2016, while no blocks were determined to be in Category 3, and three blocks were in Category 0 in 2020. The exponential decay model prediction is oriented towards gaining malaria-free status in thirteen blocks of Purulia by 2025. This study will incite the government to uphold and strengthen the current efforts to meet the malaria elimination goals.1JAN 121
Clinical outcomes of single-bundle versus double-bundle ACL reconstruction in adolescent elite athletes: A retrospective comparative study
No full textObjective: The aim of the study was to evaluate the single bundle (SB) and double bundle (DB) anterior cruciate ligament (ACL) reconstruction in terms of graft survival, complications, and patient reported functional outcomes in adolescent athletes. Methods: In this retrospective study, 89 elite adolescent athletes who underwent either SB or DB ACL reconstruction were included. All patients were then divided into two groups: group 1 including 51 patients with SB ACL reconstruction (31 male, 20 femalemean age = 15.4 +/- 1.03 years) and group 2 including 38 patients with DB ACL (30 male, 8 femalemean age = 15.7 +/- 1.3 years). Clinical data were obtained, comprising skeletal maturity, sports type, ACL reconstruction technique, Lachman scores, KT-1000 (TM) arthrometer measurement, additional meniscal procedures as well as International Knee Documentation Committee (IKDC) score, Cincinnati score, and graft size. Results: The mean follow-up period was 53.1 +/- 8.6 months in group 1 and 46.4 +/- 9.1 months in group 2 (P = 0.61). The type of ACL reconstruction technique (SB or DB), gender, skeletal maturity, sports type, additional meniscal procedures and Lachman scores were not associated with the re-rupture of the ACL (P > 0.05). Moreover, ACL reconstruction technique did not effect the rate of re-rupture of an ACL. There were 21 re-ruptures (23.5\%) and 11 (12.3\%) contralateral ACL ruptures in total. Among 21 re-ruptures, 12 of them were in the DB group while nine of them in the SB group (P > 0.05). The groups did not differ with respect to age, the injured side, the time from injury to surgery, the postoperative follow-up time, or the preoperative physical examination results KT-1000 device (SSD), Cincinnati score, IKDC objective and subjective score,Lachman test and pivot-shift test). Conclusion: There are no differences in the re-rupture of an ACL, patient reported outcomes, and complications in adolescent elite players, when either an SB or DB technique is performed.1JAN20-255
The Socioeconomic and Psychological Impact of the COVID-19 Pandemic on People with Multiple Sclerosis in Turkey
No full textIntroduction: Various restrictions due to the coronavirus infection have affected working life globally. People with multiple sclerosis (pwMS) have several difficulties in social life, patient follow-up, and receiving treatments. In this study, we aimed to evaluate the experiences of pwMS during the COVID-19 pandemic. Method: We developed a 50-question survey aiming to determine fears, anxieties, and the problems experienced by patients regarding their diseases and social lives during the COVID-19 pandemic. The questionnaire was released online via the Turkish MS Society website, local MS societies websites, and social media accounts. Only the answers of the patients who filled out the questionnaire completely were evaluated. Results: In total, 6008 patients took the survey, and 3255 of them completed the questionnaire. Among all, 378 patients (11.6\%) were positive for COVID-19. The most common COVID-19-related symptom was fatigue (48.4\%). The routine medical follow-up was interrupted in 61.4\% and the medication was discontinued in 14\% of the patients. Approximately 25\% of the patients reported different symptoms related to relapse activity. The main concern of the patients related to the COVID-19 pandemic was the disruption of the health of the ones they loved. Among all the patients, 4.4\% lost their jobs. Conclusion: Our data showed that the COVID-19 pandemic strongly affected the working lives of pwMS. Also, the pandemic changed the attitudes of patients and neurologists. Therefore, the long-term effects of the COVID-19 pandemic on disease approach, patient follow-up, social conditions, and working life should be monitored.3SEP226-2315
Magnetic Resonance Imaging-Guided Radiation Therapy for Early-Stage Gastric Mucosa-Associated Lymphoid Tissue Lymphoma
No full textLymphoid neoplasia derived from mucosa-associated lymphoid tissue (MALTalso abbreviated as MALToma) is most commonly seen in the stomach. Radiotherapy (RT) is indicated in early-stage disease as a standard of care. With the advent of RT techniques, large field irradiation was replaced by involved site and involved field approaches. Magnetic resonance imaging-guided online adaptive RT (MRgRT) has the advantage of better soft tissue visualization, adaptive planning before each fraction, and online tumor tracking during treatmenthence, it could be a safe and effective choice for gastric MALToma patients. Herein, we investigated the interfractional changes in target and the impact of MRgRT on daily dosimetry in a gastric MALToma case. A patient diagnosed with MALToma who failed to respond to antibacterial treatment was referred to our clinic for RT. He was found to be suitable for MRgRT. We treated the patient with MRgRT in 20 fractions to a total dose of 30 Gy. Reoptimized adaptive plans were generated before each fraction since the coverages of the original plan were inadequate in each fraction. The patient showed good compliance and tolerated the treatment well. To our knowledge, this is the first documented case of a gastric MALToma treated with MRgRT. MRgRT is safe and feasible for this patient group with improved target coverage using small planning target volume margins. Without online adaptive planning, the target coverages would be inadequate and we would risk surrounding tissues to get higher doses.9SEP 111
Letter to the editor `Augmented compression in exchange nailing for femoral and tibia non-unions accelerates time to radiographic union'
No full text6AUG12193
Bias, the unfinished symphony
No full textIn laboratory medicine, mathematical equations are frequently used to calculate various parameters including bias, imprecision, measurement un-certainty, sigma metric (SM), creatinine clearance, LDL-cholesterol concentration, etc. Mathematical equations have strict limitations and cannot be used in all situations and are not open to manipulations. Recently, a paper ``Bias estimation for Sigma metric calculation: Arithmetic mean versus quadratic mean `` was published in Biochemia Medica. In the paper, the author criticized the approach of taking the arithmetic mean of the multiple biases to obtain a single bias and proposed a quadratic method to estimate the overall bias using external quality assurance services (EQAS) data for SM calculation. This approach does not fit the purpose and it should be noted that using the correct equation in calculations is as important as using the correct reagent in the measurement of the analytes, therefore before using an equation, its suitability should be checked and confirmed.3OCT3
Mental Health Problems in Renal Nurses During Novel Coronavirus Disease of 2019 Pandemic
No full textObjective: The most important factor in facing the pandemic is to ensure the physical and mental health status of the healthcare workers. Studies have found serious stressors experienced by the hemodialysis incharge-nurses but report less burnout than the other nurses. Determining the mental distress of the hemodialysis incharge-nurses during the pandemic is important in determining the necessary precautions. The objective of this study is to determine the psychological complaints of the hemodialysis incharge-nurses during the pandemic. Methods: The participants of the study are hemodialysis incharge-nurses who work in different provinces of Turkey. The data of the study were collected from April to June 2020. Beck Anxiety Inventory was used to measure the frequency of anxiety symptoms experienced by the individuals. Beck Depression Inventory was used to measure the behavioral manifestations of depression. Maslach Burnout Inventory was used to measure burnout in the workplace. The Perceived Trauma Coping Scale was used to evaluate the perception of coping-up with a traumatic life. Results: In our study, we found Beck Anxiety Inventory mean score was 13.42 +/- 11.28, Beck Depression Inventory mean score was 11.88 +/- 9.57, Maslach emotional exhaustion mean score was 15.74 +/- 8.19, Maslach depersonalization mean score was 4.96 +/- 3.70, and Maslach personal failure mean score was 8.95 +/- 4.50, respectively. Finally, the mean Perceived Trauma Coping Scale trauma score was 63.05 +/- 12.78, the mean Perceived Trauma Coping Scale future score was 36.34 +/- 8.65, and the mean Perceived Trauma Coping Scale elasticity score was 71.94 +/- 17.67, respectively. Conclusion: The findings of the study show the importance of the improvements to be made in reducing the depression and burnout levels of the nurses.1MAR12-201