Acıbadem Üniversitesi Açık Erişim Sistemi
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What Experts Think About Prostate Cancer Management During the COVID-19 Pandemic: Report from the Advanced Prostate Cancer Consensus Conference 2021
No full textPatients with advanced prostate cancer (APC) may be at greater risk for severe illness, hospitalisation, or death from coronavirus disease 2019 (COVID-19) due to male gender, older age, potential immunosuppressive treatments, or comorbidities. Thus, the optimal management of APC patients during the COVID-19 pandemic is complex. In October 2021, during the Advanced Prostate Cancer Consensus Conference (APCCC) 2021, the 73 voting members of the panel members discussed and voted on 13 questions on this topic that could help clinicians make treatment choices during the pandemic. There was a consensus for full COVID-19 vaccination and booster injection in APC patients. Furthermore, the voting results indicate that the expert's treatment recommendations are influenced by the vaccination status: the COVID-19 pandemic altered management of APC patients for 70\% of the panellists before the vaccination was available but only for 25\% of panellists for fully vaccinated patients. Most experts (71\%) were less likely to use docetaxel and abiraterone in unvaccinated patients with metastatic hormone-sensitive prostate cancer. For fully vaccinated patients with high-risk localised prostate cancer, there was a consensus (77\%) to follow the usual treatment schedule, whereas in unvaccinated patients, 55\% of the panel members voted for deferring radiation therapy. Finally, there was a strong consensus for the use of telemedicine for monitoring APC patients. Patient summary: In the Advanced Prostate Cancer Consensus Conference 2021, the panellists reached a consensus regarding the recommendation of the COVID-19 vaccine in prostate cancer patients and use of telemedicine for monitoring these patients. (c) 2022 The Authors. Published by Elsevier B.V. on behalf of European Association of Urology. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).1JUL6-118
Management of endocrine surgical disorders during COVID-19 pandemic: expert opinion for non-surgical options
No full textPurpose The COVID-19 pandemic brought unprecedented conditions for overall health care systems by restricting resources for non-COVID-19 patients. As the burden of the disease escalates, routine elective surgeries are being cancelled. The aim of this paper was to provide a guideline for management of endocrine surgical disorders during a pandemic. Methods We used Delphi method with a nine-scale Likert scale on two rounds of voting involving 64 experienced eminent surgeons and endocrinologists who had the necessary experience to provide insight on endocrine disorder management. All voting was done by email using a standard questionnaire. Results Overall, 37 recommendations were voted on. In two rounds, all recommendations reached an agreement and were either endorsed or rejected. Endorsed statements include dietary change in primary hyperparathyroidism, Cinacalcet treatment in secondary hyperparathyroidism, alpha-blocker administration for pheochromocytoma, methimazole +/- beta-blocker combination for Graves' disease, and follow-up for fine-needle aspiration results of thyroid nodules indicated as Bethesda 3-4 cytological results and papillary microcarcinoma. Conclusion This survey summarizes expert opinion for the management of endocrine surgical conditions during unprecedented times when access to surgical treatment is severely disrupted. The statements are not applicable in circumstances in which surgical treatment is possible.1FEB325-3357
Restrained, emotional eating and depression can be a risk factor for metabolic syndrome
No full textIntroduction: metabolic syndrome (MetS) can have a bidirectional effect on emotional and restrained eating. Objectives: our aims are to find interrelations between MetS and emotional eating, restrained eating, additionally with depression.Methods: cross-sectional study. Participants aged between 18 and 63, and mostly were obese (n = 200). Eating Attitudes Test (EAT-26), Beck Depression Inventory (BDI) and Dutch Eating Behavior Questionnaire (DEBQ) were used to find associations between eating patterns and metabolic syndrome.Results: our study ensured evidences for physiological relations between restrained and emotional eating with MetS. Biochemical parameters showed that restrained eaters were less insulin resistant and participants with MetS had higher emotional eating and lower restrained eating. Besides, restrained eaters had lower triglyceride, homeostasis model assessment-insulin resistance (HOMA-IR), fasting insulin, blood glucose, and higher high-density lipoprotein cholesterol (HDL-C) levelsand emotional eating was parallel with fasting insulin level and HOMA-IR.Conclusions: MetS had strong associations with eating behaviors as restrained, emotional and external. In line with the findings of the study, additionally, women were more susceptible to MetS than men were. In the regulation of restrictive, emotional and external eating behaviors, dietitians and psychology experts should be in cooperation to treat disordered eating patterns.6NOV-DEC1264-12713
The effect of concentration of biological fluids by hydrophilic elastic polymer beads on the sensitivity of SARS-CoV-2 diagnosis by real-time PCR
No full textEvaluation of Feed Strategy for High Quality Biosimilar IgG Production in CHO Cell Fed-batch Process
No full textABSTRACT
Purpose: Chinese Hamster Ovary (CHO) cells are currently the leading hosts for biosimilar Immunoglobulin G (IgG)
production in the biopharmaceutical industry. Most eukaryotic proteins are glycosylated, and charge variants affect both
the in vivo and in vitro properties of monoclonal antibodies (mAb). Adjusting the N-glycosylation patterns and charge
variants while achieving high antibody titer is a production challenge. In this study, the effects of feed type and strategy
on cell growth, product titer, glycosylation and charge variation were investigated using different CHO clones producing
different IgG mAbs.
Methods: Cultivated CHO cells were supplemented with different feeding schemes, under fed-batch productions of 14
days. Screenings were conducted in spin-tubes and further investigated in 3L bioreactor systems.
Results: Change in feed strategy decreased productivities by 10.4% (P < 0.05), while it increased non-fucosylated
glycoforms by 33.3% and enhanced galactosylation up to 3-folds. Basic variants were observed to increase 2.5 folds.
Conclusion: These remarkable alterations are of great importance in terms of mAb quality, in a manufacturing point
of view, as they provide modulation of efficacy and safety. This reveals that feed strategy is a major driving force that
significantly impacts culture longevity, galactosylated glycoforms, high-mannose glycan contents and charge variants
Eating Behaviours of Lactating Women Differ by Infant Age and Maternal BMI
No full textABSTRACT
Purpose: In lactation, women experience major changes in their lives as new internal and external demands for attention
and care for themselves and the baby, also body mass index due to eating behaviours. Our aim was to define relationships
between mindful eating and eating behaviours of breastfeeding mothers by baby’s age and maternal BMI.
Methods: This cross-sectional study was conducted between October-November 2021 with 302 lactating mothers
without chronic disease. Our study was approved by Ethics Committee of the Acibadem Mehmet Ali Aydinlar University.
A questionnaire form that examined demographic data and Mindful Eating Questionnaire (MEQ-30) were applied.
Anthropometric variables were reported by participants due to Covid-19 pandemic.
Results: Mean age of our participants was 30.6±4.2 years. Mothers with obesity had lowest score in MEQ-30 (p<0.001).
Lactating mothers who were underweight had highest MEQ-30 score (p<0.001). It was shown that lactating mothers
have highest MEQ-30 score in the first 6 months, and MEQ-30 scores decreased as baby grows (p<0.001).
Conclusion: Lactation period can be an appropriate time to bring about long-term changes in eating behavior. Healthcare
professionals and teams can apply treatments focused on eating behavior and mindful eating for mothers with obesity in
terms of their physical and emotional health, especially after the 6th month of breastfeeding
Electroencephalography and Neuroimaging Markers of Poor Prognosis in Hypoxic-Ischemic Brain Injury
No full textABSTRACT
Purpose: Hypoxic-ischemic brain injury (HIBI) can cause coma.Several factors may affect the outcome after
HIBI and prediction of the prognosis is challenging in clinical practice.Magnetic Resonance Imaging (MRI) and
Electroencephalography (EEG) are two reliable tools to predict the possible outcome after brain damage.We aimed to
test the utility of MRI and EEG in predicting the outcome by exploring specific lesion and electrophysiological patterns.
Method: Patients admitted to the intensive care unit (ICU) due to hypoxic-ischemic brain injury between January 2017
and March 2020 were retrospectively reviewed.Patients over 18 years of age with a history of cardiac arrest or respiratory
problems leading to hypoxic-ischemic brain injury were included in the study. Glasgow Coma Score (GCS) was used as a
clinical measure for the level of consciousness.All patients had a Glasgow Coma Score (GCS) of <8 and had both MRI and
EEG investigations.Patients were classified as having Poor Outcome (PO) and Good Outcome (GO).Poor outcome defines
either death or lack of recovery in consciousness (GCS<8).MRI findings that could lead to a coma state were classified as
“MRI-positive”, otherwise were classified as “MRI-negative”. Modified Hockaday Scale was used for grading of EEG.
Results: Nineteen patients with HIBI were included. In the MRI-positive group, 87.5% of the patients had poor outcome
whereas the remaining 12.5% had good outcome. In the MRI-negative group, 45.5% of the patients had poor outcome
whereas the remaining 54.5% had good outcome. According to the Modified Hockaday EEG Grading System, 91% of the
patients with a score of Grade 4 and above had poor outcome whereas only the remaining 9% had good outcome.
Conclusion: Although MRI is a valuable clinical marker, EEG seems to be more reliable for predicting prognosis in HIBI.The
modified Hockaday scale can be useful for determining the cut-off points for the prediction of poor prognosis
The immediate effect of deliberate practice and real-time feedback on high-quality CPR training in intern doctors, acute care providers, and lay rescuers
No full textThe quality of cardiopulmonary resuscitation (CPR) is the main determinant of survival in cardiac arrest, so high-quality CPR (HQ-CPR) from bystanders is essential. The best instructional model for HQ-CPR performed by bystanders remains under investigation, and an instructional model's effect on various learner types is unknown. This study examined the immediate effect of a brief, blended instructional design that combines deliberate practice (DP) with real-time feedback (RTF) on the booster training of intern doctors (IDs) and acute care providers (ACPs) as well as on the skills acquisition training of lay rescuers (LRs). This cohort crossover study was conducted in a university-affiliated hospital in January 2020. Just-in-time training on HQ-CPR that featured a popular song was provided to IDs (n = 24), ACPs (n = 29), LRs (n = 25)groups performed one-minute cardiac compressions twice, without RTF and with verbal coaching, followed by debriefing, and then with only RTF. The impact of RTF on depth, rate, compression quality (CQ), and recoil was assessed. RTF significantly improved depth, rate, CQ, and recoil (p < 0.001). Among the LRs, the depth was 0.2 millimeters below the lower cutoff. Without RTF, the previously trained IDs and ACPs tended to perform inadequately faster and deeper compressions, while the untrained LRs performed slower, shallow compressions. DP combined with RTF yielded a significant immediate effect on the HQ-CPR training outcomes of all learner types.2MAR48-551
Biological variation estimates of thyroid related measurands - meta-analysis of BIVAC compliant studies
No full textObjectives Testing for thyroid disease constitutes a high proportion of the workloads of clinical laboratories worldwide. The setting of analytical performance specifications (APS) for testing methods and aiding clinical interpretation of test results requires biological variation (BV) data. A critical review of published BV studies of thyroid disease related measurands has therefore been undertaken and meta-analysis applied to deliver robust BV estimates. Methods A systematic literature search was conducted for BV studies of thyroid related analytes. BV data from studies compliant with the Biological Variation Data Critical Appraisal Checklist (BIVAC) were subjected to meta-analysis. Global estimates of within subject variation (CVI) enabled determination of APS (imprecision and bias), indices of individuality, and indicative estimates of reference change values. Results The systematic review identified 17 relevant BV studies. Only one study (EuBIVAS) achieved a BIVAC grade of A. Methodological and statistical issues were the reason for B and C scores. The meta-analysis derived CVI generally delivered lower APS for imprecision than the mean CVA of the studies included in this systematic review. Conclusions Systematic review and meta-analysis of studies of BV of thyroid disease biomarkers have enabled delivery of well characterized estimates of BV for some, but not all measurands. The newly derived APS for imprecision for both free thyroxine and triiodothyronine may be considered challenging. The high degree of individuality identified for thyroid related measurands reinforces the importance of RCVs. Generation of BV data applicable to multiple scenarios may require definition using ``big data{''} instead of the demanding experimental approach.4MAR 28483-4936
Intramural Component of Venous, Lymphatic, and Perineural Invasion in Colon Cancer: A Threat or an Illusion?
No full textBackground: Extramural venous invasion is an independent predictor of poor outcome in colorectal cancer, whereas the significance of the intramural component of venous and lymphatic and perineural invasion is unclear. Aims: To evaluate the prognostic impact of intramural components for venous, lymphatic, and perineural invasions and the relation of these invasion patterns with clinicopathological features in patients with colon cancer. Study Design: A retrospective cross-sectional study. Methods: The analysis included 626 patients with colon cancer in stages II and III. All patients were divided into four categories (no invasion, intramural invasion only, extramural invasion only, or both intramural and extramural invasions) for vascular invasion, lymphatic invasion and perineural invasion. The primary outcomes were 5-year disease-free and overall survival. Results: Right-sided (for vascular invasion, 24.7\% vs. 33.9\%, p = 0.007for perineural invasion, 34.5\% vs. 41.5\%, p = 0.034) and dMMR tumors (for vascular invasion, 13.5\% vs. 33.5, p < 0.001for perineural invasion, 25\% vs. 41.4\%, p = 0.004) exhibited less venous and perineural invasion. Compared with no invasion, presence of intramural invasion only, did not exert any effect on disease-free or overall survival for vascular invasion, lymphatic invasion, and perineural invasion. Multivariate analyses revealed that the presence of both intramural and extramural invasion was independently associated with poor disease-free and overall survival for venous (hazard ratios: 2.39, p = 0.001hazard ratios: 2.46, p = 0.001), lymphatic (hazard ratios: 2.456, p < 0.001hazard ratios: 2.13, p = 0.02) and perineural invasion (hazard ratios: 2.99, p < 0.001hazard ratios: 2.68, p < 0.001), respectively. Conclusion: Our data strongly advocates the importance of reporting intramural and extramural components of invasion since the presence of intramural invasion alone may not be considered as a high-risk factor for systemic recurrence.6NOV436-4433