60 research outputs found
Are patients and physicians willing to accept less-radical procedures for cervical cancer?
No full textOzdemir, Aykut/0000-0001-5457-3312; Basaran, Derman/0000-0002-2689-1417WOS: 000433285800006PubMed ID: 29770621Objective: To evaluate the opinions of women who underwent surgery for cervical cancer (CC) and physicians who treat CC about the acceptability of increased oncological risk after less-radical surgery. Methods: One hundred eighty-two women who underwent surgery for CC and 101 physicians participated in a structured survey in 3 tertiary cancer centers in Czech Republic and Turkey. Patients and physicians were asked whether they would accept any additional oncological risks, which would be attributable to the omission of parametrectomy (radical hysterectomy/trachelectomy vs. simple hysterectomy/trachelectomy) or pelvic lymph node dissection (systematic resection vs. sentinel lymph node sampling). Results: Although 52.2% of patients reported morbidity related to their previous treatment, the majority of patients would not accept less-radical surgical treatment if it was associated with any increased risk of recurrence (50%-55%, no risk; 17%-24%, risk < 0.1%). Physicians tended to accept a significantly higher risk than patients in the Czech Republic, but not in Turkey. Patients with higher education levels, more advanced-stage of disease, or adverse events related to previous cancer treatment, and patients who received adjuvant therapy were significantly more likely to accept an increased oncological risk. Conclusion: Patients, even if they suffered from morbidity related to previous CC treatment, do not want to choose between oncological safety and a better quality of life. Physicians tend to accept the higher oncological risk associated with less-radical surgical procedures, but attitudes differ regionally. Professionals should be aware of this tendency when counselling the patients before less-radical surgery.Charles University in Prague [UNCE 204065, PROGRES-Q28/LF1]; Czech Ministry of HealthMinistry of Health, Czech Republic [MZ CR-RVO VFN64165]This work was supported by Charles University in Prague (UNCE 204065 and PROGRES-Q28/LF1) and by a project from the Czech Ministry of Health (MZ CR-RVO VFN64165)
Introduction to unified mechanics theory with applications
No full textThis text describes the mathematical formulation and proof of the unified mechanics theory (UMT) which is based on the unification of Newton’s laws and the laws of thermodynamics. It also presents formulations and experimental verifications of the theory for thermal, mechanical, electrical, corrosion, chemical and fatigue loads, and it discusses why the original universal laws of motion proposed by Isaac Newton in 1687 are incomplete. The author provides concrete examples, such as how Newton’s second law, F = ma, gives the initial acceleration of a soccer ball kicked by a player, but does not tell us how and when the ball would come to a stop. Over the course of Introduction to Unified Mechanics Theory, Dr. Basaran illustrates that Newtonian mechanics does not account for the thermodynamic changes happening in a system over its usable lifetime. And in this context, this book explains how to design a system to perform its intended functions safely over its usable life time and predicts the expected lifetime of the system without using empirical models, a process currently done using Newtonian mechanics and empirical degradation/failure/fatigue models which are curve-fit to test data. Written as a textbook suitable for upper-level undergraduate mechanics courses, as well as first year graduate level courses, this book is the result of over 25 years of scientific activity with the contribution of dozens of scientists from around the world including USA, Russia, Ukraine, Belarus, Spain, China, India and U.K. Presents engineering mechanics through explanation of the unified mechanics theory with extensive experimental validation and finite element implementation using real world examples Draws the connections to the thermodynamics of degradation in solids from mathematical and microstructural perspective Discusses shortcomings and incompleteness of Newton’s universal laws of motion Posits why the space-time coordinate system is insufficient to describe organic and inorganic systems and modifies Newtonian space-time with introduction of an additional axis (Thermodynamic State Index axis)
FORTUNA, VIRTÙ Y GLORIA CONSIDERACIONES SOBRE LA MORAL REPUBLICANA DE MAQUIAVELO
No full textIn this paper some key concepts, such as fortune, virtù, and glory,are considered in order to seek clarification regarding the problemof the relation between morality and politics in Machiavelli. TheMachiavellian virtù certainly includes a good deal of energy andtalent, but does not completely lack moral components. From theconcept of fortune we can derive a number of criteria for politicalaction, which form a part of the Machiavellian virtù, which, thoughdistant from the Christian morals of his time, places him within arepublican conception of morality. Starting from an inquiry into the concept of glory, we discover how glory is a reward for virtù, but itis not awarded to every politician who is successful in his ventures,but only to those who are able to save their country by benign mean
THE COMPARISON OF VITAMIN D LEVELS OF HEALTHY AND GESTATIONAL DIABETIC PREGNANT WOMEN
No full textAim: To evaluate and compare 25-hydroxyvitamin D [25(OH)D3] levels of women with gestational diabetes mellitus (GDM) and those with normal glucose tolerance (NGT). Material and Method: A total of 40 women (20 with GDM and 20 with NGT) admitted to the clinic of obstetrics and gynecology due to follow-ups between the 24th and 28th gestational weeks and exposed to 50 and/or 100 gr oral glucose tolerance testing (OGTT) were enrolled into this prospective case-controlled study. Patients with GDM and controls with NGT were defined according to the 2013 criteria of the American College of Obstetricians and Gynecologists (ACOG). Age, height, weight, body mass index (BMI), history of previous diseases and surgeries, vitamin D replacement, clothing style (in this region 95% of participants dress in a style that prevents the sun from reaching skin) exercising status, and familial history were recorded. Serum samples were collected between the 24th and 28th gestational weeks to measure 25(OH)D3 levels via the chemiluminescence method. Results: Mean 25(OH)D3 levels were found as 8.71 +/- 3.36 ng/mL (ranging from 4.20 to 18.84). Vitamin D deficiency (< 10 ng/mL) and insufficiency( 10-30 ng/ml) were observed at the rate of 70% and 30%, respectively. 25(OH)D3 levels were 9.40 +/- 3.53ng/mL in patients with GDM and 8.0 +/- 3.11 ng/mL in controls with NGT. In terms of vitamin D deficiency, no statistically significant difference was found between the GDM and NGT groups. Discussion: 25(OH)D3 levels were found to be similar or lower in patients with GDM and those with NGT. We consider that prospective, randomized-controlled and comprehensive studies with larger populations are needed to illuminate the role of 25(OH)D3 levels in the development of GDM
Radical Hysterectomy and Total Abdominal Vaginectomy for Primary Vaginal Cancer
No full textThe aim of this surgical video is to demonstrate en bloc radical removal of uterus and vagina in a patient with clinical early-stage vaginal cancer. Surgical treatment was offered to our patient for clinical early-stage primary vaginal cancer. An en bloc radical hysterectomy, systematic pelvic lymphadenectomy, and total abdominal vaginectomy were performed. Postoperative adjuvant radiation or chemotherapy was not recommended for completely resected pathologic stage I disease with no lymph node involvement and negative surgical margins. Radical surgery can be a treatment option for selected patients with primary vaginal cancer
Comparison of endometrial cancer risk in patients with endometrial precancerous lesions: WHO 1994 vs EIN classification
No full textOur aim was to investigate the frequency of concurrent endometrial cancer in patients with endometrial precancerous lesions (PCLs) using World Health Organization 1994 (WHO94) and endometrial intraepithelial neoplasia (EIN) systems. We retrospectively investigated patients that underwent surgery for endometrial PCLs according to WHO94 or EIN systems at Hacettepe University Gynecology Clinic between January 2002 and June 2014. Of the 267 patients, 189 (70.9%) were in the WHO94 group, 78 (29.2%) were in the EIN group. Mean age of patients was 50.2 years. Sixteen patients (8.5%) in WHO94 group and 15 (%19.2) patients in the EIN group had EC (p = 0.013). In WHO94 group, EC rate in patients with atypical EH (32.6%) was significantly more than patients with non-atypical EH (1.4%) (p < .001). Atypical EH and EIN are actual PCLs which could be accompanied by EC. Therefore, atypical EH and EIN should be treated surgically if there is no desire for fertility. IMPACT STATEMENT What is already known on this subject? Endometrial hyperplasias are precursors lesion in the pathogenesis of endometrium adenocarcinomas. There are two classification systems: World Health Organization System and endometrial intraepithelial neoplasia system (WHO and EIN). What do the results of this study add? In this paper, we report on endometrial precancerous lesions. Controversy continues over the endometrial precancerous lesion classification. We also share our experiences in this regard. We concluded that the EIN system was superior in determining concurrent cancer risk. What are the implications of these findings for clinical practice and / or further research? The paper should be of interest to readers in the areas of gynecology.It is important to clarify the classifications of precancerous lesions in order to guide clinicians in the treatment of patients with endometrial precancerous lesions. In this context, it could be suggested to use the EIN system more widely
Conservative management of a retroperitoneal hemorrhage following a ruptured renal angiomyolipoma in pregnancy
No full textVaginoperineal Fistula as a Complication of Perianal Surgery in a Patient with Sjögren’s Syndrome: A Case Report
No full textForty-seven-year-old woman with Sjögren’s syndrome had been operated on because of transsphincteric perianal fistula secondary to perianal abscess. Vaginal wall injury occurred during the course of the operation and injured tissue was repaired primarily. Three months later, patient suffered from the recurrence of perianal fistula symptoms and fistulectomy was performed once again under antibiotic suppression. Several months later, perineal discharge continued, and, therefore, patient was admitted to the hospital for the third time and a fistulotomy was performed. Two months after the third operation, patient was admitted with leukorrhea and a perineovaginal fistula was detected. This time, not only her surgical problem but also her immune system disorder was considered in the preoperative workup. Then, patient was hospitalized for the fourth time and “fistulectomy/perineoplasty” was performed successfully. We believe that patients with autoimmune disorders with or without medical treatment may have healing problems during the course of surgical processes and therefore such medical problems must be taken into consideration by the surgeons
Carcinogenic and non-carcinogenic health risks related to arsenic exposure and other metal contamination in the water of Afyon Volcanites (Türkiye)
No full textThis study investigates the heavy metal contamination of water in volcanic rocks and its effects on human health, with a particular focus on arsenic. A total of 28 water samples were collected from wells and springs on volcanic rocks between June and July 2024. Ca+2, HCO3-, and SO4-2 were dominant ions in sampled waters. The average concentrations of heavy metals (mu g/L) included Al: 39.9, As: 9.4, B: 29.3, Fe: 108.8, and Mn: 42.2. The water quality index (WQI) values indicated very good to poor class, heavy metal pollution index results revealed that 28 % of the samples were not suitable for drinking, while the heavy metal evaluation index results indicated that most of the samples were in low pollution class. The average cancer risk of children via ingestion was considered harmful (9.44 x 10-4); dermal contact was 8.02 x 10-6, indicating a negligible risk. For adults, the average cancer risk from ingestion was considered harmful (4.05 x 10-4), while the dermal contact risk indicated an acceptable belt (5.15 x 10-6). Furthermore, the average hazard quotients via oral ingestion were 2.09 for children and 0.89 for adults. The average hazard quotients for dermal absorption were 0.02 and 0.01 for children and adults, respectively. Water ingestion in the study area may cause carcinogenic health risks for adults and children. An examination of the dermal effect of arsenic revealed that the waters did not pose a health risk. The source of the relatively high arsenic was water-rock interaction with volcanic rocks and possible geothermal water mixing. Further research is needed to take necessary precautions to reduce groundwater pollution, protect local people's health, and transfer water to future generations.Afyon Kocatepe University-BAPK [24.MUH.01]The author thanks to Afyon Kocatepe University-BAPK for financial support with project number 24.MUH.01
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Dependence of Drop Speed on Nozzle Diameter, Viscosity and Drive Amplitude in Drop-on-Demand Ink-Jet Printing
No full textResults of recent experiments and numerical simulations are presented, which have been used to establish empirical rules for
the dependence of drop speed on nozzle diameter and drive amplitude for Newtonian and non-Newtonian fluids printed with a
range of different ink-jet print-head technologies. Experiments were carried out with Xaar, MicroFab and Spectra Dimatix print heads and with solutions of polystyrene in diethyl phthalate as model fluids. These results are compared with
predictions from recent numerical codes developed by collaborators in the University of Leeds, and from simple models for drop-on-demand fluid jetting resulting from physical law
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