Retrospective analysis of urogynecological symptoms of patients undergoing gynecological oncology surgery

Objectives: Treating gynecological cancer with radical surgery, pelvic radiotherapy, and systemic chemotherapy may lead to pelvic floor dysfunction. Materials and Methods: Lower urinary tract symptoms are common after surgery for gynecological cancer. We used the Urogenital Distress Inventory (UDI)-6, Incontinence Impact Questionnaire (IIQ)-7, and International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) to compare the severity of urinary incontinence and quality of life between patients who underwent staging surgery for gynecological caner and those who underwent hysterectomy for benign disease. In total, 50 patients with cancer and 50 patients with benign disease were included in the patient and control groups, respectively. Results: There were no significant differences between the groups in terms of preoperative IIQ-7, UDI-6, and ICIQ-SF scores. There was a significant difference between the groups in scores 1 and 12 months after surgery. Postoperative IIQ-7, UDI-6, and ICIQ-SF scores were significantly increased compared to preoperative scores, although there were no significant differences between preoperative and postoperative scores in the control group. Incontinence was present after surgery in 15 (43.2%) and 4 (21.1%) patients in the test and control groups, respectively. In multivariate analyses of variance, surgery for cancer was an independent risk factor for urinary incontinence. Conclusion: Genitourinary symptoms should be evaluated in cancer patients undergoing staging procedure. The quality of life of patients should be assessed in terms of incontinence in the postoperative period

The use of coffee for the prevention of ileus following abdominal surgery: A review of the current evidence

Postoperative ileus (POI) is a form of intestinal paralysis that is seen especially after surgical procedures performed by entering the abdominal cavity. POI is common, particularly after abdominal surgery, with an incidence of 8-30%. The initial phase of postoperative paralytic ileus is treated with decompression using a nasogastric tube to correct electrolyte imbalances, with analgesia applied as needed. Prokinetic compounds have been used to prevent ileus and control pain (such as serotonin receptor antagonists, neostigmine, alvimopan, and ghrelin agonists), along with early mobilization, minimally invasive surgery, early introduction of solid food into the diet, thoracic epidural analgesia, and fluids. Coffee has been shown to accelerate postoperative bowel movements. However, despite extensive research on the physiological impacts of coffee, little is acknowledged regarding how it affects the gut. Coffee increases colonic motility within 4 min of consumption. In the postoperative period, the number of intestinal vocals heard by auscultation of intestinal vocals, first gas and first defecation times of patients who consume coffee are smaller/shorter than patients who do not consume coffee. Patients who drink coffee also have shorter hospital stays

Risk Factors for Chronic Obstructive Pulmonary Disease in Women

In the rural part of our country the use of traditional biomass was common and as a result of this, women who light the fire and bake bread and cook meals as well as children around them are exposed to the smoke that come out . The aim of this study was to to determine possible risk factors and associated conditions of COPD in women. The study was prospective and case-controlled. Fifty-two female patients with COPD followed up in Akdeniz University Hospital Department of Respiratory Medicine were included in this study. All cases were enrolled between December 2000 and October 2003. Fifty-four female non COPD subjects were chosen as the control group. These control subjects who did not have lung diseases were randomly selected in different outpatient clinics in the same hospital. Age, place of residence, comorbid conditions, cigarette smoking (active and passive), occupational exposure, air pollution, socio-economic status, education level, passive smoking in childhood, the fuel used for heating, cooking and baking bread and its duration were questioned. Results from this study suggest that exposure to cooking smoke, low education level, living in rural area, baking bread at home were associated risk factors with COPD among women

THE SUCCESS OF CUSTOMER RELATIONSHIP MANAGEMENT: FACTORS AND THE PROCESS

Günümüzde firmaların müsterilerine etkin, kaliteli, verimli ve sürekli hizmet sunmaları rekabetçi kalabilmeleri için bir ön kosul olmustur. Hızla gelisen teknolojiler, özellikle bilisim ve iletisim teknolojileri, pazarlama faaliyetlerini birer teknoloji uygulaması haline getirmistir. Bilisim teknolojilerinin pazarlama faaliyetlerine uygulanmasının günümüzde en yeni görülen sekillerinde biri Customer Relationship Management (CRM – Müsteri Äliskileri Yönetimi) dir. Bu makalede CRM uygulamalarının basarı ile yapılması ve sürdürülmesi için gerekli sosyal, teknik, kültürel ve örgütsel faktörler tartısılmıs ve bütün bu faktörleri içeren bir basarı modeli gelistirilmis ve sunulmustur. Bu makale ilk kez CRM uygulamalarının basarısı konusunda isletme, psikoloji ve bilisim sistemleri literatüründeki bulguların özgün bir model olarak bir araya getirmistir. Today, in order to remain competitive, organizations have to provide efficient, high quality, productive and continuous services to their customers. Fast developing Technologies, especially information and communication Technologies have made marketing as technology implementations. One of the newly emerging applications of technology in marketing is Customer Relationship Management (CRM). In this article, social, technical, cultural and organizational factors that are required for successful CRM implementations are discussed and an Implementation Success Model is proposed. This study, for the first time the important factors derived from management, psychology and information systems literature are presented in an original model

A Case of Swyer-James (Macleod’s) Syndrome with Bilateral Involvement

Swyer-James (Macleod’s) syndrome (SJMS) is a rare disorder thought to be a complication of childhood infections. Unilateral hyperlucency, reduced lung volume, diminished vascular markings and bronchiectasis may be detected on radiological analysis. Bilateral involvement is rare. We present a 20-yearl-old man who was diagnosed as having bilateral SJMS by radiological analysis and ventilation-perfusion scintigraphy

Management of cervical cancer during pregnancy

WOS: 000373739200023PubMed ID: 26467977Cervical cancer (CC) is the most common gynaecological cancer during pregnancy. The rarity of the disease and lack of randomised control studies have prevented the establishment of treatment guidelines. The management of CC mainly follows the guidelines for the non-pregnant disease state, expert opinions and limited case reports. Although the management of CC diagnosed during pregnancy appears to be a significant dilemma for the patients and specialists, the prognosis of CC is not influenced by pregnancy. The treatment decision should be made collaboratively with a multidisciplinary team consisting of an obstetrician, gynaecologist, oncologist and paediatrician. The concerns of the patient should be taken into account

A literature review on accounting education in Turkey, etichal values, and occupational ethicsTürkiye’de muhasebe eğitimi, etik değerler ve meslek etiği üzerine literatür taraması

In this study, the basic ethical approaches in accounting are discussed by referring the concepts of accounting education, ethics, professional ethics, professional ethics training, accounting ethics education. Also it is devoted to fundamental ethical principles held by various institutions and organizations in Turkey and the World. The literature review are conducted on the studies carried out about the professional ethics in Turkey, accounting ethics, accounting ethics education and ethical principles. The purpose of this work is to try to create a perspective for the future within the scope of accounting ethics education and accounting ethics committees in Turkey. If examining the studies in Turkey within the code of ethics and accounting education, it is seen that the professionals and business owners generally exhibit behaviors consistent with ethical principles, but for exceptions there are reasons of gaps in legislation and pressure from payers. Studies show that people are more prone to the unethical behavior who are men by gender variable, youngs by age variable and low-income people by level of income variable. As examining the education variable, the results demonstrate that the level of education is lower in the parties done unethical behavior, the education received is not effective and efficient and the institutions offering education do not give importance sufficiently to the ethical education. ÖzetBu çalışmada muhasebe eğitimi, etik, meslek etiği, meslek etiği eğitimi, muhasebe etiği eğitimi kavramlarından bahsedilerek muhasebe de yer alan temel etik yaklaşımların bahsedilmiştir. Ayrıca Türkiye’de çeşitli kurum ve kuruluşlar tarafından düzenlenen ve tüm dünyada da benzer şekilde var olan temel etik ilkelerden bahsedilmiştir.  Türkiye’de meslek etiği, muhasebe etiği, muhasebe etik eğitimi ve etik ilkeler üzerine yapılan çalışmalar üzerine literatür taraması yapılmıştır. Bu çalışmanın amacı, Türkiye’de muhasebe etik kurulları ve muhasebe etik eğitimi kapsamında geleceğe ilişkin bir perspektif oluşturmaya çalışmaktır. Muhasebe eğitimi ve etik kodlar kapsamında Türkiye’de yapılan çalışmalar incelendiğinde,  genel itibariyle meslek mensupları ve işletme sahiplerinin etik ilkelere uygun davranışlar sergiledikleri, etik dışı davranışlarda bulunanların ise bunun nedeni olarak mükelleflerin baskısı ve yasal mevzuattaki boşlukları göstermişlerdir. Çalışmalarda cinsiyet değişkenine göre erkeklerin, yaş değişkenine göre gençlerin, gelir düzeyi değişkenine göre ise geliri düşük düzeyde olanların etik dışı davranışlara daha fazla yöneldikleri belirlenmiştir. Eğitim değişkenine bakıldığında ise etik dışı davranışlarda bulunan tarafların eğitim seviyesinin daha düşük olduğu, alınan eğitimlerin etkili ve verimli olamadığı ve bu eğitimi veren kurumların etik eğitimine gerekli önemi vermediği sonuçlarına ulaşılmıştır

Effect of adenomyosis on prognosis of patients with endometrial cancer

OBJECTIVE: Our goal was to contrast the prognoses of patients with endometrial cancer who had adenomyosis against those that did not. METHODS: All patients who had received surgical staging for hysterectomy-based endometrial cancer had their medical data retrospectively examined. The analysis covered 397 patients, who were split into two groups depending on the presence of adenomyosis. Comparisons were made between patients covering type of surgery, histopathology, endometrial cancer stage, lymphovascular space invasion, presence of biochemical or histochemical markers, adjuvant therapy, presence of adenomyosis in the myometrial wall, and outcomes in terms of overall survival and disease-free survival. RESULTS: There is no statistically significant difference in the 5-year disease-free survival or overall survival rates between endometrial cancer patients with and without adenomyosis. This is based on comparisons of tumor stage, tumor diameter, histological type and grade of tumor, myometrial invasion, lymphovascular space invasion, and biochemical markers that affect the course of the disease. The median follow-up times were 61 months for the adenomyosis-positive group and 56 months for the group without adenomyosis. CONCLUSION: Coexisting adenomyosis in endometrial cancer has no bearing on survival rates and is not a prognostic factor

Ultrasonographically detected hepatosteatosis independently predicts the presence and severity of coronary artery disease

Objectives: The aim of our study was to evaluate the association between the presence and severity of CAD and NAFLD. Methods: The study group consisted of 153 patients who underwent coronary angiographies. Patients were categorized into CAD and non-CAD groups. CAD severity was determined by the number of CAD-involved arteries and the vessel score multiplied by Gensini score, the latter judging CAD severity. Fatty liver was diagnosed by abdominal ultrasonography (USG), with the patients being categorized by the degree of hepatosteatosis, as Grade 0, Grade 1, and Grade 2-3. Results: Among the whole study population, 47.1% of patients (n=72) were female and 52.9% of patients (n=81) were male. Forty-three patients had normal coronary arteries; 27 patients had non-critical CAD and side branch disease; and 83 patients had clinically significant CAD (stenosis>50%). The rate of CAD and Gensini score were significantly different between Grade 0, 1 and 2-3 hepatosteatosis groups (p<0.05). Patients with CAD had a significantly higher AST level than those without (p< 0.05). Conclusion: Ultrasonographically detected hepatosteatosis independently predicts the presence and severity of CAD. Keywords: Nonalcoholic fatty liver disease; gensini score; obesity

Granüloza hücreli over tümörlerinin yönetimi: Tersiyer bir merkeze ait 10 yıllık deneyim

Objective: Granulosa cell tumors (GCT) arise from the mesenchymal cells and sex cords of the ovaries and can be observed in women of all age groups. This study presented our 10 year-long gynecology oncology experience on the clinical course and outcome of GCT cases. Methods: Thirty-one patients who were operated due to suspicious adnexal masses in our hospital between January 2011 and January 2018 and whose final pathology report confirmed the diagnosis of GCT was included in the study. The data of the patients were evaluated. Preoperative ultrasound findings and serum tumor marker results are noted. Results: Twenty-nine (94%) patients were diagnosed with AGCS and only two (6%) patients were diagnosed with JGCS. The mean age of the study population was 47.74 14.47 years and the mean body mass index was 32.51 7.1. Most patients presented with heavy menstrual bleeding (29%). 48.4% of the patients underwent hysterectomy with bilateral salpingo-oophorectomy, and complete lymph-node dissection, whereas 22.6% of them had hysterectomy with bilateral salpingo-oophorectomy, and 29% of them had oophorectomy only. Three patients (9.3%) had a disease recurrence. The overall survival was 54.4 29.3 months and disease free survival was 49.6 24.2 months. Conclusion: The most important predictor of survival among patients with GCT is a disease stage at the time of initial diagnosis. Long-term surveillance, including routine clinical follow-up and evaluation of tumor markers is mandatory.Amaç: Granüloza hücreli tümörler (GCT) yumurtalıkların mezenkimal hücrelerinden ve cinsiyet kordonlarından ortaya çıkar ve her yaş grubundaki kadınlarda görülebilir. Bu çalışma, GCT olgularının klinik seyri ve sonuçları hakkında 10 yıllık jinekoloji onkoloji deneyimimizi sunmayı amaçladı. Yöntem: Ocak 2011-Ocak 2018 tarihleri arasında hastanemizde şüpheli adneksiyal kitle nedeniyle ameliyat edilen ve son patoloji raporu GHT tanısı ile doğrulanan 31 hasta çalışmaya dahil edildi. Hastaların verileri değerlendirildi. Preoperatif ultrason bulguları ve serum tümör belirteç sonuçları not edildi. Bulgular: Yirmi dokuz (%94) hastaya AGCS tanısı kondu ve sadece iki (%6) hastaya JGCS tanısı kondu. Çalışma popülasyonunun ortalama yaşı 47,74 14,47 yıl ve ortalama vücut kitle indeksi: 32,51 7,1 idi. Hastaların çoğu ağır adet kanaması (%29) ile başvurdu. Hastaların %48,4’üne bilateral salpingo-ooferektomi ve tam lenf nodu diseksiyonu ile histerektomi, %22,6’sına bilateral salpingo-ooferektomi ile histerektomi, %29’una sadece ooferektomi yapıldı. Üç hastada (%9,3) hastalık nüksü vardı. Genel sağkalım 54,4 29,3 aydı ve hastalıksız sağkalım 49,6 24,2 aydı. Sonuç: GCT’li hastalar arasında sağkalımın en önemli prediktörü, ilk tanı anındaki hastalık evresidir. Tümör belirteçlerinin rutin klinik takibi ve değerlendirmesini içeren uzun vadeli sürveyans zorunludur