Kanser hastalarında palyatif bakım ve fitoterapi

Cancer is defined as a complex disease that occurs with the uncontrolled proliferation of cells and develops under the influence of genetic and environmental conditions. Chemotherapy and radiotherapy are frequently used in cancer treatment. Side effects related to these treatments are observed in most of the patients. Palliative care, which is an important part of cancer management today, aims to alleviate the symptoms and side effects of these treatments and to increase the quality of life of the patient. A growing number of patients with cancer are inclined towards complementary and integrative medicine, including herbal medicine. The interest in this field is increasing because it has been shown by preclinical and clinical studies that some phytotherapeutic products can reduce the side effects of chemotherapy and radiotherapy. This review summarizes phytotherapeutic approaches supported by clinical studies for palliative care in cancer patients.Kanser, hücrelerin kontrolsüz çoğalması ile ortaya çıkan, genetik ve çevresel koşulların etkisi altında gelişen kompleks bir hastalık olarak tanımlanmaktadır. Kemoterapi ve radyoterapi kanser tedavisinde sıklıkla kullanılmakta ve hastaların çoğunda buna bağlı yan etkiler gözlenmektedir. Günümüzde kanser yönetiminin önemli bir parçası olan palyatif bakım da bu tedavilerde ortaya çıkan semptomların ve yan etkilerin hafifletilmesini sağlayıp hastanın yaşam kalitesini artırmayı hedeflemektedir. Giderek artan sayıdaki kanser hastası, bitkisel ilaçlar da dahil olmak üzere tamamlayıcı ve entegratif tıbba yönelmiş durumdadır. Bazı fitoterapötik ürünlerin kemoterapi ve radyoterapiye bağlı yan etkileri azaltabildiğinin preklinik ve klinik çalışmalarda gösterilmesi sebebiyle bu alana olan ilgi artmaktadır. Bu derleme kanser hastalarında uygulanabilecek palyatif bakımda, klinik çalışmalarla desteklenen fitoterapötik yaklaşımları özetlemektedir

Impactul disulfurii de alil asupra distrugerii oxidative æi regenerãrii hepatice pe un model experimental de hepatectomie

Backgraund: We investigated the effects of allyl disulfide (a garlic extract) on tissue damage, regeneration, proliferation and oxidative damage in an experimental liver resection model. Materials and Methods: In the study, 24 female Wistar albino rats weighing approximately 200-250 g were used. Group 1: The rats in the experimental group all received a 70% hepatectomy and were fed an Allyl disulfide (30 µg/kg/day, Allyl disulfide, Sigma-Aldrich, formula: C6H10S2, CAS Number: 2179-57-9, formula weight: 146.27 g/mol) in supplement to a regular diet for 1 week both preoperatively and postoperatively. Group 2: The rats in the control group also underwent a 70% hepatectomy and were given regular food and water for 1 week both preop and postop. Group 3: In the sham group, all rats were sacrificed 7 days after surgery. For biochemical evaluation, SGOT, SGPT, bilirubin, CRP and MDA were studied. In a histopathological examination, the fattening of the liver tissue, existence of (macro-micro vesicular), fibrosis, pleomorphism at hepatocyte nuclei, portal inflammation, existence of intralobular inflammatory cells, dilation at sinusoids, congestion, congestion at the central vein, regeneration, existence of Kupffer cells in the sinusoidal lumen and ki-67 proliferation index at hepatocytes were examined. Results: A significant difference between group 1 and group 2 was observed regarding the existence of regeneration, (p:0.06), the occurrence of nuclear pleomorphisms (p:0,001) and the fibroblast activity status (p:0.001). Significant differences were found between the experimental groups in regard to Kupffer cell increase and dilation and the hyperemia status in the sinusoid lumens (p:0.013 and p:0.001, respectively). In the Allyl disulfide group, the proliferation index was significantly higher than that of the other groups (p:0,001), while the average plasma MDA value was lower than that of the other groups (p: 0,042). No significant differences were found among the groups with respect to tissue MDA values (p:0,720). No significant difference was found for SGPT (ALT) and SGOT (AST) levels between Group 1 and the other groups (p:0.247 and p:0.539, respectively). The average total bilirubin (T. Bili) values were 0,12, 0,08 and 0,04 in the allyl disulfide group, control group and Sham group, respectively. This difference among the groups is statistically significant (p:0.001). The average direct bilirubin (D. Bili) values were 0,06, 0,02 and 0,02 in the allyl disulfide group, control group and Sham group, respectively. This variation among the groups is also statistically significant (0.001). Conclusion: We observed that the use of Allyl disulfide supplementation after major hepatectomy has a positive impact on liver regeneration, proliferation and oxidative damage. Abbreviations: Postop: post-operative, Preop: pre-operative, SGOT(AST): serum glutamic oxaloacetic transaminase, SGPT(ALT): serum glutamate-pyruvate transaminase, CRP: C- Reactive protein, MDA: Malondialdehyde, DAS: Garlic extract diallyl sulfide, AGE: aged garlic extract.Date generale: Am investigat efectele disulfurii de alil (un extract de usturoi) asupra distrucåiei tisulare, regenerãrii, proliferãrii æi distrugerii oxidative pe un model experimental de rezecåie hepaticã. Materiale æi metode: În acest studiu 24 de femele de æobolani albi Wistar cu greutãåi de aproximativ 200-250 g au fost utilizaåi. Grupul 1: toåi æobolanii din acest grup experimental au fost supuæi unei hepatectomii de 70% din dimensiunea ficatului æi au fost hrãniåi cu disulfurã de alil (30 μg/kg/zi, disulfurã de alil, Sigma-Aldrich, formula: C6H10S2, NumãrulCAS: 2179-57-9, greutate molecularã: 146.27 g/mol) suplimentar faåã de dieta normalã timp de câte o sãptãmânã pre- æi postoperator. Grupul 2: Æobolanii din grupul control au fost de asemenea supuæi unei hepatectomii în proporåie de 70% æi au primit un regim nutriåional æi de hidratare normale atât pre-, cât æi postoperator. Grupul 3: În grupul de control non-placebo toåi æobolanii au fost sacrificaåi la 7 zile dupã intervenåia chirurgicala. În vederea evaluãrii biochimice, AST, ALT, bilirubina, CRP æi malondialdehida sericã au fost studiate. În cadrul analizei histopatologice au fost examinate acumularea de åesut grãsos la nivel hepatic, existenåa fibrozei (macro-micro veziculare), pleomorfismul nucleilor hepatocitelor, inflamaåia portalã, existenåa de celule inflamatorii intralobulare, dilatarea la nivelul sinusoidelor, congestia, congestia venei centrale, regenerarea, existenåa de celule Kupffer în lumenul sinusoidal æi indicele de proliferare ki-67 la nivelul hepatocitelor. Rezultate: S-a observat o diferenåã semnificativã între grupurile 1 æi 2 în ceea ce priveæte prezenåa regenerãrii, (p:0.06), pleomorfismelor nucleare (p:0,001) æi statusului de activitate fibroblasticã (p:0.001). Diferenåe semnificative au fost gãsite între grupurile experimentale vizând creæterea numericã æi dilatarea celulelor Kupffer æi statusul hiperemic la nivelul lumenelor sinusoidelor (p:0.013 æi p:0.001 respectiv). În grupul cu administrare de disulfurã de alil indicele de proliferare a fost semnificativ mai ridicat decât în celelalte grupuri (p:0,001), în timp ce valoarea medie a malondialdehidei serice a fost mai scãzutã comparativ cu celelalte 2 grupuri (p: 0,042). Nu s-au înregistrat diferenåe semnificative între grupuri referitor la valorile de malondialdehidã tisularã (p:0,720). Nu s-au gãsit diferenåe importante între nivelurile de ALT æi AST din grupul 1 în comparaåie cu celelalte grupuri (p:0.247 æi p:0.539 respectiv). Valorile medii de bilirubinã totalã au fost de 0,12, 0,08 æi 0,04 în grupurile 1, 2 æi 3. Aceastã diferenåã dintre grupuri prezintã semnificaåie statisticã (p:0.001). Valorile medii ale bilirubinei directe au fost 0,06, 0,02 æi 0,02 în grupul experimental, grupul control æi grupul control non-placebo. Æi aceastã variaåie între grupuri este semnificativã din punct de vedere statistic (0.001). Concluzii: Am observat cã suplimentarea de disulfurã de alil dupã o hepatectomie majorã are un impact pozitiv asupra regenerãrii, proliferãrii æi distrugerii oxidative la nivel hepatic

Psychometric validation of the Turkish version of the questionnaire on the integration of complementary and alternative medicine in oncological treatment

– Objective: The aim of this study was to psychometrically validate the Turkish version of the questionnaire on the integration of complementary and alternative medicine (cam) in oncological treatment. Patients and Methods: This methodological study was conducted between December 2020 and September 2021 involving 247 cancer patients. To ensure cultural appropriateness of the scale, the sample size for each item of the scale was set at 5-10 patients. Results: Expectations for integrating CAM therapies into health care were improvement in the patient's over-all ability to cope with the disease, improvement in the patient's daily functioning, emotional and spiritual support for the patient, and support for the patient's family (p[removed

Meme kanseri ve kronik lenfositik loseminin birlikteliği: Olgu sunumu

Certain malignancies may occur concomitantly or consecutively. . We present a female patient with breast carcinoma who had chronic leukemia concurrently with breast cancer.. She underwent a modified radical mastectomy. The histopathologic examination of both mastectomy and axillary specimen revealed diffuse, atypical lymphoid proliferation and microscopic foci of lymphocytic infiltrations beside the typical breast carcinoma findings. Lymphocytes taken from peripheral blood and bone marrow aspirates were stained with CD5 and CD20. The diagnosis of chronic lymphocytic leukemia (CLL) was confirmed. CLL was diagnosed as a synchronous malignancy together with breast carcinoma. It should be kept in mind that breast carcinoma may occur concomitantly with other malignancies especially CLL. Second malignancies occur with an increased frequency in patients with CLL, mainly because of the immune defects associated with this disease.Maligniteler aynı anda veya birbirini takiben aynı hastada görülebilir. Biz bu çalışmada kronik lösemi ile aynı anda olan meme kanseri nedeniyle modifiye radikal mastektomi yapılan bayan hastayı sunduk. Histopatolojik incelemede tipik meme kanseri bulguları yanında hem memede hem de aksiller spesmende atipik lenfoid proliferasyon ve mikroskopik lenfositik infiltrasyon odakları saptandı. Periferik kandan alınan lenfositler ve kemik iliği CD5 ve CD20 ile boyandı. Kronik lenfositik lösemi (KLL) tanısı doğrulandı. KLL, meme kanseri ile senkron malignite olarak teşhis edildi. Meme kanserinin özellikle KLL gibi diğer maligniteler ile birlikte olabileceği akılda tutulmalıdır. İkinci maligniteler, KLL hastalarında immün defekt sebebiyle daha fazla görülebilir

Transmural Migration of a Retained Sponge Through the Rectum: A Case Report

Retained surgical sponge in the abdomen following abdominal and pelvic surgery is an uncommon condition. Here we present a case of retained surgical sponge with unusual presenting symptoms. A 27-year old female patient presented to our department with a foreign body localized in the anal region. She had a past history of a myomectomy 1 year earlier. Clinical examination and radiographic workout revealaed a sponge migrating towards the rectum. The sponge was removed under visual guidance of rectoscopy without laparotomy. The patient was discharged without complications

Endoskopide yenlikçi girişimler

Hipokrat döneminde hastayı ameliyat etmeden gastrointestinal kanalı görüntüleme şeklinde başlayan endoskopi süreci zaman içinde gelişmiştir. Günümüzde tanı koymanın yanı sıra tedavi edici yöntemlerin de uygulandığı endoskopik sistemler mevcuttur. Teknolojide atılan adımlar ile tanısal özellikleri, kısıtlı da olsa, biyopsiye gerek kalmadan sergileyebilecek düzeye gelen FICE, NBI gibi sistemler mevcuttur. Teknolojideki ilerlemeler ile gelecekte birçok açık cerrahi yöntemin yerini alabilecek duruma gelen endoskoplar umut vericidir