Identification of Risk Factors for Breast Cancer for Women in Istanbul

Background: Breast cancer is the most common cancer type seen in women, accounts for 18% of all cancer types in women and the risk of a woman to get breast cancer during her life is 11%. These notified rates enable breast cancer to be defined as a preventable and if pre-diagnosed, a treatable cancer type, despite it was regarded as a terrifying type of cancer in the past. Objective: The aim of the study was to determine the lifestyle pattern of women without breast cancer in Istanbul. Method: The study was carried out as a descriptive and cross-sectional study with 1000 women. Results: The majority of the women (29.7%) were in the 35-44 year old age group. Out of these 93.1% gave birth before the age of 30, 29.5% breastfed for 7-12 months, 65.8% started menarche between 13-15 years of age (mean of 13.3 years), 15.5% were in menopause and had entered menopause at a mean age of 46.5 years. Their mean body mass index was 24.3kg/m2 and 24.5% of them preferred foods containing high fat content. The majority of the women (85.4%) did not participate in sports regularly. One third (30.3%) of the women had underwent Breast Self Examination. There was a positive family history of breast cancer for 12.1% of the women. Conclusion: Sedentary lifestyles, lower Breast Self Examination and routine mammography rates and family histories of breast cancer were the risk factors that needed to be given priority for further action

Kadın Doğum Hekimi ve Ebelerin Elektif Sezaryen Doğum Hakkındaki Görüş ve Deneyimleri

Background: At the present time, the most frequent reason for the application of caesarean birth is the caesareans without medical indications (elective). Becoming a routine of caesarean application brings along various ethical discussions. Objectives: This cross-sectional descriptive study was planned to analyze the opinions and experiences of obstetricians and midwives about the elective caesarean birth. Methods: The samples of the research consisted 36 obstetricians and 84 midwives who accept to participate the study. Results: 100% of the obstetricians (elective=40.9%, medical indication=59.1%) and 48.7% of midwives (elective=47.4%, medical indication=52.6%) were determined to have experienced caesarean in their birth. 58.3% of the obstetricians and 39.3% of the midwives said they or their wives would choose elective caesarean birth if they were pregnant now. In both groups, the primer reason for the choice of elective caesarean births was "unwillingness and fear of dissertation/pain" among the obstetricians and midwives with 33.3% and 78.7% respectively. It was found that 54.8% of the midwives and 80.5% of the obstetricians partly or totally agreed with the idea of "caesarean is a birth type that is preferred by the obstetricians nowadays since it saves more time to health professionals"(p = .024). Conclusion: This study indicates that obstetricians and midwives are tendency to elective caesarean birth. It is thought that opinions and experiences of health professionals may be router choose the type of birth of families. Giriş: Tıbbi endikasyon olmadan (elektif) yapılan sezaryenler günümüzde karşılaşılan en sık sezaryen doğum uygulama nedenidir. Sezaryen uygulamasının rutin hale gelmesi, çeşitli etik tartışmaları da beraberinde getirmektedir. Amaç: Bu kesitsel tanımlayıcı çalışma, kadın doğum hekimi ve ebelerin elektif sezaryen doğum hakkındaki görüş ve deneyimlerini incelemek amacıyla planlandı. Yöntem: Araştırmanın örneklemini, çalışmaya katılmayı kabul eden 36 kadın doğum hekimi ve 84 ebe oluşturdu. Bulgular: Hekimlerin %100'ünün (elektif=%40.9, tıbbi endikasyon=%59.1) ebelerin ise %48.7'sinin (elektif=%47.4, tıbbi endikasyon=%52.6) kendi doğumlarında sezaryeni deneyimledikleri saptandı. Hekimlerin %58.3'ü ebelerin ise %39.3'ü eğer şuanda hamile olsalar kendileri ya da eşleri için elektif sezaryen doğumu seçeceklerini belirtti. Her iki grup için, elektif sezaryen doğumu seçmedeki ilk neden hekimlerde %33.3, ebelerde %78.7 ile "ağrı çekmek istememek/korkmak" olarak belirlendi. Ebelerin %54.8'inin, hekimlerin ise %80.5'inin "sezaryenle yapılan doğum sağlık ekibine daha fazla zaman kazandırdığı için günümüzde hekimler tarafından tercih edilmektedir" görüşüne tamamen ya da kısmen katıldığı saptandı (p = .024). Sonuç: Bu çalışma, kadın doğum hekimi ve ebelerin elektif sezaryen doğuma eğilimli olduğunu göstermektedir. Sağlık profesyonellerine ait görüş ve deneyimlerin, ailelerin doğum şekli tercihinde yönlendirici olabileceği düşünülmektedi

Osteoporozda Güncel Tedavi

Düşük kemik mineral yoğunluğu ve kemik dokunun mikro yapısında bozulma ile karakterize, kemik frajilitesinde ve kırık riskinde artışa neden olan sistemik bir hastalık olarak tanımlanan osteoporoz dünyada ve ülkemizde önemli bir sağlık sorunu haline gelmiştir. Özellikle postmenopozal kadınlarda olmak üzere milyonlarca insanı etkilemektedir. Yol açtığı kırıklarla yaşam kalitesini düşürmekte, ekonomik ve sosyal yükün yanı sıra morbidite ve mortaliteyi de artırmaktadır. Ortalama yaşam süresinin artması kronik hastalıklarla beraber osteoporoz görülme sıklığını da arttırmaktadır. osteoporozun tanısı ve tedavi prensipleri gözden geçirilmiş ve son kılavuzlar ışığında osteoporoza güncel bir yaklaşım ele alınmaya çalışılmıştır

COVID-19 in pediatric nephrology centers in Turkey

Background/aim: There is limited data on COVID-19 disease in children with kidney disease. We aimed to investigate the characteristics and prognosis of COVID-19 in pediatric nephrology patients in Turkey. Materials and methods: This was a national, multicenter, retrospective cohort study based on an online survey evaluating the data between 11th March 2020 and 11th March 2021 as an initial step of a detailed pediatric nephrology COVID-19 registry. Results: Two hundred and three patients (89 girls and 114 boys) were diagnosed with COVID-19. One-third of these patients (36.9%) were between 10–15 years old. Half of the patients were on kidney replacement therapy: kidney transplant (KTx) recipients (n = 56, 27.5%), patients receiving chronic hemodialysis (n = 33, 16.3%) and those on peritoneal dialysis (PD) (n = 18, 8.9%). Fifty-four (26.6%) children were asymptomatic. Eighty-two (40.3%) patients were hospitalized and 23 (28%) needed intensive care unit admission. Fifty-five percent of the patients were not treated, while the remaining was given favipiravir (20.7%), steroid (16.3%), and hydroxychloroquine (11.3%). Acute kidney injury developed in 19.5% of hospitalized patients. Five (2.4%) had MIS-C. Eighty-three percent of the patients were discharged without any apparent sequelae, while 7 (3.4%) died. One hundred and eight health care staff were infected during the study period. Conclusion: COVID-19 was most commonly seen in patients who underwent KTx and received HD. The combined immunosuppressive therapy and frequent exposure to the hospital setting may increase these patients’ susceptibility. Staff infections before vaccination era were alarming, various precautions should be taken for infection control, particularly optimal vaccination coverage

FHIT gene sequence variants and reduced fhit protein expression in glioblastoma multiforme

Molecular studies have an important role in the elucidation of the mechanisms involved in Glioblastoma multiforme (GBM) development. The occurrence of FHIT gene alterations, which has an important role in different cancers, has not yet been studied well in GBM. We aimed to investigate the occurrence of alterations of FHIT gene sequence and protein expression in the GBMs. Sequence alterations in exons 5-9 of the FHIT gene were screened in 63 GBMs using the single-strand conformational polymorphism method, followed by DNA sequencing. Additionally, the level of Fhit protein expression in tissues of 48 tumors was assessed by immunohistochemistry (IHC). In our investigation, FHIT gene alterations in the coding region were detected in 11 of the 63 GBM cases (17.5%). Two different sequence variants were determined: one novel missense variant (G -> C transition at codon 49) and one previously described silent alteration (C -> T transition at codon 88). Using web-based programs, such as SIFT and ESEfinder, it was determined that both alterations might have caused significant modification on protein function. In addition, we identified a previously reported an intronic polymorphism (T -> A transition at IVS8-17) in 47.5% of cases as a similar rate (45%) in the control group. Moreover, it was observed that Fhit protein expression was reduced in 87.5% of tumors. In conclusion, the reduction or loss of Fhit protein expression by genetic alterations or epigenetic mechanisms in GBM might be associated with brain tumorigenesis

Effects of position change and of back massage on arterial blood gas, heart rate, and blood pressure in intensive care patients

Amaç: Yoğun bakım hastalarında pozisyon değişimi vesırt masajının arteryel kan basıncı, kalp atım hızı, arteryel kan gazları üzerindeki etkileri değerlendirildi.Gereç ve Yöntem: Araştırma, klinik prospektif çalışma olarak yapıldı. Araştırma sırasında, sırtüstüpozisyonu verilen 60 hastadan elde edilen veriler,temel değerler olarak kabul edildi ve rastgele hastaların 30’una sol lateral, 30’una sağ lateral pozisyon verildi. Pozisyon değişimleri sonrası 1, 5 ve 15.dakikada arteryel kan gazları, kalp atım hızı, arteryel kan basıncı ölçüldü ve ardından hastalara 1 dakika sırt masajı uygulandı. Masaj sonrasında 1’erdakika aralıklarla 5 dakika kalp atım hızı, arteryelkan basıncı, 1 ve 5. dakikalarda arteryel kan gazları değerleri alındı. Çalışma verileri ortalama±standart sapma olarak verildi. Veriler değerlendirilirkenANOVA, eşleştirilmiş t-testi ve Ki-kare (χ2) testi kullanıldı.Bulgular: Kalp atım hızı sağ lateral pozisyonda arttı,fakat bu artış istatistiksel açıdan anlamlı değildi. Kalpatım hızı aynı pozisyonda sırt masajı sonrası arttı ve buartış istatistiksel anlamlılık gösterdi. Sağ lateral pozisyonda parsiyel oksijen basıncı ve arteryel oksijen satürasyonu değerlerinin arttığı, sol lateral pozisyonda azaldığı görüldü.Sonuç: Çalışma sonuçları, nöroşirürji yoğun bakımhastalarında sağ lateral posizyonun ve sırt masajınınarteryel oksijen satürasyonunu ve parsiyel oksijen basıncını artırdığını gösterdiObjectives: Effects of position change and back mas-sage on arterial blood pressure, heart rate and arterialblood gases in intensive care patients were evaluated.Materials and Methods: The study was carried out as aclinical prospective study. During the research, dataobtained from 60 patients given supine position were con-sidered as baseline values and afterwards, randomlyselected 30 patients were given left and another 30patients were given right lateral position. Arterial bloodgases, heart rate, and arterial blood pressure were mea-sured following the position changes in the 1st, 5th and15th minutes and subsequently a 1 minute back massagewas given. Following the massage, heart rate and arter-ial blood pressure were measured for 5 minutes with 1minute intervals. Arterial blood gases were determined inthe 1st and 5th minutes. Values were expressed asmean±standard deviation. ANOVA, paired samples t-test,and chi-square (χ2) tests were used to analyze the data.Results: Heart rate was increased in right lateral position,though the difference was not statistically significant.Heart rate was also increased following back massage inthe same position and the difference was statistically sig-nificant. It was observed that partial oxygen pressure andarterial oxygen saturation levels were increased in rightlateral position and decreased in left lateral position.Conclusion: The study results show that right positionand back massage increase arterial oxygen saturationand partial oxygen pressure in critically ill patients inneurosurgery intensive care units