Chondro-osseous Type Metaplastic Carcinoma of Breast

[Cukurova Med J 2015; 40(4.000): 847-849

Controversies in Polycystic Ovary Syndrome

Polycystic ovarian syndrome (PCOS) is the most common endocrinopathy that affects women from puberty to whole reproductive life. Diagnosis and treatment of PCOS is not clear. Polycystic ovary syndrome is a multisystem disease that involves dermatologist examining patients with clinical hyperandrogenism and/or biochemical signs of hyperandrogenism; gynecologist examines patients with oligo-ovulation or infertility. The management of PCOS should be tailored to each woman’s specific symptoms, fertility-related implications, and metabolic disorders. Pharmacologic treatment is not necessary for all patients with PCOS, also lifestyle changes like exercise, weight loss, and diet are effective for treatment. Lifestyle changes are often recommended as first-line treatment for PCOS to benefit general health. Topical nonhormonal therapies and laser hair removal may be effective for cutaneous symptoms like acne, hirsutism, and androgenetic alopecia in the PCOS population and are useful first-line agents. Some pharmacological agents (anti-androgens) are used to control the dermatological symptoms of hyperandrogenism. Metformin is useful for metabolic and glycemic anomalies and for the treatment of menstrual irregularities, but less effective than antiandrogens for the treatment of both hirsutism and acne. The aim of this study is to talk about unclear topics in PCOS and multidisciplinary approach to patients

Trichotillomania and Traction Alopecia

Trichotillomania and traction alopecia are chronic habitual disorders characterized by repetitive pulling of hair that results in alopecia. They are commonly observed in children and adolescents but may present in adults due to occupational or traditional behavioral patterns. Trichotillomania (hair‐pulling disorder) has been described more than a century ago, but we still have very limited data about its etiology and treatment. It is classified under the obsessive‐compulsive and related disorders along with hoarding disorder, skin‐picking disorder (excoriation) and body dysmorphic disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM‐5; American Psychiatric Association, May 2013). Traction alopecia is defined as loss of hair caused by repetitive or continuous and prolonged tension applied to the hair, usually on the scalp periphery and associated with mechanical traction of hair due to occupational behavioral patterns such as ballerinas or traditional behavioral patterns of hairstyles that cause tension. We aim to overview the clinical and diagnostic features of trichotillomania and traction alopecia and review the therapeutic options of these disorders in this chapter

utjecaj Theranekrona® na aktivnost glukoza-6-fosfat dehidrogenaze u neoštećenim jajnicima štakora i jajnicima štakora s ishemijsko- reperfuzijskom ozljedom

The effect of Theranekron® on rat ovaries was evaluated in healthy and ischemia-reperfusion injury models. The rats were divided into four groups: group 1: control, group 2: Theranekron® (single dose of 0.3 mg/kg intraperitoneally), group 3: torsion + detorsion, and group 4: torsion + detorsion + Theranekron® (single dose 0,3 mg/ kg, intraperitoneally). The ovaries were homogenized by sonication before the analysis and supernatant glucose-6- phosphate dehydrogenase activity, reduced nicotinamide adenine dinucleotide phosphate, reduced glutathione and total protein levels were evaluated spectrophotometrically. Ovary tissues were histologically examined. In group 2, glucose-6-phosphate dehydrogenase activity was significantly reduced (P<0.01) compared to the control group and an increased number of atretic follicles, and hyperaemic and haemorrhagic regions were seen histologically; in group 3, although glucose-6-phosphate dehydrogenase activity was not changed, intense hyperaemia and hemorrhage was observed in the veins of the medulla region and in the cortex. Group 4 showed a decrease in glucose-6-phosphate dehydrogenase activity compared to the control group (P<0.01). Histologically, when compared to group 3, group 4 showed fewer atretic follicles and decreased hyperaemia and hemorrhage in the ovaries, excluding the medulla region. There were no significant differences regarding reduced glutathione and reduced nicotinamide adenine dinucleotide phosphate levels between the groups. The Theranekron® dose applied had some negative effects, such as reduced glucose-6-phosphate dehydrogenase activity, an increased number of atretic follicles, and hyperemia in the corpus luteum and medulla region in intact rat ovaries. Although it reduced glucose-6-phosphate dehydrogenase activity, Theranekron® may have had slight remedial effects on rat ovaries with ischemia-reperfusion injury.Učinak Theranekrona® na jajnike štakora procijenjen je u zdravih jedinki i onih s ishemijsko-reperfuzijskom ozljedom. Štakori su podijeljeni u četiri skupine: prva je skupina bila kontrolna, druga je skupina dobivala Theranekron® (pojedinačna doza od 0,3 mg/kg intraperitonealno), treća je skupina imala torziju i detorziju, a četvrta je skupina imala torziju i detorziju i primala je Theranekron® (pojedinačna doza od 0,3 mg/kg intraperitonealno). Jajnici su homogenizirani sonikacijom prije analize te je spektrofotometrijom istražena aktivnost supernatant glukoza- 6-fosfat dehidrogenaze, smanjenje nikotinamid-adenin-dinukleotid-fosfata, smanjenje glutationa i razina ukupnih proteina. Histološki je analizirano tkivo jajnika. U drugoj skupini aktivnost glukoza-6-fosfat dehidrogenaze bila je znakovito smanjena (P < 0,01) u usporedbi s kontrolnom skupinom. Histološki, ustanovljen povećan broj atretskih folikula te hiperemičnih i hemoragičnih područja. U trećoj skupini, iako aktivnost glukoza-6-fosfat dehidrogenaze nije bila promijenjena, u venama medularne regije i korteksu uočena je jaka hiperemija i hemoragija. Četvrta skupina pokazala je smanjenu aktivnost glukoza-6-fosfat dehidrogenaze u usporedbi s kontrolnom skupinom (P < 0,01). U usporedbi s trećom skupinom, četvrta skupina pokazala je manje atretskih folikula i smanjenu hiperemiju i hemoragiju u jajnicima, osim medularne regije. Nije bilo znakovite razlike s obzirom na smanjene razine glutationa i nikotinamid- adenin-dinukleotid-fosfata među skupinama. Primijenjena doza Theranekrona® imala je neke negativne učinke poput smanjene aktivnosti glukoza-6-fosfat dehidrogenaze, povećanog broja atretskih folikula te hiperemije u žutom tijelu i medularnoj regiji intaktnih jajnika štakora. Iako je smanjio aktivnost glukoza-6-fosfat dehidrogenaze, Theranekron® bi mogao imati i neznatne terapijske učinke na jajnike štakora s ishemijsko-reperfuzijskom ozljedom

Comparison of Sociodemographic and Clinical Characteristics of Patients with Bipolar Disorder with and without Guardianship Decision

Aim:We aimed to compare the sociodemographic and clinical variables of the patients with bipolar disorder (BD), who were required guardianship by Mental Health Hospital’s Health Board.Materials and Methods:This retrospective study consisted of 201 patients with BD-1, aged between 18 and 65 years, who were sent to medical health board in order to prepare a report on whether guardianship was required by the courts. Sociodemographic and clinical variables data form including age, marital status, education, employment, the number of episodes, the history of electroconvulsive therapy (ECT), the type of medication, the number of hospitalization, and the history of suicide were used.Results:One-hundred (49.75%) patients with BD were required guardianship decision (GD). The mean age of the group with GD (43.57±11.53 years) was significantly higher than the group without GD (39.54±10.73 years). There was a significant relationship between GD and marital status and employment. The group with GD had significantly higher number of total and manic episodes, duration of hospitalization, and duration of illness than the group without GD. A significant relationship was found between GD and medical comorbidity, history of ECT, the presence of psychotic Manndelusion, and treatment with antipsychotic, lithium and valproic acid. Paranoid-persecution, reference, and bizarre types of delusion were found to be related to GD.Conclusion:A significant relationship was found between GD and marital status, employment, duration of illness, number and duration of hospitalizations, number of total and manic episodes, medical comorbidity, and history of ECT, presence of psychotic delusions, and type of treatment. Clinicians should be aware of these variables during the decision of guardianship for patients with BD

COVID-19 vaccine hesitancy and Its relationship with illness risk perceptions, affect, worry, and public trust: An online serial cross-sectional survey from Turkey

Objective: A better understanding of public attitudes towards vaccination and recognition of associated factors with vaccine hesitancy or refusal is important regarding the control of the pandemic. Our aim was to analyze the public's attitudes toward COVID-19 vaccines and to identify factors affecting them. Materials and Methods: Data were drawn from the Turkish COVID-19 Snapshot Monitoring, between July-December 2020, a serial online cross-sectional survey. The sample comprised 3888 adult respondents. Attitudes to vaccines and trust were investigated in 3 periods corresponding to the timeline of pandemic-related events in Turkey. Results: In the third period of our study, in parallel with the increase in the spread of COVID-19, vaccine hesitancy/refusal increased significantly from 43.9% to 58.9% (P < .001). The significant predictors of vaccine refusal were female gender, being elder, and conspiracy thinking. Having a chronic illness, worrying more about loved ones and the health system being overloaded were significant predictors of vaccine willingness. Less compliance with preventive measures, less knowledge of prevention, reduced risk perception, and higher perception of media hype were COVID-19 variables that correlated with vaccine refusal. Trust in the Ministry of Health and medical professional organizations (e.g., Turkish Medical Association) was the lowest in the third period and vaccine refusal was significantly related to the decreased trust (P < .001, P = .002). Conclusion: Most respondents (approximately 60%) refused or hesitated to get a COVID-19 vaccine, though acceptability should be monitored when a vaccine becomes available. Health authorities should consider public trust, risk perception, and behavioral factors to improve COVID-19 vaccine acceptability

Behaviors and pandemic-related knowledge, perceptions, worry content, and public trust in a Turkish sample

Background: This study aimed to explore the effect of knowledge, COVID-19-related perceptions, and public trust on protective behaviors in Turkish people. Methods: Data were collected from an online survey (Turkish COVID-19 Snapshot Monitoring) conducted between July 2020 and January 2021. The recommended protective behaviors (hand cleaning, wearing a face mask, and physical distancing) to prevent COVID-19 were examined. The impacts of the following variables on protective behaviors were investigated using logistic regression analysis: knowledge, cognitive and affective risk perception, pandemic-related worry content, public trust, conspiracy thinking, and COVID-19 vaccine willingness. Results: Out of a total of 4210 adult respondents, 13.8% reported nonadherence to protection behavior, and 86.2% reported full adherence. Males and young (aged 18–30 years) people tend to show less adherence. Perceived self-efficacy, susceptibility, and correct knowledge were positively related to more adherence to protective behavior. Perceptual and emotional factors explaining protective behavior were perceived proximity, stress level, and worrying about the relatives who depended on them. Trust in health professionals and vaccine willingness were positive predictors, while conspiracy thinking and acquiring less information (<2, daily) were negative predictors. Unexpectedly, trust in the Ministry of Health showed a weak but negative association with protection behavior. Conclusions: Perceived stress, altruistic worries, and public trust seem to shape protection behaviors in addition to individuals’ knowledge and cognitive risk perception in respondents. Males and young people may have a greater risk for nonadherence. Reliable, transparent, and culture-specific health communication that considers these issues is required

Clinical course of psoriasis patients that discontinued biologics during the COVID-19 pandemic

BackgroundSince psoriasis is a chronic disease, it is not recommended to discontinue the treatment agents used. However, in real life, the treatment of psoriasis patients may be interrupted for various reasons. During the pandemic period, the treatment of many patients was also interrupted. ObjectivesTo evaluate relapse and clinical worsening in psoriasis patients whose biological therapy was interrupted during the pandemic and reveal associated factors. MethodsThe study included patients aged >= 18 years, who were followed up with moderate and severe chronic psoriasis controlled by the last biological agent [Psoriasis Area Severity Index (PASI) 75 response achieved] but had to discontinue their treatment during the pandemic. The patients' demographic and clinical characteristics, clinical course after the discontinuation of these agents, presence of clinical worsening, and relapse were evaluated. Risk factors were analyzed with the logistic regression analysis. ResultsThe study included 169 patients, with a mean age of 47.3 +/- 14.5 (18-87) years. The mean biologics-free time was 18.2 +/- 12.3 (2-56) weeks. Clinical worsening was detected in 41.4% and relapse in 48.5% of the patients. The significant risk factors for clinical worsening and relapse in both univariate and multivariate analyses were alcohol use during the biologics-free period, total time off biologics, and the presence of an additional triggering factor. The use of secukinumab and ustekinumab was found to be a protective factor against clinical worsening in multivariate analyses. ConclusionAs the biologics-free period is prolonged, the likelihood of clinical worsening and relapse increases, therefore, we do not recommend discontinuing biological agents

Tekstil sektöründe Avrupa Birliği IPPC direktifi ile uyum çalışmaları: BAT uygulamaları

TÜBİTAK ÇAYDAG15.01.2008Bu çalışma, Türkiye'de bir tekstil işletmesi için IPPC (Entegre Kirlilik Önleme ve Kontrolü) Direktifi kapsamında "Mevcut En İyi Teknikler"in ilk uygulaması ve değerlendirmesidir. IPPC Direktifi'nin hayata geçirilmesinde rehber olacak bir "en iyi uygulama örneği" tekstil sektörü için geliştirilmiş ve bu kapsamda işletme için "Mevcut En İyi Teknik" ihtiyaçları belirlenmiştir. Sürdürülebilir hammadde ve atık yönetimi için, ilk olarak, üretim süreçlerinin BREF ("Mevcut En İyi Teknikler" Referans) Dokümanı ile detaylı karşılaştırılması yapılmıştır. Su yoğun bir sektör olması sebebiyle, proseslerde geri kullanımı mümkün olabilecek atıksular belirlenip atıksu karakterizasyon çalışmaları yürütülmüştür. Proses atıksularında ve tesisten çıkan toplam atıksuda geri kazanım olanaklarının araştırılması için atıksu yönetim stratejisi oluşturulmuştur. Bu stratejiyle uyumlu olarak, üretim süreçlerinin BREF Tekstil Dokümanı ile detaylı karşılaştırılması yapılmış, gerek atıksuların geri kullanım amaçlı arıtılabilirliği gerekse su kullanımının ve atıksu üretiminin azaltımı üzerine çalışılmıştır. Uygulanabilir BAT önerileri fabrika yetkilileri ile birlikte çalışarak belirlenmiştir. Atıksu yönetimi çalışmalarının yanı sıra, enerji tüketiminin azaltılması, kimyasal değişikliği ve çevresel risk analizi çalışmaları da yürütülmüştür.This study was undertaken as the first application and evaluation of Best Available Techniques (BAT) within the context of the IPPC (Integrated Pollution Prevention and Control) Directive to a textile mill in Turkey. A “best practice example”, which will form a guideline for the implementation of the IPPC Directive, is to be developed for the textile sector; and within this context BAT requirements for the mill were determined. In order to achieve a sustainable resource and waste management; firstly, a detailed screening of the production processes with respect to BREF (BAT Reference) Textile Document was made. Being a water intensive sector, wastewater characterization study was conducted to identify the possible candidate wastewaters to be reused. A wastewater management strategy was adopted to investigate the possible reuse opportunities in the process wastewaters along with the composite mill effluent. In line with this strategy, production processes were analyzed in depth in accordance with the BREF Document not only to treat the generated wastewaters for their possible reuse but also to reduce the amount of water consumption and wastewater generation. Applicable BAT options were determined in cooperation with the mill staff. Besides studies related to wastewater management, minimization of energy consumption, chemical substitution and environmental risk analysis studies were also conducted