Distinct Postsurgical Management in Young and Elderly Breast Cancer Patients Results in Equal Survival Rates

Background: Although breast cancer (BC) is one of the most common malignant diseases in women, the majority of the studies describing the characteristics of BC in elderly patients have been limited to survival assessments or tumor features, without using younger BC patients as a reference group. The aim of our study was to describe and compare tumor characteristics and management patterns in elderly versus younger breast cancer patients in Turkey. Materials and Methods: We retrospectively analyzed 152 patients with invasive breast cancer who underwent surgery in our institution between 2002 and 2012. Patients were divided into 2 groups according to age at the time of diagnosis. Results: There were 62 patients in the elderly group (>= 65 years) and 90 patients in the younger group (0.001). There were no significant differences regarding histology, localization, lymph node involvement, or types of surgical procedures between the 2 groups. Comorbidities were more common in elderly patients (p<0.001). In addition, elderly patients were more likely to receive hormonal therapy (p<0.001) and less likely to receive radiotherapy (p=0.08) and chemotherapy (p=0.003). There was no difference in survival and locoregional recurrence rates between the groups. Conclusions: The results of this study demonstrate that breast cancer in elderly patients has more favorable tumor features, warranting less aggressive treatment regimens after surgery

A domestic violence course for medical students: A study on its effectiveness

International health institutions emphasize the necessity of including the topic of domestic violence which is accepted as a health problem worldwide, into the training of physicians. The fact that physicians should diagnose domestic violence victims who over the years were either neglected or overlooked is also mentioned. The present study aims to measure the effectiveness of the interactive domestic violence course given to Dokuz Eylul University Faculty of Medicine (DEUFM) Year V students, with tests implemented before and after the course. The same students were given the same test during Year VI (internship). The students' average knowledge scores were found respectively as follows: pretest 78.66 +/- 10.54, second test 94.13 +/- 3.95 and third test 89.65 +/- 7.48. There was a statistically significant difference between tests' average scores. It was observed that, after the course, 4 out of 19 students (21.1%) changed their answers from "no" to "yes" for the question "Have you ever been a victim of physical domestic violence?" A statistically significant difference was found between pre-course answers and the after course answers given to this question. This study showed that the course on domestic violence increased students' knowledge level and awareness on this issue. Considering that average knowledge level will decrease over time and aiming to improve future physicians' approach to domestic violence cases, addition of other interactive educational methods to Year V's course program and proposal of an advanced training session to Year VI's curriculum are being planned

Determination of advanced life support knowledge level of residents in a Turkish university hospital

The aim of the study was to determine the advanced cardiac life support (ACLS) knowledge level of residents and related factors in the departments of Anesthesiology, Emergency Medicine, Internal Medicine, and Cardiology in a university hospital. For this cross-sectional study, a total of 20 multiple-choice questions were prepared concerning several different topics, including: fatal dysrhythmias, oxygenation, ventilation and airway control, asystole, and pulseless electrical activity. Questions were given to residents before their periodic training meetings and collected in 30 min. There were 101 of 120 residents from four clinical departments (participation rate 84%) tested. Average point total and standard deviations of all residents were 66.3 :L 17 out of 100 points. On a departmental basis, statistically significant differences were found in the knowledge level of residents (Emergency Medicine: 86.2 8.2, Cardiology: 66.7 12.9, Anesthesiology: 59.3 16.2, Internal Medicine: 56.1 13.5, F: 28.6, p < 0.0001). The factors that affect ACLS knowledge level of residents were "postgraduate ACLS training..... awareness of guidelines," and "resuscitation frequency." Postgraduate training and the frequency of ACLS practice seem to increase the ACLS knowledge level of residents. The present study emphasizes the necessity for a standardized systematic postgraduate ACLS training program for the residents of related medical disciplines. Further studies with larger groups are needed to investigate theoretical knowledge, resuscitation skill competency, and related factors. (c) 2008 Elsevier Inc

Management of Idiopathic Granulomatous Mastitis Diagnosed by Core Biopsy: A Retrospective Multicenter Study

Idiopathic granulomatous mastitis (IGM) is a rare, benign, chronic inflammatory condition of the breast, which usually mimics breast carcinoma. The aim of this study was to analyze the clinical features of IGM by identifying a more reliable diagnostic protocol, and evaluating the treatment methods and patient outcomes on follow-up. We performed a retrospective analysis of 46 patients diagnosed with IGM and managed by the same surgical team between 1999 and 2011, at three high-volume hospitals. The median age of the patients was 33years. The most common symptom was painful breast mass (n=39), followed by abscess (n=11). All patients underwent ultrasonography (USG). Mammography (MG) and magnetic resonance imaging (MRI) were also performed in 20 patients (43%) and 17 patients (37%), respectively. The mean size of the lesions was 32.8 +/- 8.8mm and ranged from 15 to 50mm. Preoperative diagnosis of IGM was established by core needle biopsy (CNB) under USG guidance. Eighteen patients (39%) underwent complete excision of the lesion and 25 (54%) were treated with steroids. Three patients treated with steroids subsequently underwent local excision. The mean follow-up period was 35.4 +/- 30.9months. Eight patients (17%) developed disease recurrence; three of these were successfully treated with steroids, one with surgery, and four with both steroids and surgery. CNB in conjunction with high diagnostic accuracy has a significant role in distinctive diagnosis of IGM and hence, is useful for treatment planning. Treatment can be designated according to the extent and the severity of the disease, and the patient's general health and treatment preferences. Patients with IGM must be closely followed up due to the frequency of disease recurrence

Perceptions of first and third year medical students on self-study and reporting processes of problem-based learning

<p>Abstract</p> <p>Background</p> <p>The objective of this study is to investigate the perceptions of first and third year medical students on self-study and reporting processes of Problem-based Learning (PBL) sessions and their usage of learning resources.</p> <p>Methods</p> <p>The questionnaire applied to the students consisted of; questions about students' perceptions on searching and preparing phases of the self-study process, the breadth and depth of discussion during reporting phase and the usage of learning resources.</p> <p>Results</p> <p>First-year students spent more time for self-study and more highly rated the depth of discussion compared to third-year students. The searching and preparing phases of the self-study process were considered as statistically important factors strongly influencing the breadth and depth of discussion during the reporting phase. The effect of extensiveness of searching on the depth of discussion was negative among the first-year students, and positive among third-year students.</p> <p>Conclusions</p> <p>The relative shortness of third-year students' self-study periods can be related to their mental weariness, decreased motivation or first-year students' slowness in accessing appropriate resources. The third-year students' more frequent use of textbooks may be due to the improvement of their abilities in reaching relevant learning resources. The findings implied that the increase in students' PBL experience paralleled the development of their discussion skills using different learning resources.</p