Substance Use Characteristics and Attitudes of Students in a Faculty of Health Sciences

Amaç: Bir Sağlık Bilimleri Fakültesinde okuyan öğrencilerin madde kullanım özelliklerini ve madde kullanımı ile ilgili damgalayıcı tutumlarını belirlemektir. Yöntem: Çalışma tanımlayıcı tiptedir. Evren 1154 öğrenciden, örneklem 271 öğrenciden oluşmuştur. Veriler bilgi toplama formu ve Alkol ve Madde Bağımlılığı Damgalayıcı Tutumlar Ölçeği ile toplanmıştır. Bulgular: Öğrencilerin %79,3'ü kadın, yaş ortalaması 20,84±1,58 idi. Öğrencilerin %8,9’u sigara, %5,2’si alkol ve bir öğrenci de madde kullandığını ifade etti. Alkol ve sigara içen öğrenciler, başlama nedeni olarak en çok arkadaş ortamının etkilediğini belirttiler. Bu öğrencilerin %59,4’ü sigaraya, %64,3’ü ise alkole 17 yaş ve üzerinde başladığını belirtti. Öğrencilerin %42,4’ü madde kullanımıyla ilgili bilgilerinin yetersiz olduğunu ve üniversitede bu konuda aktiviteler yapılırsa %14,8’inin bu aktivitelere gönüllü olarak destek verebileceklerini ifade ettiler. Öğrencilerin Alkol ve Madde Bağımlılığı Damgalayıcı Tutumlar ölçek puanı ile yaş, cinsiyet ve okudukları bölüm arasında istatistiksel olarak anlamlı fark bulunmazken, sınıflar arasında istatistiksel olarak anlamlı bir fark olduğu ve sınıflar arttıkça damgalayıcı tutumların arttığı görüldü. Sonuçlar: Alkol ve sigara kullanımına başlamada öğrencilerin arkadaş ortamından etkilendikleri ve bu maddelere başlamalarının üniversite yıllarında olduğu belirlendi. Madde kullanımı ile ilgili dördüncü sınıf öğrencilerinin daha fazla damgalayıcı tutum içinde oldukları söylenebilir.Objective: The objective is to assess substance use characteristics of students attending to a Faculty of Health Sciences and their stigmatizing attitude to substance use. Methodology: The study is of descriptive type. The universe consists of 1,154 students and the sample size is 271 students. Data were collected by using the form “Scale of Stigmatizing Attitudes in Alcohol and Substance Addiction.” Findings: 79.3% of students were women and their average age was 20.84±1.58. Of responding students, 8.9% stated that they smoke, 5.2% take alcohol and 1 student said he uses substance. Students who smoke and have alcohol state that they started these as a result of their circle of friends. 59.4% of smokers and 64.3% of alcohol users started these after age 17. 42.4% of students say their information about substance use is inadequate and 14.8% say they will voluntarily support if there are activities in the university in this regard. No statistically significant relationship was found between students’ scores in Scale of Stigmatizing Attitudes in Alcohol and Substance Addiction and their ages, gender and departments they are attending to. However, grade levels in the school make statistically significant difference as stigmatizing attitudes increase as grade levels get higher. Conclusion: ıt was found that smoking and alcohol use start in university years under the influence of friends. It can be said that stigmatizing attitude to substance use is adopted more widely by senior level students

First-line treatment of patients with HER2-positive metastatic gastric and gastroesophageal junction cancer

Fluoropyrimidine+cisplatin/oxaliplatin+trastuzumab therapy is recommended for the first-line treatment of HER2-positive metastatic gastric adenocarcinoma. However, there is no comprehensive study on which platinum-based treatment should be preferred. This study aimed to compare the treatment response and survival characteristics of patients with HER2-positive metastatic gastric or gastroesophageal junction (GEJ) cancer who received fluorouracil, oxaliplatin, and leucovorin (mFOLFOX)+trastuzumab or cisplatin and fluorouracil (CF)+trastuzumab as first-line therapy. It was a multicenter, retrospective study of the Turkish Oncology Group, which included 243 patients from 21 oncology centers. There were 113 patients in the mFOLFOX+trastuzumab arm and 130 patients in the CF+trastuzumab arm. The median age was 62 years in the mFOLFOX+trastuzumab arm and 61 years in the CF+trastuzumab arm (P = 0.495). 81.4% of patients in the mFOLFOX+trastuzumab arm and 83.1% in the CF+trastuzumab arm had gastric tumor localization (P = 0.735). The median progression-free survival (PFS) was significantly higher in the mFOLFOX+trastuzumab arm (9.4 months vs. 7.3 months, P = 0.024). The median overall survival (OS) was similar in both groups (18.4 months vs. 15.1 months, P = 0.640). Maintenance trastuzumab was continued after chemotherapy in 101 patients. In this subgroup, the median OS was 23.3 months and the median PFS was 13.3 months. In conclusion, mFOLFOX+trastuzumab is similar to CF+trastuzumab in terms of the median OS, but it is more effective in terms of the median PFS in the first-line treatment of HER2-positive metastatic gastric and GEJ cancer. The choice of treatment should be made by considering the prominent toxicity findings of the chemotherapy regimens

Patient Safety during Propofol Sedation before and after Implementation of Capnography Monitoring

Endoscopic procedures are routinely applied to cancer screening programs and surveillance. The preferred technique is usually deep sedation with propofol being a convenient agent allowing for a quicker patient recovery while maintaining a similar safety profile compared to traditional agents. However, adverse events, including respiratory depression and consequent undesirable cardiovascular side effects, may occur. The goal of this work is to evaluate the patient safety impact of adding capnography during endoscopic procedures under deep propofol sedation. Data were retrospectively collected from patients undergoing deep, procedural sedation for gastrointestinal (GI) endoscopy in October 2019 to January 2021 in a single Turkish university hospital. Included in the analysis were all adult patients classified by the American Society of Anesthesiologists (ASA) as I–IV, who were scheduled for GI endoscopy utilizing propofol alone or in combination. Data on 1840 patients were collected, of whom 1610 (730 pre- and 880 post-capnography implemention) met inclusion criteria. The primary outcome was a change in the composite incidence of mild oxygen desaturation (SpO2 75–90% for 2 60 s), bradycardia (25% from baseline). Without capnography, on average, 7.5 events of the primary endpoint were observed per 100 procedures and 2.9 with additional capnography monitoring (p < 0.001). A significant reduction was observed for mild oxygen desaturation, with a resulting odds ratio of 0.25 (95% CI 0.14 to 0.46). ASA I patients had the highest difference in combined incidence of any oxygen desaturation of 5.85% in the pre-capnography group and 0.64% in the post-capnography group. Although procedural sedation using propofol is not associated with severe adverse events, the incidence of composite adverse events could be reduced with the addition of capnography monitoring

La Responsabilidad Social y los Valores Universitarios en la Formación Profesional de la UAEMex

Décimo Congreso Internaciona

The effect of intra-articular levobupivacaine on shoulder cartilage at different doses - experimental study

Abstract Background and objectives: In this study it was aimed to examine the histological and morphometric effects on cartilage structure of intra-articular application of levobupivacaine to the shoulder joint. Methods: In twenty New Zealand adult male rabbits, 35 shoulders were used for the study and prepared in 5 groups of 7. These groups were defined as Groups L1, L2, L3 and L4 which were right shoulders administered with 0.25% and 0.5% levobupivacaine, Group C which were left shoulders as the control group and Groups S1 and S2 which were left shoulders administered with 0.9% saline. On the 2nd and 15th days the animals were killed, the glenohumeral joints were evaluated macroscopically then cartilage samples were taken. These samples were evaluated with Mankin score, and histomorphometrically by measuring the thickness of the cartilage between the superficial cartilage layer and the tidemark and the thickness of calcified cartilage between the tidemark and the subchondral bone. Results: Macroscopically, on the 15th day the joint fluid was seen to have reduced in all the groups. After microscopic evaluation, the highest Mankin score (mean: 3.14 ± 2.1/14) was in the L4 group (15th day 0.5% levobupivacaine) and was found to be statistically significant (p < 0.05). No statistically significant difference was determined between the other groups. Conclusions: Histologically, as the highest Mankin score was in the L4 group, this indicates that in a single intra-articular injection of levobupivacaine a low concentration should be selected. Level of evidence: Level 5, animal study

Predictive and Prognostic Factors in Ovarian and Uterine Carcinosarcomas.

BACKGROUND: Prognostic factors and the standard treatment approach for gynaecological carcinosarcomas have not yet been clearly defined. Although carcinosarcomas are more aggressive than pure epithelial tumours, they are treated similarly. Serous/clear cell and endometrioid components may be predictive factors for the efficacy of adjuvant chemotherapy (CT) or radiotherapy (RT) or RT in patients with uterine and ovarian carcinosarcomas. Heterologous carcinosarcomas may benefit more from adjuvant CT. AIMS: We aimed to define the prognostic and predictive factors associated with treatment options in ovarian (OCS) and uterine carcinosarcoma (UCS). STUDY DESIGN: Retrospective cross-sectional study. METHODS: We retrospectively reviewed the medical records of patients with ovarian and uterine carcinosarcoma from 2000 to 2013, and 127 women were included in this study (24 ovarian and 103 uterine). Patients admitted to seventeen oncology centres in Turkey between 2000 and December 2013 with a histologically proven diagnosis of uterine carcinosarcoma with FIGO 2009 stage I-III and patients with sufficient data obtained from well-kept medical records were included in this study. Stage IV tumours were excluded. The patient records were retrospectively reviewed. Data from 104 patients were evaluated for this study. RESULTS: Age (≥70 years) was a poor prognostic factor for UCS (p=0.036). Pelvic±para aortic lymph node dissection did not affect overall survival (OS) (p=0.35). Macroscopic residual disease was related with OS (p<0.01). The median OS was significantly longer in stage I-II patients than stage III patients (p=0.03). Adjuvant treatment improved OS (p=0.013). Adjuvant radiotherapy tended to increase the median OS (p=0.075). However, this tendency was observed in UCS (p=0.08) rather than OCS (p=0.6).Adjuvant chemotherapy had no effect on OS (p=0.15).Adjuvant radiotherapy significantly prolonged the median OS in patients with endometrioid component (p=0.034). A serous/clear cell component was a negative prognostic factor (p=0.035). Patients with serous/clear cell histology for whom adjuvant chemotherapy was applied had significantly longer OS (p=0.019), and there was no beneficial effect of adjuvant radiotherapy (p=0.4). Adjuvant chemotherapy was effective in heterologous tumours (p=0.026). In multivariate analysis, the stage and chemotherapy were prognostic factors for all patients. Age was an independent prognostic factor for UCS. However, serous/clear cell histology and radiotherapy tended to be significant prognostic factors. CONCLUSION: The primary location, the histological type of sarcomatous and the epithelial component may be predictive factors for the efficacy of chemotherapy or radiotherapy in UCS and OCS

Predictive and Prognostic Factors in Ovarian and Uterine Carcinosarcomas.

Prognostic factors and the standard treatment approach for gynaecological carcinosarcomas have not yet been clearly defined. Although carcinosarcomas are more aggressive than pure epithelial tumours, they are treated similarly. Serous/clear cell and endometrioid components may be predictive factors for the efficacy of adjuvant chemotherapy (CT) or radiotherapy (RT) or RT in patients with uterine and ovarian carcinosarcomas. Heterologous carcinosarcomas may benefit more from adjuvant CT