Laparoscopic Surgery for Gastric Cancer

In patients with gastric cancer, surgical resection is the only treatment that can offer cure or increase long-term survival. With the accumulation of experience in laparoscopic radical gastrectomy and the progress in surgical instruments, laparoscopic surgery for gastric cancer has gained popularity despite initial concerns regarding safety and oncological adequacy. As a result, laparoscopic technique has been widely applied in gastric cancer. Different meta-analyses showed that laparoscopic procedures are associated with less blood loss but longer operation time. Many studies have reported outcomes of laparoscopic surgery for early gastric cancer, but several authors also have shown that a laparoscopic approach can also be used in cases of advanced gastric cancer. We therefore conducted this study to expand our experience and to evaluate laparoscopic gastrectomy step by step in the light of recent reports while defining key points and surgical technique

Work motivation and related demographic factors in unemployed patients with schizophrenia

Objective: Working rate in patients with schizophrenia is considerably low. Nonetheless, unemployed patients might have desire to work and look for a job. Identifying the reasons underlying the patients' work motivation and related factors can be instructive for the vocational rehabilitation services. The purpose of this study was to determine the reasons for work motivation and to identify the predictors of motivation in unemployed patients with schizophrenia. Methods: Sociodemographic and working life information of 379 unemployed patients with schizophrenia or schizoaffective disorder diagnosed for at least two years was collected from six different centers. The patients were questioned about their desire to work and its reasons. Having desire to work and job seeking behavior together was considered as work motivation. Patients with and without having work motivation were compared regarding to their sociodemographic information and illness characteristics. Logistic regression analysis was conducted to find the factors predicting the work motivation. Results: The participants' mean age was 42, level of education was nine years, duration of illness was 18 years, and majority consisted of males and single patients. It was found that 33% of the patients were motivated to work. While distinct underlying reasons of the work motivation were found as financial needs (45%) and will for independent living (35%), idea of not being able to deal with the requirements of the job (66%) and not receiving social welfare payment (24%) were dominant in patients who weren't motivated to work. The predictors of work motivation were found as male gender (OR=2.0), having a profession (OR=2.0), having work experience after the illness (OR=1.2), level of education (OR=1.1), and duration of illness (OR=0.9). Conclusion: We found that one-third of unemployed patients with schizophrenia have work motivation as an important finding. The patients may feel more comfortable and motivated to work if they would continue to receive social welfare payment after they started a job. It could be concluded patients who have a profession, high level of education, previous job experience, and who are at the early stage of their illness are suitable candidates for the vocational rehabilitation services

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Phenotypic and genotypic spectrum of Turkish patients with isovaleric acidemia

Dursun, Ali/0000-0003-1104-9902; Ozturk-Hismi, Burcu/0000-0001-7146-0248; Ozgul, Riza Koksal/0000-0002-0283-635XWOS: 000343331200010PubMed: 25220015We aim to investigate the genetic basis of isovaleryl-CoA dehydrogenase (IVD) gene mutations and genotype-phenotype correlations in Turkish patients. Accordingly, bi-directional sequencing was performed to screen 26 patients with isovaleric acidemia (IVA). Nine novels (c.145delC, c.234 + 3G > C, c.506_507insT, p.Glu85Gln, p.Met147Val, p.Ala268Val, p.Ile287Met, p.Gly346Asp and p.Arg382Trp) and six previously reported (c.456 + 2T > C, p.Arg21His, p.Arg21Pro, p.Arg363Cys, p.Arg363His p.Glu379Lys) pathogenic mutations were identified. Pathogenicity of the novel mutations was supported using computational programs. No clear genotype-phenotype correlation could be determined. One of the cases with the novel c.234 + 3G > C mutation has portoseptal liver fibrosis, the clinical condition that was first reported for IVA. This study is the first comprehensive report from Turkey related to IVA genetics that provides information about the high number of disease-causing novel mutations. (C) 2014 Elsevier Masson SAS. All rights reserved.[DPT-1206400603]; [TUBITAK-111S217]This study was funded by the DPT-1206400603 and TUBITAK-111S217 projects

Sea cucumber (Holothuria tubulosa Gmelin, 1790) culture under marine fish net cages for potential use in integrated multi-trophic aquaculture (IMTA)

WOS: 000406894400014In this study, integrated aquaculture of Mediterranean sea cucumber species Holothuria tubulosa under finfish net cages was investigated. To evaluate whether H.tubulosa can be reared under net cage farms without additional feed and to compare growth performances, three underwater ranches (10x10m), just below a net cage (A), between the net cages (B) and 750 m away from the net cage systems (K) were set. Fifty sea cucumbers (92.81 +/- 2.29 g) were placed into each research station and growth performances like specific growth rate (SGR) and weight gain were observed for 90 days. SGR of sea cucumbers in stations A, B and K were 0.3 +/- 0.04, 0.22 +/- 0.02 and 0.10 +/- 0.01 %/d, respectively. The highest mean weight gain 31.11 +/- 0.84 g was recorded at station A where the lowest was in station K as 8.89 +/- 0.12 g. Organic carbon and organic material amount of research stations significantly affected the final mean weights of sea cucumbers where the highest growth was determined at the stations A and B. The results suggest that integrated multi-trophic aquaculture (IMTA) systems combined with finfish and sea cucumber H. tubulosa under net cages would provide by-products to aquaculture farms without an extra feed costs in the Mediterranean Sea.Ege University Research FundsEge University [03BIL021]This study was granted by Ege University Research Funds (03BIL021). Authors would like to thank marine cage farm owner Gurler Muhtaroglu for his contribution

Sea cucumber (<i>Holothuria tubulosa</i> Gmelin, 1790) culture under marine fish net cages for potential use in integrated multi-trophic aquaculture (IMTA)

749-756In this study, integrated aquaculture of Mediterranean sea cucumber species Holothuria tubulosa under finfish net cages was investigated. To evaluate whether H.tubulosa can be reared under net cage farms without additional feed and to compare growth performances, three underwater ranches (10x10m), just below a net cage (A), between the net cages (B) and 750 m away from the net cage systems (K) were set. Fifty sea cucumbers (92.81±2.29 g) were placed into each research station and growth performances like specific growth rate (SGR) and weight gain were observed for 90 days. SGR of sea cucumbers in stations A, B and K were 0.32±0.04, 0.22±0.02 and 0.10±0.01 %/d, respectively. The highest mean weight gain 31.11±0.84 g was recorded at station A where the lowest was in station K as 8.89±0.12 g. Organic carbon and organic material amount of research stations significantly affected the final mean weights of sea cucumbers where the highest growth was determined at the stations A and B. The results suggest that integrated multi-trophic aquaculture (IMTA) systems combined with finfish and sea cucumber H. tubulosa under net cages would provide by-products to aquaculture farms without an extra feed costs in the Mediterranean Sea

The relation between cervical and thoracal disc herniations and multiple sclerosis plaques: a retrospective review

The aim of the study is the evaluation cervical and thoracal disc herniations are predisposant factor to the formation and activation of plaques formation of relapsing remitting (R-R ) type multiple sclerosis (MS) patients. We performed a retrospective study on R-R type MS diagnosed patients who also had cervical and thoracal disc herniations. 185 cervical and 136 thoracic in total 321 MR images of 104 (42 men, 62 women) MS patients with R-R type were evaluated retrogradly. When we evaluate the association between cervical or thoracal disc herniation and MS plaques we determined the same localization of cervical herniation and MS plaques was statistically significant. In conclusion, cervical and thoracic disc herniations may contribute to distrupion of blood brain barrier by generating microtraumas and this may lead to MS plaque formation. Therefore, early and effective treatment of MS patients having disc compression is crucial for preventing from sequels and for providing a better life quality. [Med-Science 2017; 6(4.000): 643-645