Duzce University Medical Oncology Practice in COVID-19 Pandemic

The available data about the COVID-19 (SARS-CoV2) pandemic, which emerged in Wuhan, China, and influenced the whole world, has shown that people with chronic diseases such as active cancer, diabetes,chronic respiratory tract, kidney or cardiovascular diseases have higher risk. Cancer patients have suppressed immune systems and are more prone to infections depending on the treatments such as the disease itself, surgery and chemotherapy. Therefore, they are at a higher risk for COVID-19. In this article, we wanted to explain our own practice in the pandemic process, as Diizce University Faculty of Medicine, Department of Medical Oncology.WOS:00058856330001

Prognostic & predictive factors for planning adjuvant chemotherapy of early-stage breast cancer

Breast cancer is a heterogeneous disease and may present with different clinical and biological characteristics. At present, breast cancer is divided into molecular subgroups besides its histopathological classification. Decision for adjuvant chemotherapy is made based on not only histopathological characteristics but also molecular and genomic characteristics using indices, guidelines and calculators in early-stage breast cancer. Making a treatment plan through all these prognostic and predictive methods according to risk categories aims at preventing unnecessary or useless treatments. In this review, an attempt to make a general assessment of prognostic and predictive methods is made which may be used for planning individualized therapy and also the comments of the guidelines used by the oncologists worldwide on these methods

Type and Level of Anxiety Affects the Perception of Pain During Bone Marrow Biopsy

Objective: Bone marrow aspiration and biopsy (BMAB) is an essential tool for diagnosis of hematological disorders. The most frequent complaint after BMAB is pain but the severity of this pain is described very different among patients. We investigated factors predicting this pain focusing on the role of state and trait anxiety. Methods: One hundred and ten adult patients undergoing BMAB, were informed adequately and assessed with The State-Trait Anxiety Inventory (STAI) before the procedure. In this Likert-type inventory, State Anxiety Scale evaluates the current state of anxiety, asking how respondents feel at that moment. The Trait Anxiety Scale evaluates relatively stable aspects of anxiety proneness, including general states of confidence, calmness, and security. After the biopsy, pain was measured with visual analog scale. Results: Most of the patients (71.8%) described mild pain but moderate to severe pain were significantly more frequent in both high state and trait anxiety groups. Pain severity had a positive but weak correlation with trait anxiety but not with state anxiety. The described pain level was associated with older age but was not with indication of biopsy, performance status, comorbidities or previous BMAB experiences. Conclusions: Results of our study made us thought that a good communication with the patient and talking about possible outcomes days before procedure might play a role reducing his or her anxiety but because age and trait anxiety cannot be changed by using fast acting anxiolytic drugs, advantage of premedication with anxiolytics in order of reducing pain, would be limited.WOS:00068972950000

A Rare Case of Rectal Cancer With Endometrial Metastasis: A Case Report

Background:Colorectal cancer (CRC) is ranked third in the world in incidence and cancer-related mortality. In this case report, we aimed to present a case of rectum cancer with endometrial metastasis which is rare in the literatüre.Case report:On October, 2014; a 62-year-old woman was admitted to outer clinic with a complaint of rectal bleeding. In the colonoscopy, an ulcerovegetan mass was detected and biopsied. Biopsy pathology was reported as adenocarcinoma and the patient underwent a low anterior resection due to diagnosis of rectal cancer. The adjuvant therapy of the patient was completed and the patient was transferred to our clinic for follow-up. After adjuvant therapy, PET/CT examination was performed due to the fact that the sizes of nodules showed 20% increase according to RECIST criteria by thoracic tomography performed three months intervals. In PET / CT, hipermetabolic foci were detected in nodular lesions in the lung and within the uterine corpus. The patient's lung tru-cut biopsy and biopsy of the endometrial cavity was reported adenocarcinoma.Conclusion:Approximately 20% of patients with CRC have distant metastasis at the time of diagnosis. In general, CRCs metastasize to regional lymph nodes, liver, lung, and less frequently to the bone, brain, and peritoneal cavity. The uterus, which is mostly composed of smooth muscle tissue, is rarely described as the metastatic region of extragenital cancers. Endometrium metastases of CRCs are cases in a limited number in the literature. We emphasize this case because of its rarity and beacuse of importance of differatial diagnosis of primary and metastatic tumors of the uterus

Presentation of Diffuse Large B-Cell Lymphoma Relapse as a Penile Mass

WOS: 000392282500022PubMed: 27095140

An unexpected challenging airway: Urticaria factitia caused difficult mask ventilation and tracheal intubation

Yorulmaz, Ilknur Suidiye/0000-0002-1441-6360WOS: 000480372100047PubMed: 30981179

Let us save the brain with cerebral oximeter: Two case reports

In the neonates, tracheal atresia and tracheoesophageal fistula (TEF) surgery may result in hemodynamic instabilization, leading to cerebral perfusion insufficiency due to the retraction of the pulmonary vessels and truncus brachiocephalicus. We represented one male and one female neonates which were performed thoracoscopic primary repair of TEF through right thoracotomy at the 3th and 4th postpartum day. Anesthesia was induced using sodium thiopental (5 mg/kg), fentanyl 4 mcg, and rocuronium (0.5 mg/kg) given through intravenous route. Sevoflurane 2% and 50% O2in air were used for the maintenance therapy. During the right lung compression to expose posterior esophagus, no value was observed on the pulse oximeter (PO) probe placed on the right hand, and radial artery was not palpated. At the same time, oxygen saturation was observed as 96%–97% on the left foot probe. As the right cerebral oximeter values (rSO2) were rapidly decreased to 31%, the lung compression was ceased. Right pulse oximeter and right rSO2measurements return to the baseline levels. For the second case - different from the first case -both left and right rSO2was rapidly decreased to 40% levels and return to the baseline levels after was removed the retractors. Right PO and right and left cerebral rSO2values returned to baseline immediately when the retractor compression was ended During the operations involving the great vessels in neonates, cerebral perfusion could be preserved using cerebral oximeter. Cerebral oximeter is more efficient than pulse oximeter for detecting cerebral tissue oxygenation and could be helpful to minimize neuronal damage in the neonates

Relation of resistin levels with C-reactve protein, homocysteine and uric acid in smokers and non-smokers

Background: The association between C-reactive protein, homocysteine, uric acid levels and cardiovascular risk have been debated for decades. Resistin is a newly discovered adipocyte derived cytokine. Smoking besides its effect on atherosclerosis, is shown to alter adipocytokine levels. Bearing in mind, these complex relationship of resistin with smoking, C-reactive protein, homocysteine and uric acid, we planned to investigate the association of resistin and these cardiovascular risk factors in smoker and non-smoker subjects. Methods: We conducted a cross-sectional randomized study including 52 smoking and 33 non-smoking men. After making comparisons of C-reactive protein, homocysteine, uric acid and resistin between the two groups, we classified the subjects according to their insulin resistance and body mass and made again the comparisons.. Results: Resistin levels were higher in smokers than in non-smokers (p<0.001) and also in insulin resistant than in non-insulin resistant smokers (p<0.05). Resistin levels were indifferent in non-smokers as insulin resistance was concerned and in smoker or non-smokers as body mass index was concerned. As all subjects were grouped based on homeostasis model assesment index and body mass index, neither C-reactive protein nor homocysteine and uric acid levels differred. Conclusions: We found that smoking may have influence on resistin levels and in smokers, insulin resistance is related to resistin levels, but in smoker and non-smokers body mass may not have any association with resistin. Resistin also may not have a role in C-reactive protein, homocysteine and uric acid levels both in smokers and non-smokers

Progesterone receptor status in determining the prognosis of estrogen receptor positive/HER2 negative breast carcinoma patients

Purpose: To evaluate the impact of progesterone receptor (PR) status on estrogen receptor (ER)-positive and HER2-negative breast cancer