Is polysomnographic examination necessary for subjects with diaphragm pathologies?

OBJECTIVES: While respiratory distress is accepted as the only indication for diaphragmatic plication surgery, sleep disorders have been underestimated. In this study, we aimed to detect the sleep disorders that accompany diaphragm pathologies. Specifically, the association of obstructive sleep apnea syndrome with diaphragm eventration and diaphragm paralysis was evaluated. METHODS: This study was performed in Süreyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital between 2014-2016. All patients had symptoms of obstructive sleep apnea (snoring and/or cessation of breath during sleep and/or daytime sleepiness) and underwent diaphragmatic plication via video-assisted mini-thoracotomy. Additionally, all patients underwent pre- and postoperative full-night polysomnography. Pre- and postoperative clinical findings, polysomnography results, Epworth sleepiness scale scores and pulmonary function test results were compared. RESULTS: Twelve patients (7 males) with a mean age of 48 (range, 27-60) years and a mean body mass index of 25 (range, 20-30) kg/m2 were included in the study. Preoperative polysomnography showed obstructive sleep apnea syndrome in 9 of the 12 patients (75%), while 3 of the patients (25%) were regarded as normal. Postoperatively, patient complaints, apnea hypopnea indices, Epworth sleepiness scale scores and pulmonary function test results all demonstrated remarkable improvement. CONCLUSION: All patients suffering from diaphragm pathologies with symptoms should undergo polysomnography, and patients diagnosed with obstructive sleep apnea syndrome should be operated on. In this way, long-term comorbidities of sleep disorders may be prevented

Our Results of Genetic Mutation Analysis in Lung Cancer

Objective: Molecular pathways thought to be effective in carcinogenesis in non-small cell lung cancer (NSCLC), new agents have developed in cancer cells against specific targets on these molecular pathways. We wanted to determine the genetic mutation analyzes of our patients before treatment begins and to see the genetic mutation data of our country. Materials and Methods: The pathology results of 680 patients with NSCLC were evaluated (between 2015-2017). Mutation detection and EGFR mutation analysis were performed by real time PCR method. For gene translocation detection: by using specific a probe to Anaplastic Lymphoma Kinase (ALK) and ROS1 gene molecules, fluorescence in situ hybridization (FISH), ALK and ROS1 gene rearrangement tests were performed. Results: 542 patients had adenocarcinoma (79.7%), and 138 patients (21.3%) had non-adeno associated NSCLC pathology. The EGFR mutation was found in 651 patients, 75 (11.5%) were positive and were mutant. ALK was found to be positive in 11 patients (2.25%) in 488 patients. ROS was evaluated in 393 patients and in 4 patients (1.01%) it was evaluated as positive. Conclusion: The most common mutations for adenocarcinoma occur with EGFR, ALK, and ROS 1 gene rearrangements. Unlike literature data, we found that 3 mutations were higher than the literature in terms of age and smoking rates were higher in cases with EGFR mutation. Genomic examination should be performed in non-adeno NSCLC, especially in non-smokers. With high number of cases and having a mosaic of the country, our study is important to share

Gastroenteropancreatic Neuroendocrine Tumors: Recommendations Of Turkish Multidisciplinary Neuroendocrine Tumor Study Group On Diagnosis, Treatment And Follow-Up

Gastroenteropancreatic neuroendocrine tumors (GEPNETs) are a relatively rare, heterogeneous group of diseases in which important advances have been observed in the diagnosis and treatment as well as in our understanding of the biology and genetics of the disease in recent years. Given the insufficient scientific data available on evidence-based management of GEPNETs and the differences in circumstances in individual countries, a multidisciplinary study group was established to provide guidelines for the management of GEPNETS. This study group consisted of a medical oncologist, endocrinologist, surgeon, pathologist, gastroenterologist, and a nuclear medicine specialist, who aimed to prepare a practical guide in the light of existing scientific data and international guidelines, to be used in common clinical practice.PubMedWoSScopu

Analysis of pregnancy-related death reasons in a province from Turkiye over 20 years

The aim of the present study was to calculate maternal mortality rates by analyzing pregnancy-related death cases in Samsun over the last 20 years, to identify causes of death and preventability, and to examine the change over the years. The Samsun Provincial Health Directorate's pregnancy-related mortality data from 2002 to 2021 were examined retrospectively. Causes of maternal death were classified as direct, indirect, undecided, and incidental. The maternal mortality rate was calculated as the number of maternal deaths per 100,000 live births. Between 2002 and 2021, Samsun experienced a total of 344,324 live births juxtaposed with 79 pregnancy-related deaths. The computed maternal mortality rate is 19.16 per 100,000 live births across the two-decade span. Detailed analysis reveals that 30 deaths (38%) were attributable to direct causes, 31 (39.2%) to indirect causes, 13 (16.5%) were incidental, and 5 (6.3%) remained inconclusive post-autopsy. A breakdown of the direct causes unveils obstetric bleeding as the primary culprit (18.2%), trailed by cardiovascular diseases (13.6%). Moreover, incidental causes, represented by traffic accidents, account for a 7.6% fatality rate. While the observed decline in maternal deaths, particularly from preventable direct causes, over the previous twenty years signifies the efficacy of the instated health policies, the persistent mortality underscores the imperative for ongoing research and strategy recalibration. Identifying fluctuations in causative factors through comparative analyses is pivotal in strategizing future preventive studies on pregnancy-related deaths. The results advocate a pronounced emphasis on continuous professional development to curtail mortalities from avoidable sources, especially postpartum hemorrhage, thereby fortifying existing health policies with reinforced, data-driven interventions. [Med-Science 2023; 12(4.000): 1252-7

Should patients with risk factors be tested for hypersensitivity to contrast media: a prospective study

Previous hypersensitivity reactions to contrast media (CM), atopy, atopic disease, drug allergy, and age (20-29 or > 55) are risk factors for CM hypersensitivity reactions. Our aim was to evaluate whether these risk factors should prompt skin testing for diagnosing CM allergy