Diffusion-Weighted Imaging for the Discrimination of Benign and Malignant Breast Masses; Utility of ADC and Relative ADC

Purpose: To determine the contribution of apparent diffusion coefficient (ADC), and relative ADC (rADC) values to differentiate between benign and malignant breast masses. Materials and Methods: Magnetic resonance imaging (MRI) of the breast with diffusion-weighted imaging (DWI) of patients with benign or malignant breast masses diagnosed either by histopathological findings or by follow-up imaging were evaluated retrospectively. Histopathological analyses were performed for 71 lesions (80.7%) while the remaining were followed up every six months for one year. DWI was performed using b-values of 0 and 1000 sec/mm2, and ADC and rADC were calculated and compared. A receiver operating characteristic (ROC) curve and Youden index were used to evaluate the parameter’s optimal threshold and diagnostic value. Statistical significance was set as p < 0.05. Results: Eighty-eight lesions from a total of 81 patients, aged between 16 and 73 (mean age 42 ± 11.3) years were obtained and evaluated. Pathological results of 34 (38.6%) out of 71 lesions were malignant and 37 lesions (42%) were benign. Seventeen (19.3%) lesions remained stable at one-year follow-up and were accepted as benign breast masses. Mean ADC values of benign and malignant lesions were 1.584 × 10–3mm2/sec and 0.884 x 10–3mm2/sec (p < 0.05), respectively. Sensitivity and specificity of ADC were 88% and 87%, respectively at a cut-off value of 1.04 x 10–3mm2/sec. Mean rADC was 0.931 for benign lesions and 0.557 for malignant lesions (p < 0.05). Sensitivity and specificity were 82% and 83% at a cut-off value of 0.639. No prominent superiority of rADC over ADC is identified in the differentiation of breast masses. Conclusion: ADC and rADC values derived from DWI can be equally useful in clinical setting to differentiate benign from malignant breast masses

Evaluation of nutritional status in pediatric intensive care unit patients: the results of a multicenter, prospective study in Turkey

IntroductionMalnutrition is defined as a pathological condition arising from deficient or imbalanced intake of nutritional elements. Factors such as increasing metabolic demands during the disease course in the hospitalized patients and inadequate calorie intake increase the risk of malnutrition. The aim of the present study is to evaluate nutritional status of patients admitted to pediatric intensive care units (PICU) in Turkey, examine the effect of nutrition on the treatment process and draw attention to the need for regulating nutritional support of patients while continuing existing therapies.Material and MethodIn this prospective multicenter study, the data was collected over a period of one month from PICUs participating in the PICU Nutrition Study Group in Turkey. Anthropometric data of the patients, calorie intake, 90-day mortality, need for mechanical ventilation, length of hospital stay and length of stay in intensive care unit were recorded and the relationship between these parameters was examined.ResultsOf the 614 patients included in the study, malnutrition was detected in 45.4% of the patients. Enteral feeding was initiated in 40.6% (n = 249) of the patients at day one upon admission to the intensive care unit. In the first 48 h, 86.82% (n = 533) of the patients achieved the target calorie intake, and 81.65% (n = 307) of the 376 patients remaining in the intensive care unit achieved the target calorie intake at the end of one week. The risk of mortality decreased with increasing upper mid-arm circumference and triceps skin fold thickness Z-score (OR = 0.871/0.894; p = 0.027/0.024). The risk of mortality was 2.723 times higher in patients who did not achieve the target calorie intake at first 48 h (p = 0.006) and the risk was 3.829 times higher in patients who did not achieve the target calorie intake at the end of one week (p = 0.001). The risk of mortality decreased with increasing triceps skin fold thickness Z-score (OR = 0.894; p = 0.024).ConclusionTimely and appropriate nutritional support in critically ill patients favorably affects the clinical course. The results of the present study suggest that mortality rate is higher in patients who fail to achieve the target calorie intake at first 48 h and day seven of admission to the intensive care unit. The risk of mortality decreases with increasing triceps skin fold thickness Z-score

An Inquiry on application process of EU Erasmus Programme & students' views regarding Erasmus programme of student exchange

In the globalising world, the number of international organizations in education field increases with each passing day as in all the other fields. The most meaningful one among the said organization is Education Programmes of European Union (Demir ve Demir, 2009). The Europe based activity in higher education was changed into a structural frame through Erasmus Programme of Student Exchange as from 1995 and it keeps continueing increasingly today. Erasmus Programme of Student Exchange was formed to increase the quality of higher education in Europe and to give weight to European facet. It provides the exchange of students and educators in Europe encouraging universities to cooperate. (Yagci, Ekinci, Burgaz, Kelecioðlu & Ergene, 2007). The aim of this study is to examine the progress and historical process of Erasmus Programme of Student Exchange in Turkey and to introduce the current situation seeking the views of students who benefit from the programme. In the first part of the study, the aim and formation of Erasmus Programme of Student Exchange and the process of Turkey�s participation in this formation were examined while in the second part of the study, you can find the results of the study in which the views of students who participated in Erasmus Programme of Student Exchange in Canakkale Onsekiz Mart University regarding this exchange programme were examined. The views of students were stated using a half structured form of interview which was developed by Sahin (2007). When looked at the results of the interviews, it is seen that students stated this experience stood out with meeting different cultures, seeing different countries and making new friends. They also stated that they were going to keep their experiences in their future professional life and the program was going to make a positive contribution to their profession. The students participating in the inquiry also indicated that the experience they gained made them to have more self-confidence in themselves, to have a intercultural perspective and it was beneficial to improve their horizon