Level of Information About Radiation Among Medical Staff Working in Operating Rooms With Fluoroscopy

DergiPark: 379005tmsjAims: The aim of this study is to determine the level of information regarding radiation safety and the side effects related to the use of fluoroscopy among a group of teaching assistants, research assistants, medical students, nurses, technicians and caretakers working at Trakya University Health Center for Medical Research and Practice.Methods: A descriptive, cross-sectional survey study was conducted from December 2014 to April 2015 at Trakya University Health Center for Medical Research and Practice. The questionnaire consisted of 24 questions and was applied to 53 people. Responses regarding radiation safety and the side effects of fluoroscopy were analyzed in Statistical Package for the Social Sciences (SPSS) 20.0 using descriptive statistics including frequencies and percentages.Results: 98.08% of the participants responded “yes” to the question ”Do you think fluoroscopy is hazardous to health?”. On the other hand, the results showed that only 32.69% of the participants wore lead apron and 32.77% used thyroid shields in every operation. 88.46% of the participants reported that they would like to attend a training regarding fluoroscopy and radiation safety.Conclusion: The results indicated that the operating room staff of Trakya University Health Center for Medical Research and Practice does not possess adequate knowledge regarding radiation safet

Effects of ethylenediaminetetraacetic acid and sodium hypochlorite on the bond strength of bonding agents to pulp chamber lateral walls

AbstractBackground/purposeThe purposes of this in vitro study were to determine the microtensile bond strengths of four different dentin adhesive materials placed in pulp chamber walls, and to test the effects of 5% sodium hypochlorite (NaOCl) and 17% ethylenediaminetetraacetic acid (EDTA) pretreatments on resin dentin bond strengths.Materials and methodsRecently extracted human third molars were selected. The teeth were divided into four groups. Specimens in each group were treated as follows: irrigated with distilled water; irrigated with EDTA for 5 minutes; irrigated with sodium hypochlorite for 5 minutes; and irrigated with EDTA for 5 minutes followed by NaOCl for 5 minutes. Treated specimens were dried, bonded with a total-etching adhesive, two self-etching adhesives, or a one-bottle self-etching adhesive system. After the bonding procedure and composite restoration, teeth were sectioned, and 15 dentin sticks were obtained. Microtensile testing was performed, and scanning electron micrographs were taken of each irrigated group.ResultsIn the control group, the one-bottle self-etching adhesive system showed statistically higher bond strength values. EDTA irrigation did not affect the bond strength except for the total-etching adhesive. NaOCl significantly reduced the bond strengths of all adhesives. The EDTA and NaOCl combination did not show a statistically significant reduction in bond strengths of the adhesives to pulpal dentin.ConclusionThere was a reduction in bond strengths of all adhesive systems used to test pulp chamber lateral walls after endodontic irrigation solutions were used

Effect of standard versus patient-targeted in-patient education on patients' anxiety about self-care after discharge from cardiovascular surgery clinics

We compared standard and patient-targeted in-patient education in terms of their effect on patients' anxiety. One hundred and ninety-eight patients who were hospitalised for coronary artery bypass surgery were given standard education (group 1) or individualised education (group 2) on the management of their healthcare after discharge. Patients in group 2 were assessed on the patient learning needs scale and were given education according to their individual needs. The level of anxiety was measured by the state-trait anxiety inventory. Anxiety scores were significantly lower in group 2 than group 1 after education (p < 0.001). While state anxiety did not change after education in group 1 (p = 0272), it decreased significantly in group 2 (p < 0.001). For cardiovascular surgery patients, patient-targeted in-patient education was more effective than standard education in decreasing anxiety levels, therefore the content of the education should be individualised according to the patient's particular needs

Metastatik küçük hücre dışı akciğer kanseri hastalarının ikinci veya ileri sıra tedavisinde immünoterapinin gerçek yaşam analizi

Background: Immunotherapy agents such as atezolizumab and nivolumab are appropriate option for non-small cell lung cancer (NSCLC) accounts in the absence of driver mutation, regardless of PDL-1 expression in second and later line setting. Herein we aimed to evaluate the efficacy and safety of immunotherapy for the second and later line settings in metastatic NSCLC patients as a single center experience. Methods: Totally, 37 patients with metastatic NSCLC who received atezolizumab or nivolumab in the second or later lines were included. Clinicopathological features of patients and survival outcomes were analyzed. The safety profile and the factors that may predict survival were also evaluated. Results: Twenty-nine (78.4%) of patients were men and 8 of patients (21.6%) were woman with median age of 61 years (range:42-80). Atezolizumab was preferred in 22 (59.5%) of these patients and nivolumab in 15 (40.5%) of them. Objective response rate was 35.1%. At a median follow up of 22.5 months, median progression-free survival (PFS) was 4.7 months, median overall survival (OS) was 24.1 months. Univariate analysis for PFS revealed that gender (p=0.03), age (p=0.005), the presence of brain metastasis (p=0.02), PDL-1 status >1% (p=0.035), ECOG PS (p=0.04) and the good response to frontline treatment (p=0.015) were found to be significant prognostic indicators. It also showed that the presence of brain metastasis (p=0.03), PDL-1 status >1% (p=0.027), good response to frontline treatment (p=0.022) and atezolizumab preference (p=0.018) were prognostic factors for OS. Conclusion: Our real-life analysis indicated that atezolizumab and nivolumab improved survivals with good safety profile in second and later lines treatment of metastatic NSCLC patients.Atezolizumab ve nivolumab, driver mutasyon yokluğunda, küçük hücre dışı akciğer kanserinin (KHDAK) ikinci ve sonraki basamak tedavisinde PDL-1 durumundan bağımsız olarak kullanılabilen iyi bir seçenektir. Burada, metastatik KHDAK’li hastalarda ikinci ve sonraki sıra tedavide immünoterapinin etkinliğini ve güvenliğini değerlendirmeyi tek Merkez deneyimi olarak amaçladık. Gereç ve yöntem: Çalışmaya, ikinci veya sonraki sıralarda atezolizumab veya nivolumab alan toplam 37 metastatik KHDAK hastası dahil edildi. Hastaların klinikopatolojik özellikleri ve sağkalım sonuçları analiz edildi. Güvenlik profili ve sağkalımı öngörebilecek faktörler değerlendirildi. Bulgular: Hastaların 29'u (%78.4) erkek, 8'i (% 21.6) kadın, ortanca yaş 61 (aralık: 42-80) idi. Bu hastaların 22'sinde (%59.5) atezolizumab, 15'inde (% 40.5) nivolumab tercih edilmişdi. Objektif yanıt oranı %35.1 idi. Medyan 22.5 aylık takipte, medyan progresyonsuz sağkalım 4.7 (PSK) ay iken, medyan genel sağkalım (OS) 24.1 ay olarak bulundu. PFS için tek değişkenli analizde, cinsiyet (p=0.03), yaş (p=0.005), beyin metastazı varlığı (p=0.02), PDL-1 durumu >%1 (p=0.035), ECOG PS (p=0.04) ve ilk sıra tedaviye iyi yanıt varlığı (p=0.015) anlamlı prognostik göstergeler olarak bulundu. OS için ise, beyin metastazı varlığı (p=0.03), PDL-1 durumu >%1 (p=0.027), ilk sıra tedaviye iyi yanıt varlığı (p=0.022) ve atezolizumab tercihi (p=0.018) prognostik faktörler olarak bulundu. Sonuçlar: Gerçek hayat analizimiz, atezolizumab ve nivolumabın, metastatik KHDAK hastalarının ikinci ve sonraki basamak tedavilerinde iyi güvenlik profili ile sağkalımı iyileştirdiğini gösterdi

Karın ağrılı hastalarda ortalama trombosit hacmi bir belirteç olarak kullanılabilir mi?

Amaç: Kolay elde edilebilirlik ve yaygın kullanım imkanı akut karın ağrılı hastaların erken tanısında biyokimyasal belirteçleri oldukça önemli hale getirmektedir. Bu çalışmada akut karın ağrısı ile acil servise başvurup yatışı yapılan hastalarda ortalama trombosit hacmi MPV ’nin tanısal değerinin araştırılması planlandı. Gereç ve Yöntem: Ocak 2012 -Mart 2013 tarihleri arasında acil servise başvuran 812 hasta ile 45 sağlıklı kişinin kayıtları retrospektif olarak incelendi. Kayıtlardan olguların; yaş, cinsiyet, fizik muayene bulguları, 5.gün MPV, platelet, nötrofil lenfosit oranı, lökosit, C-reaktif protein CRP ile MPV değerleri aralarındaki ilişki incelendi.Bulgular: Çalışmaya alınan hastaların 467’sini %57,5 erkekler, 345’ini %42,5 kadınlar oluşturmuştur. Hastaların yaş ortalamaları 53,09±0,75’dir . Hastaların kesin tanıları incelendiğinde en sık safra kesesi ve koledok patolojileri %18,7 , ikinci sırada nonspesifik karın ağrısı %17,3 , üçüncü ise ileus-volvulus %13,8 idi. Çalışmaya alınan 812 hastanın 5. gün MPV ortalama değeri 8,358±1,046 fL, platelet değerleri ortalama 246,82±91,3 u/L, nötrofil lenfosit oranı ortalama değeri 10,025±12,75 u/L olarak bulundu. Çalışmadaki akut karın ağrılı hasta grubunda giriş MPV değerleri ortalama 7,869±1,071 fL, sağlıklı kontrol grubu MPV değerleri ortalama 8,47±1,058 fL olup, hasta grubunun ortalama MPV düzeyi, sağlıklı bireylerden daha düşüktü. Sonuç: Pankreatit ve ileus-volvulus tanısı alan hastalarda MPV’nin tanıya yardımcı bir belirteç olabileceğini düşünmekteyi

The comparison of local tumor control after microwave ablation, surgical resection and combined treatment for colorectal liver metastases

Aim. We aimed to compare the local therapeutic efficiency of microwave ablation (MWA), surgical resection, and combined treatment, assess the outcomes, and identify predictive factors for local treatment response in colorectal liver metastases (CLMs). Methods. From March 2013 to September 2019, a total of 54 patients with 302 CLMs were enrolled in this retrospective study. Eleven patients (20.4%) were treated with MWA, 9 patients (16.7%) with surgery, and 34 patients (63%) with the combined method. Univariate and multivariate analyses were performed to investigate overall survival (OS) and hepatic progression-free survival (HPFS) using the Cox proportional hazard regression model. The logistic regression analysis was used to identify the predictive factors for the local treatment response. Results. Total treatment response was achieved in 46.3% (n=25) of the patients. Local tumor progression was seen in 7.4% (n=4) of the patients, and the rate of intrahepatic distal recurrence was 46.3% (n=25). There were no significant differences in HPFS and OS between the three groups (p=0.56 and 0.90, respectively). Younger age

Metaproteogenomic analysis of saliva samples from Parkinson's disease patients with cognitive impairment

Cognitive impairment (CI) is very common in patients with Parkinson's Disease (PD) and progressively develops on a spectrum from mild cognitive impairment (PD-MCI) to full dementia (PDD). Identification of PD patients at risk of developing cognitive decline, therefore, is unmet need in the clinic to manage the disease. Previous studies reported that oral microbiota of PD patients was altered even at early stages and poor oral hygiene is associated with dementia. However, data from single modalities are often unable to explain complex chronic diseases in the brain and cannot reliably predict the risk of disease progression. Here, we performed integrative metaproteogenomic characterization of salivary microbiota and tested the hypothesis that biological molecules of saliva and saliva microbiota dynamically shift in association with the progression of cognitive decline and harbor discriminatory key signatures across the spectrum of CI in PD. We recruited a cohort of 115 participants in a multi-center study and employed multi-omics factor analysis (MOFA) to integrate amplicon sequencing and metaproteomic analysis to identify signature taxa and proteins in saliva. Our baseline analyses revealed contrasting interplay between the genus Neisseria and Lactobacillus and Ligilactobacillus genera across the spectrum of CI. The group specific signature profiles enabled us to identify bacterial genera and protein groups associated with CI stages in PD. Our study describes compositional dynamics of saliva across the spectrum of CI in PD and paves the way for developing non-invasive biomarker strategies to predict the risk of CI progression in PD.FEMS Research and Training Gran

Cost-effectiveness of sorafenib for treatment of radioactive iodine (rai)-refractory locally advanced/metastatic differentiated thyroid cancer (dtc) in Turkey

WOS: 000354498503198OBJECTIVES: Sorafenib is the first product approved for treatment of RAI refractory locally advanced/metastatic DTC patients. This study was conducted in order to analyze cost-effectiveness of sorafenib for treatment of patients with RAI refractory locally advanced/metastatic DTC in Turkey. METHODS: A cohort partition model assigning patients to one of three health states according to the proportion of patients who are progression-free, progressed, or dead in each 28-days cycle was adapted to Turkish setting. The incremental cost-effectiveness ratios (ICER) were calculated per quality-adjusted life years (QALYs) and life-years (LYs) gained. Turkish payer’s perspective was taken and time-horizon was set as patient’s lifetime (maximum 30 years). Sorafenib was compared to the best supportive care (BSC) within the model since there are no agents for treatment of patients on this stage of the disease. Essential clinical inputs were derived from DECISION trial and local resource-utilization data were based on expert opinions through an expert panel. Sensitivity of the results was evaluated in terms of key inputs by deterministic oneway and probabilistic sensitivity analyses. All costs were calculated in Turkish Liras (TL) and converted to USD using TL/USD currency rate as 2.2 (mid-2014). RESULTS: Total cost of sorafenib-treated patients is 24,384 USD higher compared to BSC. Besides, sorafenib is associated with increments of 1.29 LYs and 0.80 QALYs compared to BSC. The ICER of sorafenib per LYs and QALYs gained compared to BSC were determined as 18,851 USD and 30,485 USD respectively. One-way sensitivity analysis demonstrated that results are not sensitive to the changes in model inputs and pharmacoeconomic analysis results were validated by probabilistic sensitivity analysis. CONCLUSIONS: Sorafenib is cost-effective for treatment of patients with RAI refractory locally advanced/metastatic DTC compared to BSC with an ICER value below the willingness-to-pay threshold (3-times GDP per capita ─ 32,346 USD) for Turkey

Evaluation of the placenta with relative apparent diffusion coefficient and T2 signal intensity analysis

PURPOSEWe aimed to test the null hypothesis that relative apparent diffusion coefficient (rADC) and relative signal intensity values (rSIHASTE) do not change in the evaluation of placental maturation with advancing gestational age.MATERIALS AND METHODSFifty-six fetuses with diffusion-weighted magnetic resonance imaging (DW-MRI) data were enrolled in this retrospective study. Fetuses were analyzed in three different gestational age groups: group 1, 18–23 weeks; group 2, 24–28 weeks; and group 3, 29–38 weeks. The rADC (mean ADC/ADCglobe) and rSIHASTE values (mean SIHASTE/SIglobe) were obtained. Two radiologists experienced in fetal MRI who were blinded to the patient information reviewed MRI images independently. Kruskal-Wallis Test was used to compare the rADC and rSIHASTE with gestational age groups. The agreement between the two blinded readers was tested using Krippendorff’s alpha ratio.RESULTSBoth placental rADC values and placental rSIHASTE values were not significantly different between the gestational age groups (P = 0.688 and P = 0.280, respectively). rADC and rSIHASTE measurements were reproducible with a good agreement between the two readers (Krippendorff’s alpha ratio was 0.613 and 0.778, respectively).CONCLUSIONThe rADC and rSIHASTE values do not change with advancing gestational age