Center In Turkey Research Articles

Evaluation of quality of life scores and family impact scales in pediatric patients with alopecia areata: a cross-sectional cohort study.

There are a limited number of studies evaluating the effects of alopecia areata (AA) on the health-related quality of life (HRQoL) of pediatric patients and their families. This study aimed to assess the HRQoL of pediatric patients with AA and their parents. This single-center cross-sectional cohort study included 72 pediatric patients diagnosed with AA. The study was conducted between December 2020 and December 2021 in the dermatology department of a single tertiary center in Turkey. The HRQoL index of the pediatric patients was assessed with the Children's Dermatology Life Quality Index (CDLQI). At the same time, their parents, who were primarily involved in the disease process, were evaluated using the Dermatological Family Impact Scale (DeFIS). An ordinal logistic regression model was used to detect predictors for CDLQI severity. The mean ± SD CDLQI of the pediatric patients who participated in our study was 8.4 ± 5.3, corresponding to moderate impairment. The highest impairment in CDLQI was observed in the symptoms and feelings domain, while the slightest impairment was observed in the domain of personal relationships (P < 0.001). There was a statistically significant positive correlation between the Severity of Alopecia Tool (SALT) score and all CDLQI domains, and the most substantial relationship was with the leisure domain (r = 0.78, P < 0.001). DeFIS scores of female patients were substantially higher than males (25.3 ± 8.6 vs. 17.6 ± 9, P = 0.001). Our study supports that AA is a disease that significantly impacts the HRQoL of affected children and their families.

Comparative Analysis of Transoral Endoscopic Parathyroidectomy Vestibular Approach and Focused Open Surgery for Primary Hyperparathyroidism Treatment: A Single Center Experience.

BACKGROUND Primary hyperparathyroidism is one of the most common endocrine disorders, for which the definitive treatment is surgical parathyroidectomy. Generally, surgical exploration is performed as open focused neck surgery. The vestibular route is a new approach to minimally invasive endoscopic parathyroidectomy. This retrospective study from a single center in Turkey aimed to compare surgical outcomes from the transoral endoscopic vestibular approach (TOEPVA) vs direct open parathyroidectomy in 57 patients. MATERIAL AND METHODS Our study included data from 57 patients. TOEPVA was performed in 20 of these patients who did not want a cervical scar, and focused surgery was performed in the remaining 37 patients. The variables we analyzed were size, volume, and localization of the adenoma, operative time, presence of bleeding, presence of the recurrent laryngeal nerve damage, preoperative, short-term, and long-term postoperative PTH levels, use of drain, presence of postoperative hypocalcemia, and short-term and long-term calcium levels. RESULTS No laryngeal nerve and mental nerve damage was observed in either group. The mean operative time in focused open surgery was 80.54±33.1 min, while the mean operative time in TOEPVA was 128.21±30.88 (p: 0.794) min. The mean hospitalization period of patients who underwent open surgery was 3.29±1.9 days, while the mean discharge days of patients who underwent endoscopic surgery was 2.40±1.2. (p>0.05). CONCLUSIONS TOEPVA is a safe method in patients who underwent parthyroid surgery to avoid cervical scarring.

Emergency medical service use at a pediatric center in Turkey, during the COVID-19 pandemic period.

This study aimed to evaluate aspects of pediatric patients presenting to a hospital in Turkey via emergency ambulance services, including incidence of visits to the hospital, acuity of illness and most common diagnoses, during the one-year period before and after the onset of the coronavrrus dsease 2019 (COVID-19) pandemic. This was a retrospective and single center analysis of children, transported by Emergency Medical Services to the Emergency Department (ED) of a children's hospital in Turkey, between 10 March 2019 and 11 March 2021. Percentage of high acuity group (68.1% vs.76.9%) during pandemic period was significantly lower than prepandemic period (p < 0.001). On the contrary, the percentage of patients using emergency ambulance service with a low level of acuity increased during the pandemic period compared to the prepandemic period (31.9% vs. 23.1%) (p < 0.001). A significant decrease was observed in the cases of lower respiratory tract infections, febrile status epilepticus and excessive alcohol use during the pandemic period. No significant differences were found hospitalizations requiring PICU and mortality in ED during the pandemic period. During the COVID-19 pandemic; also, a decrease in admissions was observed for those with high-risk conditions. On the contrary, an increase was detected in patients with low acuity levels. Efforts should be made to ensure access to safe and quality emergency care during the pandemic.

Evaluation of late effects during a 21-year follow-up of pediatric Hodgkin lymphoma survivors: Experience of a pediatric cancer center in Turkey, as a developing country model.

Long-term survivors of Hodgkin lymphoma (HL) are at risk of developing a range of late effects, with a second malignant neoplasm and cardiovascular diseases being the leading causes of death in these patients. The present study aims to evaluate the late side effects in children with HL. Out of 53 HL patients, we assessed the long-term effects of childhood HL survivors (HLSs; n = 50) diagnosed between 1998 and 2019. Patient data related to chronic health conditions, and sociodemographic characteristics were compared with their siblings ( n = 56). The cumulative overall survival (OS) at 1, 5, and 10 years from diagnosis was 98.1 ± 1.9%, 93.3 ± 3.8%, and 93.3 ± 3.8%, respectively. Groups of HLSs and their siblings were matched according to age and gender. Compared with siblings, survivors had will be changed as 'a higher frequency of nephrotoxicity ( P = 0.02)', cardiotoxicity ( P = 0.12), thyroid dysfunction ( P = 0.001), health care service usage ( P < 0.01), limitation of physical function ( P = 0.01), and pulmonary disease ( P = 0.01). The control group of siblings had a higher incidence of marital status ( P < 0.01), parenthood ( P = 0.01), and smoking habit ( P = 0.03). Thyroid dysfunction was associated with neck radiotherapy ( P < 0.01). No secondary neoplasm was detected. In relapsed, refractory setting ( n = 10), autologous transplantation ( n = 9) is performed after a complete remission. Brentuximab vedotin with or without bendamustine and rituximab is also used in selected patients. Increased number of chronic health conditions and social problems point to the significance of long-term follow-up of HLSs. We are currently preparing a survivorship guideline appropriate for Turkey's conditions. Renal, heart, pulmonary impairment, thyroid dysfunction, limitation in physical functioning, and deterioration in social status (marriage, having children, education).

Factors Influencing Anxiety Levels in Oncology Patients: A Study on the Impact of Earthquakes.

This study aims to explore the multifaceted factors influencing anxiety levels in oncology patients, with a specific focus on the impact of earthquakes in the context of Turkey. Our objective is to identify and understand sociodemographic, clinical, and lifestyle determinants associated with anxiety in cancer patients, examining how traumatic events, such as earthquakes, contribute to heightened anxiety levels. A cross-sectional study was conducted, involving 149 oncology patients undergoing treatment at two prominent oncology centers in Turkey. The study collected comprehensive sociodemographic information and assessed anxiety levels using the Beck Anxiety Scale. The dataset was analyzed using SPSS 20.0(IBM Corp., Armonk, NY), employing a range of statistical methods including descriptive statistics, independent t-tests, Mann-Whitney U tests, and Chi-square tests. The findings underscore several factors significantly linked to anxiety levels in oncology patients. Notably, women, younger patients (age <65), and individuals with specific cancer types exhibited higher anxiety levels. Elevated anxiety was also associated with compromised physical functioning, experiences of earthquakes, irregular sleep patterns, dietary habits, fatigue, and the use of antidepressants. This study provides insights into the intricate interplay of factors influencing anxiety levels in oncology patients. Understanding these determinants is paramount for tailoring effective psychosocial support and interventions. The results underscore the need for holistic approaches to enhance the overall quality of life for cancer patients. Gender, age, cancer type, physical well-being, lifestyle choices, and exposure to trauma all play pivotal roles in influencing anxiety levels. These findings hold practical implications for the development and implementation of targeted psychosocial interventions aimed at improving anxiety management and overall well-being for oncology patients.

Electronic Health Record Adoption in Oral and Dental Health Centres in Turkey

The digitalisation studies in public hospitals in Turkey started with the Health Transformation Program in 2003. The Ministry of Health has been measuring the dissemination of meaningful usage and adoption of electronic health record (EHR) using Electronic Medical Record Adoption Model (EMRAM) and Outpatient Electronic Medical Record Adoption Model (O-EMRAM). Using a comprehensive survey, our study intends to measure the stage of EHR adoption in oral and dental health centres (ODHCs) providing primary healthcare services in Turkey. The results obtained were classified by basic and comprehensive EHR functions and benchmarked against the studies addressing EHR adoption in primary healthcare institutions of other countries. In 2021, 167 ODHCs/oral and dental health hospitals (ODHHs) actively operating in Turkey completed the O-EMRAM survey. The data obtained from the survey results were analysed with QlikView Personal Edition. The availability and prevalence of medical information systems and EHR functions and their use were measured. It is observed that 59 (40.7%) of ODHCs/ODHHs have comprehensive EHR functions, while the remaining 86 (59.3%) have basic EHR functions. Under these circumstances, it can be stated that all ODHCs/ODHHs in Turkey use at least basic EHR functions. All ODHCs/ODHHs in Turkey have at least basic EHR functions. The integration of e-prescription, electronic authorisation system and e-Pulse used throughout Turkey and Health Information Management System Society (HIMSS) used in ODHCs/ODHHs can be listed as one of the decisive factors in this result. ODHCs/ODHHs still have a long way to go in adopting EHR, but the current circumstances are also promising. It is considered that this study will serve as a baseline for future measurements and produce a notable result for decision-makers.

Hope and psychological resilience in primary caregivers of patients with a chronic mental illness followed in a community mental health center

PurposeThe aim of this study is to examine hope and psychological resilience in primary caregivers of patients with a chronic mental illness. Design and methodsThe descriptive study was conducted on 297 caregivers in community mental health centers in Turkey. Data were collected using the Introductory Information Form, Dispositional Hope Scale and the Resilience Scale for Adults. FindingsHope and psychological resilience of primary caregivers of patients with a chronic mental illness were moderate. To sociodemographic and caregiver characteristics; caregivers who are over 40 years old, lost his/her spouse, low education level, housewife or retired, unemployed, who evaluated their incomes low, mother, living in the same house with the patient, caring for ten years or more, caring for another patient and not getting help in care had lower hope and resilience levels. Compared to patients with a diagnosis of bipolar disorder, caregivers of patients with schizophrenia had lower hope and psychological resilience levels. ConclusionsPrimary caregivers of patients with a chronic mental illness should be supported in terms of hope and psychological resilience.

Demographic distributions and clinical results of assisted reproduction techniques in Turkey in 2019: a descriptive survey.

The aim of this study was to describe characteristics and outcomes of assisted reproductive technology (ART) cycles performed in 2019 in Turkey. One-hundred and sixty-five ART centers in Turkey were invited to submit data. The survey was sent to center directors via e-mail with anonymous links by Qualtrics™. The survey involved questions about their patient characteristics, clinical practices, and outcomes. Forty-one (24.8%) centers responded to e-mails, and data gathered from 25 centers was included in the analyses. In 25 centers, 18,127 fresh or frozen transfers were carried out during the study period, of which 7796 (43.0%) were fresh and the rest were either frozen (45.2%) or embryo transfers (ET) with preimplantation genetic testing (PGT) (11.8%). The live birth rate per ET was as 30.6%, 40.1%, and 50.7% in fresh, frozen and PGT cycles, respectively. A single embryo was transferred in 65.3% of all transfers and singleton live births comprised 86.1% of all deliveries. For cycles with intrauterine insemination, 1407 were started in 2019, and 195 clinical pregnancies, 150 live births with 19 multiple pregnancies occurred. A total of 1513 ART cycles were initiated for foreign patients. Russia (29.6%), Germany (7.4%), Iraq (4.6%), Uzbekistan (3.1%), and Syria (1.4%) were the top five countries with most patients coming to Turkey for ART. The survey results are in parallel with the reports of international institutions and organizations. With repeated editions, the data collected with annual surveys can be used to inform ART practices in the coming years.

Effect of HER2/CEP17 ratio on survival in metastatic HER2-positive gastric cancer, multicenter study.

HER2-positive metastatic gastric cancer is still a highly fatal disease despite advances. We aimed to investigate the relationship between HER2/CEP17 ratio and survival in patients with HER2-positive metastatic gastric cancer. A total of 99 patients from 8 different centers in Turkey were included in the study. Patients with HER2-positive metastatic gastric cancer and whose HER2/CEP17 ratio was examined were included in the study. Patients were divided into two groups according to HER2/CEP17 values, and survival analysis was performed. The median age was 64 (24-83) years. There were 74 (74.8%) male and 25 (25.2%) female patients. OS in the high HER2/CEP17 ratio group was 21.97months (95% CI: 16.36-27.58), and in the low ratio group was 16.17months (95% CI: 10.95-21.38) (p = 0.015). OS was 17.7months (95% CI: 7.02-28.37) in the high HER2 gene copy number group and 10.13months (5.55-14.71) in the group with low copy number (p = 0.03). PFS was 10.94months (95% CI: 7.55-14.33) in the group with high HER2 gene copy number and 7.56months (4.62-10.49) in the low copy number group (p = 0.06). Patients with both high HER2 gene amplification and high HER2/CEP17 ratio had better OS. The PFS of the group with high HER2 gene amplification was also better. To our knowledge, this is the first study in the literature showing that the HER2/CEP17 ratio affects survival in patients with metastatic gastric cancer.

Determination of Naphthalene Concentration in Honey a New Method using by HS-GC/MS (Headspace-Gas Chromatography/Mass Spectrometry)

Honey is seen by people as a very significant food. It is included in diets and used for the treatment of many diseases. However, contamination of honey, which is a source of healing, with harmful components from the outside makes honey harmful. Pesticides are known to be detected in honey. These pests are transmitted to honey by environmental conditions or incorrect beekeeping practices. Naphthalene is used by beekeepers to prevent mothballing of honeycombs or honey contaminated with honey due to environmental reasons. Naphthalene, which has carcinogenic properties, also causes different diseases. Therefore, the concentration of naphthalene in honey should not exceed a certain limit. For the determination of this, many different analysis methods are developed and applied.&#x0D; In this study, the naphthalene concentration of honey from Bingöl province and its districts, one of the important beekeeping centers in Turkey, was determined by a new HS-GC/MS method that does not require sample preparation. No naphthalene concentration was detected in eight different honey samples. The fact that naphthalene concentration was not detected in honeys from Bingöl province indicates that beekeepers do not use naphthalene and that naphthalene is not contaminated by environmental factors.

The clinical features, treatment and prognosis of neutropenic fever and Coronavirus disease 2019 results of the multicentre teos study

This multicentre (22 centres in Turkey) retrospective cohort study aimed to assess the clinical outcomes of patients with neutropenic fever and SARS-CoV-2 positivity. Study period was 15 March 2020–15 August 2021. A total of 170 cases (58 female, aged 59 ± 15.5 years) that fulfilled the inclusion criteria were included in the study. One-month mortality rate (OMM) was 44.8%. The logistic regression analysis showed the following significant variables for the mentioned dependent variables: (i) achieving PCR negativity: receiving a maximum of 5 days of favipiravir (p = 0.005, OR 5.166, 95% CI 1.639–16.280); (ii) need for ICU: receiving glycopeptide therapy at any time during the COVID-19/FEN episode (p = 0.001, OR 6.566, 95% CI 2.137–20.172), the need for mechanical ventilation (p < 0.001, OR 62.042, 95% CI 9.528–404.011); (iii) need for mechanical ventilation: failure to recover from neutropenia (p < 0.001, OR 17.869, 95% CI 3.592–88.907), receiving tocilizumab therapy (p = 0.028, OR 32.227, 95% CI 1.469–707.053), septic shock (p = 0.001, OR 15.4 96% CI 3.164–75.897), and the need for ICU (p < 0.001, OR 91.818, 95% CI 15.360–548.873), (iv) OMM: [mechanical ventilation (p = 0.001, OR 19.041, 95% CI 3.229–112.286) and septic shock (p = 0.010, OR 5.589,95% CI 1.509–20.700)]. Although it includes a relatively limited number of patients, our findings suggest that COVID-19 and FEN are associated with significant mortality and morbidity.

Retrospective evaluation of 130 cases with kawasaki disease follow-up in a tertiary care center in Turkey between 1999 and 2019: a 20-year experience

ABSTRACT Objectives Kawasaki disease (KD), which is a medium vessel vasculitis, is common in Asian countries and is the most common cause of childhood-acquired heart diseases in developed countries. However, disease course and epidemiological data are limited in non-Asian developing countries like ours. We aimed to evaluate the clinical features and prognosis of patients with KD in our country and ethnicity, one of the referee centers of our country. Methods Patients with KD in our center for the last 20 years in the pre-COVID-19 pandemic era were included in the study. The clinical and laboratory findings, treatments, and follow-up findings were reviewed retrospectively in different age groups. Results Of the 130 patients, 82 (63%) were male. The median age at diagnosis was 2.97 years (2 months-11.5 years). Thirty-six (27.7%) patients were diagnosed with incomplete KD, and there was no significant laboratory difference between incomplete KD and complete KD patients. Thirty-three (25.3%) patients had coronary artery lesions (CAL), and it persisted in only 3 of 33 patients. One of 15 patients with IVIG resistance had CAL. The independent risk factors were days of illness at initial IVIG administration for CAL (p = 0.013, OR [95%CI] = 1.20 [1.04–1.38]) and low hemoglobin (p = 0.003, OR [95%CI] = 0.51 [0.33–0.79]) and low sodium for IVIG resistance (p = 0.012, OR [95%CI] = 0.81[0.69–0.95]). Conclusions The rate of CAL is approximately three times higher in our results than in the Japanese data in recent years. We showed that the time of IVIG administration is the most critical factor for preventing CAL. Wide-ranging studies are needed to decently predict the disease process according to the age and region of patients.

Evaluation of in vitro activity of ceftaroline, ceftobiprole and their combination with trimethoprim/sulfamethoxazole against MRSA isolates: a two center study

There is an increasing need for new synergistic antimicrobial combinations against multidrug-resistant bacteria. Our objective was to evaluate the activity of ceftaroline, ceftobiprole and their combination with trimethoprim/sulfamethoxazole against methicillin-resistant Staphylococcus aureus (MRSA) isolates recovered at two centers in Turkey. Activities of ceftaroline and ceftobiprole were tested against 100 MRSA isolates using gradient diffusion method. Activities of ceftaroline and ceftobiprole in combination with trimethoprim/sulfamethoxazole against 20 selected isolates (including all isolates that were non-susceptible to ceftaroline or ceftobiprole, and randomly selected isolates) were investigated using MIC:MIC ratio method. Antimicrobial interactions were interpreted using the fractional inhibitory concentration (FIC) index. The MIC50/MIC90 values for ceftaroline and ceftobiprole were 0.75/1 and 1/1.5 mg/L, respectively. Ceftaroline and ceftobiprole susceptibility rates among 100 MRSA isolates were 94% and 96%, respectively. Ceftaroline, ceftobiprole and trimethoprim/sulfamethoxazole MICs of isolates were not increased when ceftaroline or ceftobiprole was combined with trimethoprim/sulfamethoxazole. Ceftobiprole- trimethoprim/sulfamethoxazole combination demonstrated additivity against 35%, whereas ceftaroline- trimethoprim/sulfamethoxazole combination demonstrated additivity against 10% of 20 MRSA isolates. The remaining interactions for MRSA isolates were indifference. Three (75%) of four ceftobiprole-resistant isolates became susceptible to ceftobiprole after adding trimethoprim/sulfamethoxazole. None of the ceftaroline non-susceptible isolates became susceptible to ceftaroline after adding trimethoprim/sulfamethoxazole. Ceftobiprole- trimethoprim/sulfamethoxazole combination may be a better treatment option than ceftaroline- trimethoprim/sulfamethoxazole combination for MRSA infections. Clinical studies are needed to confirm the results of our in vitro study.

Ocular manifestations of granulomatosis with polyangiitis: report from a tertiary eye care center.

To report demographic characteristics and ophthalmological manifestations of patients with granulomatosis with polyangiitis (GPA) in a tertiary eye care center in Turkey. Medical records of patients with GPA-related ocular manifestations evaluated between 2013 and 2023 were included. Demographic and clinical characteristics of the patients including nature of systemic involvement, ophthalmologic symptoms and signs, laboratory investigations and treatment modality were reviewed. Twelve eyes of 10 patients (5 female/5 male) were included. The mean age was 57.2 ± 12.2 (35-71) years. Five (50%) patients were already diagnosed with GPA. Ocular involvement was the first manifestation of GPA in 3 patients. The remaining 2 patients had simultaneous systemic and ocular symptoms at presentation. Conjunctival hyperemia (9 eyes) and pain (7 eyes) were the most frequent presenting symptoms followed by blurred vision (3 eyes). The frequencies of ocular manifestations were as follows:episcleritis (3 eyes), isolated peripheral ulcerative keratitis (PUK) (3 eyes), scleritis (3 eyes), simultaneous PUK and scleritis (2 eyes) and periorbital mass (1 eye). Ophthalmological manifestations can be the initial findings in GPA. Since GPA can affect different structures of the eye, it sometimes might be challenging for ophthalmologists. Therefore, it is crucial for ophthalmologists to be well-informed about GPA-related ocular findings and to have a high index of suspicion for GPA. Although PUK associated with scleritis is highly suggestive for GPA, isolated cases of PUK or scleritis can be seen in GPA. Therefore, it is important to adopt a multidisciplinary approach, consider GPA in differential diagnosis, and benefit from accurate diagnostic tests.

A Retrospective Study to Compare the Glasgow Coma Score, Pediatric Trauma Score, and Injury Severity Score and Outcomes in 118 Pediatric Trauma Patients at a Single Emergency Center in Turkey.

BACKGROUND The main causes of accidental trauma in children include road traffic accidents (RTAs) and falling from height (FFH). Rapid and accurate assessment of severity of injury is required to guide effective management. This retrospective study aimed to compare the Glasgow Coma Score (GCS), Pediatric Trauma Score (PTS), and Injury Severity Score (ISS) and outcomes for 118 pediatric trauma patients at a single Emergency Department (ED) in Turkey. MATERIAL AND METHODS Patients admitted to Ankara City Hospital due to high-energy trauma between November 1, 2019 and April 30, 2020 were analyzed retrospectively. Data for 118 patients with trauma by major mechanisms, aged 0-17, were collected. Demographic characteristics, trauma-related characteristics, outcomes, and GCS, PTS, and ISS values were compared. It was examined whether there was a relationship between trauma severity and prognosis. In this context, trauma severity was defined by these scores. RESULTS Of the 118 admitted patients, 66 (55.9%) were discharged from the ED, 33 (28%) were transferred to the intensive care unit (ICU), and 19 (16.1%) were admitted to non-ICU departments in the hospital. With hospitalization, patients with thoracic trauma (P<0.001; OR 11.1; 95% CI 3.0-40) and patients with abdominal trauma (P=0.003; OR 4.0; 95% CI 1.5-10.8) were discharged significantly less frequently than patients with other types of trauma. Patients with low ISS (P<0.001) and high PTS (P<0.001) were discharged more often. The relationship between diagnosis and hospitalization was significant (P<0.001). CONCLUSIONS RTA and FFH are the leading trauma mechanisms in children. Boys experience more trauma. ISS and PTS provide accurate predictions of severe and poor prognosis in pediatric trauma cases.

ABO and RhD blood groups and their relationship with diseases: A retrospective study.

To retrospectively evaluate the distribution of ABO and RhD blood groups and their relationship with diseases. The retrospective study was carried out in Bursa Uludag University Family Health Center in Turkey between 1-28 February, 2023. The data of individuals who were registered with the Family Health Center and whose blood types were known were evaluated retrospectively. Blood group type, sociodemographic findings, existing diseases, allergies, and genetic disease conditions were obtained. P-values below 0.05 were considered statistically significant. Analysis were made in the SPSS 25.0 program. A total of 3834 people, 1935 male (50.5%) and 1899 female (49.5%) participated in the study. The mean age of the individuals was 26.45±10.45 years. About 75.8 percent of the participants were university students, 6.3 percent were health workers, and 17.9 percent were from other occupational groups. The rates of blood groups were determined as O Rh D+ at 33.5%, AB Rh D+ at 26.9%, A Rh D+ at 14.9%, AB Rh D- at 7.7%, B Rh D+ at 7%, O Rh D- at 4.6%, B Rh D- at 3.2% and A Rh D- at 2.2%. It was determined that the O Rh D- group had a higher rate of genetic disease than the other groups (p=0.01). It was determined that the O Rh D+ blood group was found more frequently in our region's population than in other groups. This different result depending on the A Rh D+ blood group, which is the most common throughout the country may have reflected the influence of different geographical regions and ethnic characteristics due to the students in our population. In addition, the results regarding the relationships between blood groups and occupation, genetics, existing disease, presence of allergies, and visual defects in the eye are important.

Investigation of prognostic factors for non-sentinel lymph node metastasis in patients undergoing sentinel lymph node biopsy for cutaneous malignant melanoma: Experience from a reference centre in Turkey

BackgroundIn the light of the results of recent randomised controlled trials regarding the role of nodal observation and completion lymph node dissection (CLND), studies from different populations are needed. The aim of our study was to present our experience with sentinel lymph node biopsy (SLNB) and CLND and the clinical and histopathological factors associated with a positive non-sentinel node. MethodsIn this single-centre, retrospective study, we reviewed histopathological reports of patients with primary cutaneous melanoma who underwent SLNB and CLND over a period of 7 years. The primary outcomes were the positivity rates of SLNBs and CLNDs. Secondary outcomes were metastatic tumour burden in positive sentinel nodes and presence of perinodal invasion. ResultsAmong the 110 participants who underwent SLNB (53 females, 57 males), the mean Breslow thickness of the primary tumour was 4.1 (0.3–41) mm. Ulceration appeared in 62.7% of lesions. The SLNBs were positive in 38 patients (34.5%), with 35 (92.1%) undergoing CLND, among which 9 (25.7%) showed metaNBstasis. Positive SLNB was linked to a higher Breslow thickness (p = 0.022), whereas CLND results lacked such an association (p = 0.76). Perinodal invasion (p = 0.006) and sentinel lymph node metastasis exceeding 1 mm (p = 0.017) was associated with a higher probability of non-sentinel node metastasis. ConclusionTo adapt the results of the new cohort study on SLNB and melanoma to different populations, studies with different patient groups highlighting the problems and suggested solutions are needed.

Effect of Complex Decongestive Therapy on Quality of Life and Physical Parameters in Head and Neck Lymphedema.

To assess the effect of complex decongestive therapy treatment (CDT) on quality of life, neck disability, cervical range of motion, and facial and neck lymphedema size using specific anatomical landmark points. This prospective study was conducted in a tertiary cancer center in Turkey. Thirty patients included in the study were treated with CDT for 21 days. The patients were evaluated before and after CDT with MD Anderson Cancer Center Head and Neck Lymphedema (MDACC HNC) staging system, The Neck Disability Index, European Organization for Research and Treatment of Cancer Quality of Life 30 (EORTC-QLOC30), Facial Composite score and Neck Circumferences, cervical range of motion. Median follow-up was 7.2 months. After treatment of 30 patients significant cognitive function, emotional function, and social function (p < 0.001). After CDT treatment, the quality of life sub-parameters of EORTC QLQ-C30 showed significant improvement (p < 0.001). The facial composite score and neck circumferences indices showed significant improvement (p < 0.001). A decrease of 2% or more in the facial composite score and neck circumferences was observed in all patients participating in the study. There have been few studies on the effectiveness of CDT on the EORTC QLQ-C30, facial composite score, and neck circumferences in head and neck lymphedema. In patients with head and neck lymphedema following head and neck cancer, our study demonstrated the positive effects of complex decongestive therapy (CDT) on neck disability, range of motion, quality of life, and facial and neck lymphedema tissue size. 4 Laryngoscope, 134:3152-3157, 2024.

Comprehensive evaluation of patients with primary hyperoxaluria type 1: A nationwide study.

Primary hyperoxaluria type 1 (PH1) is characterized by increased endogenous oxalate production and deposition as calcium oxalate crystals. The main manifestations are nephrocalcinosis/nephrolithiasis, causing impaired kidney function. We aimed to evaluate the clinical characteristics and overall outcomes of paediatric PH1 patients in Turkey. This is a nationwide, multicentre, retrospective study evaluating all available paediatric PH1 patients from 15 different paediatric nephrology centres in Turkey. Detailed patient data was collected which included demographic, clinical and laboratory features. Patients were classified according to their age and characteristics at presentation: patients presenting in the first year of life with nephrocalcinosis/nephrolithiasis (infantile oxalosis, Group 1), cases with recurrent nephrolithiasis diagnosed during childhood (childhood-onset PH1, Group 2), and asymptomatic children diagnosed with family screening (Group 3). Forty-eight patients had a mutation consistent with PH1. The most common mutation was c.971_972delTG (25%). Infantile oxalosis patients had more advanced chronic kidney disease (CKD) or kidney failure necessitating dialysis (76.9% vs. 45.5%). These patients had much worse clinical course and mortality rates seemed to be higher (23.1% vs. 13.6%). Patients with fatal outcomes were the ones with significant comorbidities, especially with cardiovascular involvement. Patients in Group 3 were followed with better outcomes, with no kidney failure or mortality. PH1 is not an isolated kidney disease but a systemic disease. Family screening helps to preserve kidney function and prevent systemic complications. Despite all efforts made with traditional treatment methods including transplantation, our results show devastating outcomes or mortality.

Effects of the environmental factors in call centre interiors: a case study

Environmental factors in workspaces affect employee productivity and satisfaction, particularly in call centres. One of the most challenging issues in contemporary offices is overcoming the problems of concentration on work, despite adverse effects such as insufficient lighting, inappropriate acoustics, or inadequate ventilation. The challenges increase in open-plan solutions. This paper presents a case study from Turkey that elaborates on strategies to improve environmental performance in call centres. It is inspired by a questionnaire conducted among employees of a call centre, identifying existing design lacks. Based on the results, acoustic quality calculations of the physical workspace follow, and initial computing outcomes reveal that the conditions do not meet the standards for call centres. The authors propose strategies to improve acoustic performance in the workspace and apply them to a virtual model. Results reveal that the proposed solutions allow for meeting the standards. Based on the findings, the authors suggest several other strategies for improving the physical environmental quality of the place, thus forming a guideline for the architectural design of call centres. The study derives information from a specific case and context to propose universally applicable solutions. It fills a gap in the literature as it exemplifies the characteristics of call centres in Turkey, which have not been studied before.