Ali Osman Sonmez Oncology Hospital

Amaç: Bu çalışmada metastatik meme kanseri tanılı hastalarda uygulanan parenteral ve oral tedavi yöntemlerinin depresyon,anksiyete, uyku kalitesi ve bu etkenlerin kişinin hayat kalitesi üzerindeki etkilerinin karşılaştırılması amaçlanmıştır. Gereç ve Yöntem: Çalışmaya metastatik meme kanseri tanısı almış toplam 106 hasta dahil edilmiştir. Hastalar tedavi şekline göre parenteral tedavi (M grubu) ve oral CDK4/6 inhibitörü tedavisi (CDK grubu) alanlar olarak iki gruba ayrılmıştır. Anksiyete ve depresyon düzeyleri Hospital Anxiety and Depression Scale (HADS), uyku kalitesi Pittsburgh Sleep Quality Index (PSQI) ve yaşam kalitesi Nottingham Health Profile (NHP) ölçekleriyle değerlendirilmiştir. Bulgular: Çalışma grubunun ortalama yaşı 55,8±10,7 yıl olarak bulunmuştur. Hastaların %42,5’inde anksiyete, %39,6’sında depresyon, %46,2’sinde uyku bozukluğu ve %68,9’unda menopoz bulgusu saptanmıştır. Gruplar arasında yaş, HADS-A, HADS-D, PSQI ve NHP skorları açısından anlamlı fark saptanmamıştır (p>0,05). Anksiyete ve uyku bozukluğu olan hastalarda NHP skorları daha yüksek olup, yaşam kalitesiyle ters yönde ilişki göstermiştir. Sonuç: Metastatik meme kanserinde uygulanan parenteral ve oral tedavi yöntemleri arasında a depresyon, anksiyete , uyku kalitesi ve bu etkenlerin kişi üzerindeki hayat kalitesi açısından anlamlı fark saptanmamıştır. Her iki tedavi yaklaşımı da benzer düzeyde psikolojik tolere edilebilirliğe sahiptir. Tedavi seçimi yapılırken psikososyal faktörlerin dikkate alınması, hasta merkezli yaklaşımlar açısından önem taşımaktadır.

This study aimed to evaluate the diagnosis and treatment preferences of orthopedic surgeons in developmental dysplasia of the hip (DDH) cases under the age of 1 in Türkiye with a higher incidence of DDH, estimated to be around 5-15 per 1000 live births. This was a nationwide cross-sectional survey. A link for the online survey, including 16 multiple-choice questions, was sent to the email group of the National Orthopedic Society. Among 233 filled-out surveys, 211 met the inclusion criteria. Half of the participants had experience of <10 years as orthopedic surgeons, managed <25% of pediatric patients in daily practice, and treated <25 DDH cases per year before walking age. Ninety-seven percent used more than one method, hip ultrasound the most common, for exact diagnosis of DDH under 6 months. Pavlik harness was the most commonly preferred brace, but the use of Tübingen orthosis increased among experienced surgeons. The uppermost age limit for bracing was higher in surgeons dealing with more pediatric patients and treating more DDH cases. Dislocated hips and hips requiring closed/open reduction were more commonly referred to other surgeons by less experienced surgeons in terms of years, number of pediatric patients, and treated DDH cases per year. The lowest age limit for intervention under general anesthesia was lower in surgeons treating >25 DDH cases per year. Over one-third used both anterior and medial approach open reduction, but a trend to anterior open reduction alone was more evident in surgeons treating >50 DDH cases per year. More experienced surgeons were more prone to check the intraoperative reduction with postoperative computed tomography or magnetic resonance imaging. Diagnosis and treatment ages of DDH cases did not significantly change during the coronavirus disease 2019 pandemic. Management preferences of orthopedic surgeons in DDH before walking age primarily depend on the rate of pediatric patients in daily practice and the number of treated DDH cases per year.

Objectives:This study was an evaluation of the effectiveness of the Callisto eye image-guided, markerless system (Carl Zeiss Meditec AG, Jena, Germany) in toric intraocular lens (IOL) positioning.Methods:The results of a novel, markerless, alignment system used for IOL positioning were analyzed in this retrospective study. Preoperatively, reference image registration was performed with the IOLMaster 700 biometer (Carl Zeiss Meditec AG, Jena, Germany) and transferred to the Callisto eye system, which was used in conjunction with an Opmi Lumera 700 microscope (Carl Zeiss Meditec AG, Jena, Germany). Using the Callisto Z Align technology, a toric IOL was aligned precisely with the steep axis. One day after surgery, the pupil was fully dilated and a thin slit was placed on the marker of the toric IOL and the angle was measured using an axis calculator smartphone application. The degree of the measured angle and the preoperatively determined angle were compared.Results:Sixty eyes of 46 patients were included. The difference in the absolute angle between the intended and the postoperative (at day 1) axes was a mean of 2.71±1.64°.Conclusion:The Callisto eye image-guided, markerless system successfully provided assistance in precisely positioning the toric IOL.

Cilj ovoga rada preispitivanje je dominantnih historiografskih predodžbi o transformacijskim procesima u ekonomskoj povijesti Osmanskoga Carstva te obrada nepoznatih aspekata osmanskih financijskih mjera koje su na području Bosanskoga ejaleta poduzete u prvih nekoliko godina nakon Karlovačkoga mira (1699.). Rad pokazuje kompleksnost osmanske strategije u borbi sa stvarnim i percipiranim učincima gospodarske krize koju je na zapadnoj periferiji svijeta islama izazvalo dugotrajno ratovanje s koalicijom Svete lige. Nastoji se pokazati da je za potpunije razumijevanje osmanskih transformacijskih procesa potrebno temeljitije ispitati mjere koje je vlast provodila u pograničnim provincijama. Kao primjer tih mjera istaknuto je trajno oslobađanje cijeloga Bosanskog ejaleta od poreza bedel-i nüzûl, namijenjenog za opskrbu i financiranje vojske. Ukazano je i na značenje krupnih promjena u režimu ubiranja državnih prihoda kao što je ukidanje „vlaških poreza” i odsjekom određenih novčanih podavanja u znatnom dijelu osmanskoga agrarnog gospodarstva u Bosni te prijelaz na režim naturalne desetine. Analizirani su uzroci koji su doveli do tih mjera, njihove dugoročne posljedice za osmanske financije, život lokalnoga stanovništva i gospodarstvo. Zaključci izneseni u radu zasnovani su na analizi neobjavljene financijske građe iz osmanskih arhiva.

Background: To investigate the relationship between neutrophil to lymphocyte ratio (NLR) and non-sentinel lymph node (SLN) metastasis in early stages of breast cancer. Methods: Records of patients with clinically early stage (cT1-T3, N0) invasive breast cancer who underwent SLN biopsy in combination with blue dye and lymphoscintigraphy between April 2015 and January 2017 were noted retrospectively. Pre-treatment NLR of the patients with and without non-SLN metastasis were compared. Results: A total of 178 patients with a mean age of 51,65+-10,93 years were included. NLR was statistically significant in the non-SLN positive patients (p=0.011). Lymphovascular invasion and extracapsular extension of SLN were more common in the non-SLN positive group (all p 0.05). The ODDS value was found to be 3,733 (95% CI: 1,05-13,24) and the risk of metastasis in those with lymphovascular invasion was 3.73 fold. The ODDS value was found to be 10,267 (95% CI: 2,63- 40,12) and the risk of metastasis was 10,267 times greater in those with capsule spread. Conclusion: Lymphovascular invasion, extracapsular extension and NLR are the predictive parameters of non-SLN positivity. Pre-surgical NLR is a useful diagnostic tool for predicting non-SLN metastasis.

Introduction: To evaluate the preoperative CEA and CA19-9 levels and their association with clinicopathologic features and mortality. Methods: This retrospective study was conducted on patients who underwent gastric surgery due to gastric adenocarcinoma from 2008 to 2015. Preoperative serum CEA and CA19-9 levels were compared according to the TNM classification and survival data were compared. Results: A total of 335 patients were included in the study with the mean age of 66.1±11.0 years. CEA and CA19-0 positivity were 29.1% and 28.1%, respectively. According to the CEA groups, T stages of the cases were statistically significant (p = 0.013). The rates of T stage 1 in group 1 (CEA positive) were significantly higher than the group 2 (CEA negative) (p=0.007). According to the CA19-9 positivity; rate of stage 2 was significantly higher in the group 1 (CA19-9 positive) (p=0.001); however, rates of stage 2 and 3 were significantly higher in the group 2 (CA19-9 negative) (p=0.004 and p=0.007, respectively). Mortality information could be accessed for 309 cases and 108 deaths (36%) were observed. The mean survival time was 45.21±2.42 months. No significant difference was observed between the groups (p&gt;0.05). Conclusion: Patients with higher levels of CEA and CA19-9 seem to have higher grades of gastric cancer. However, CEA and CA19-9 level does not seem to be in association in our study population.