Ankara Onkoloji Eğitim ve Araştırma Hastanesi

Amaç: Bu çalışmada, adneksiyal kitlesi olan kadınlarda siberkondri düzeylerini Siberkondri Ciddiyet Ölçeği-Kısa Formu (CSS-12) kullanarak değerlendirmeyi amaçladık.Gereç ve Yöntemler: Bu çalışma, tek merkezde yürütülen kesitsel bir araştırma olarak planlandı. Jinekolojik onkoloji kliniğine başvuran ve adneksiyal kitle tanısı alan toplam 134 kadın çalışmaya dahil edildi. Tüm katılımcılara CSS-12 uygulandı. CSS-12 toplam ve alt ölçek skorları; medeni durum, eğitim düzeyi, çocuk sahibi olma durumu, CA-125 düzeyi ve menopoz durumu değişkenlerine göre karşılaştırıldı. Bulgular: Katılımcı grubun median yaşı 38 (18–75), median vücut kütle indeksi (VKİ) 30 (20–42), median parite sayısı 2 (0–8) ve median CA-125 değeri 45 (11–2350) olarak saptandı. Toplam CSS-12 skoru ve dört alt boyut karşılaştırıldığında, genç (≤35 yaş), çocuğu olmayan ve lise ve üzeri eğitim düzeyine sahip kadınlarda toplam CSS-12 skorları anlamlı olarak daha yüksek bulundu (p

Transperineal prostate biopsy (TP-Bx) is increasingly preferred due to its lower infection risk and improved clinically significant prostate cancer detection rates. Its feasibility under local anesthesia provides both clinical and economic advantages. However, acute urinary retention (AUR) remains a significant post-procedure concern. This study aims to evaluate the impact of transperineal prostate biopsy performed under local anesthesia on voiding function using uroflowmetry parameters. A prospective observational study was conducted with 74 patients. TP-Bx was performed under local anesthesia using a freehand technique. Uroflowmetry parameters, including maximum urinary flow rate (Qmax, mL/s), average urinary flow rate (Qave, mL/s), voided volume (Vv, mL), and post-void residual volume (PVR), were assessed before and after the procedure to evaluate its impact on voiding function. The average changes in Qmax and Qave between pre and post procedure were 1.78 ± 4.33 and 0.63 ± 1.70, respectively. A significant reduction in Qmax and Qave was observed after TP-Bx (p < 0.001). PVR increased after TP-Bx (p < 0.001); however, these changes were mild and did not require catheterization. With increasing experience, TP-Bx has become safer. The use of local anesthesia reduces anesthesia-related complications, and the historically feared risk of AUR appears lower than previously assumed. These findings support TP-Bx as a safe and effective diagnostic approach.

Background: Migraine is a chronic headache disorder involving neurovascular hyperexcitability and trigeminovascular sensitization, leading to functional impairment. With digital technologies now pervasive, excessive internet and social media use may contribute to migraine burden. This study examined the relationship between internet and social media addiction, screen exposure, and migraine-related disability in adults. Methods: Eighty-two adults aged 18–65 years with a diagnosis of migraine according to the International Classification of Headache Disorders, 3rd edition (ICHD-3) and without significant neurological or severe psychiatric comorbidities were included. Sociodemographic data, the Visual Analog Scale (VAS), the Migraine Disability Assessment (MIDAS), the Young Internet Addiction Scale (YIAS), and the Social Media Addiction Scale (SMAS) were administered. Average daily smartphone screen time over the past seven days was recorded. Spearman correlation coefficients and multivariable linear regression models were used for the analyses. Results: Spearman correlation analysis revealed significant positive associations between MIDAS and both YIAS (ρ = 0.458) and SMAS (ρ = 0.541), with SMAS showing the stronger relationship. Average daily screen time was also correlated with MIDAS (ρ = 0.345). In multivariable models, YIAS and screen time remained independently associated with MIDAS when included together. However, when SMAS was entered alongside screen time, only SMAS remained significant (β = 0.33; 95% CI: 0.18–0.47). Likewise, in the model including both SMAS and YIAS, SMAS remained an independent predictor (β = 0.43; 95% CI: 0.20–0.66), whereas YIAS lost significance (β = –0.21; 95% CI: –0.79 to 0.37). Conclusion: The findings suggest that migraine burden may be more closely related to social interaction–based digital exposure than to overall internet use. Social media–related behaviors could be a potential target for intervention, although prospective studies are needed to confirm this.

<title>Abstract</title> <bold>Background</bold> : Impairments in functionality and social participation are common among individuals with severe mental disorders, particularly within refugee populations. Community-based psychosocial interventions may play a crucial role in improving both psychiatric symptoms and daily functioning. <bold>Methods</bold> : This controlled, prospective study was conducted at a Community Mental Health Center in Turkey. Syrian patients under temporary protection who participated in occupational therapy workshops (experimental group) were compared with a control group receiving routine care only. Functionality (Brief Functionality Assessment Scale – BFAS), depression (Beck Depression Inventory – BDI), anxiety (Beck Anxiety Inventory – BAI), and psychotic symptom severity (Positive and Negative Syndrome Scale – PANSS) were assessed at baseline and at 6-month follow-up. <bold>Results</bold> : At baseline, no significant differences were observed between the groups. In the experimental group, significant improvements were observed in functionality, depression, anxiety, and psychotic symptoms at 6 months (p &lt; 0.001 for BFAS, BDI, and BAI; p = 0.018 for PANSS), whereas no significant changes were observed in the control group. At the 6-month assessment, the experimental group demonstrated significantly better outcomes compared to the control group. <bold>Conclusions</bold> : Occupational therapy workshops integrated into community mental health services are associated with significant improvements in functionality and psychiatric symptoms among Syrian patients, highlighting the importance of structured psychosocial interventions for vulnerable populations.

This study primarily aimed to investigate sleep habits, sleep-disordered breathing (SDB), and psychiatric problems in children with cancer compared to a control group (sibling). A secondary objective was to assess the influence of hospitalization and psychological status on sleep-disordered breathing and overall sleep quality. In this prospective case–control study, children aged 8–18 years receiving cancer treatment and their healthy siblings completed validated sleep and psychological questionnaires (PSQI, CSHQ, STAI-C, CDI). Objective assessment of sleep-disordered breathing was performed using home-based peripheral arterial tonometry. Patients were monitored during hospitalization and at home, while controls were assessed at home. Apnea–hypopnea index, respiratory disturbance index, and oxygen desaturation index were analyzed as objective outcomes. Thirty-seven participants were included (23 patients, 14 controls). Disturbed sleep habits were highly prevalent across the cohort (89.2% on CSHQ). Trait anxiety was significantly higher in patients than in siblings. No significant differences were observed between home and hospital measurements among patients. However, compared with controls, patients demonstrated substantially higher AHI, RDI, and ODI values. Subjective sleep quality (PSQI) classified 27% of the cohort as poor sleepers. Pediatric oncology patients experience impaired sleep and increased respiratory disturbances compared with siblings, independent of the hospital environment. Routine screening and early management of sleep problems should be incorporated into pediatric cancer care. Home-based objective sleep monitoring may provide a feasible approach for detecting clinically relevant sleep disturbances in this vulnerable population.

Abstract Background Developing innovation and creativity skills is essential for oncology nurses to adapt to evolving healthcare challenges. Structured interventions can enhance these competencies, yet evidence on their effectiveness remains limited. Objective This study aimed to examine the impact of a structured innovation workshop on the innovation and creativity skills of oncology nurses. Methods A semi-experimental mixed-methods design was used, incorporating a one-group pretest-posttest-follow-up approach. Quantitative data were collected using the FINCODA (Framework for Innovation Competencies and Assessment) and the Marmara Critical Thinking Dispositions Scale (MCTDS) and analyzed with SPSS. Qualitative data were obtained through structured interviews and analyzed using a phenomenological research design. Data collection occurred in three stages: before the workshop, after the workshop, and four weeks later. Results A total of 38 oncology nurses participated in the study, with a mean age of 36.50 years and a mean employment duration of 14.71 years. The mean total MCTDS score increased from 97.55±8.79 to 102.63±9.19 before and after the workshop, respectively. Similarly, the mean total FINCODA score increased from 86.18±16.35 to 94.05±18.28. Significant improvements were observed in the sub-dimensions of creativity, assertiveness, self-discipline, search for innovation, and courage. Conclusions Findings indicate that the workshop enhanced nurses' motivation, creativity, and creative thinking dispositions. Additionally, it contributed to the development of professional skills, such as self-discipline and adopting different perspectives. Implications for Practice Structured innovation workshops can be an effective learning method for fostering creativity and innovation among oncology nurses, supporting their professional development and adaptability in dynamic healthcare environments.

This study aimed to evaluate the diagnostic performance of biochemical markers in normocalcemic primary hyperparathyroidism (nPHPT), analyse their temporal variations, and assess their correlation with adenoma localisation and size. In this multicenter retrospective study-the largest patient cohort reported in the literature to date (n = 474) we comprehensively profiled normocalcemic patients diagnosed with primary hyperparathyroidism nPHPT was diagnosed based on persistently elevated PTH levels with normal serum calcium after excluding secondary causes such as vitamin D deficiency, renal impairment, and other conditions. This retrospective multicenter study included a large cohort of patients whose biochemical markers-including serum calcium, phosphorus, magnesium, vitamin D, parathyroid hormone (PTH), and glomerular filtration rate (GFR)-were measured at three time points, using standardised laboratory protocols. Although in routine clinical practice these measurements are typically performed at regular intervals of 3-6 months, resulting in approximately three assessments during an 18-month follow-up period. Urinary calcium and creatinine levels were also determined, and imaging modalities (ultrasonography, sestamibi scintigraphy, and computed tomography) were employed for adenoma detection. Statistical analyses comprised repeated measures ANOVA, logistic regression, correlation analysis, and ROC analysis, performed using Jamovi software. Serial evaluations revealed significant temporal changes in key biochemical parameters, including a significant decline in serum calcium and PTH levels alongside a significant increase in urinary calcium excretion. Logistic regression analysis identified higher PTH levels, higher corrected calcium, and larger adenoma size as independent predictors of adenoma localisation, while ROC analysis confirmed that PTH exhibited the highest diagnostic accuracy (AUC = 0.91, 95% CI: 0.84-0.95, p < 0.001). The large scale of our patient cohort reinforces the robustness of our statistical analyses and provides comprehensive insight into the dynamic nature of nPHPT. Our findings demonstrate that, even in normocalcemic patients, higher PTH levels and relatively higher calcium levels within the normal range are important indicators of parathyroid adenoma. Integrating serial biochemical measurements with targeted imaging can facilitate earlier diagnosis, potentially preventing future complications and informing more tailored management strategies.

BackgroundCDK4/6 inhibitors are primarily used to treat hormone-positive HER-2 negative (HR+/ HER2-) metastatic breast cancer. Although ribociclib is generally well-tolerated, there is limited real-world data on hepatotoxicity associated with its use. Therefore, we evaluated the characteristics and management of ribociclib-induced hepatotoxicity.MethodsPatients screened in the study received ribociclib for the treatment of metastatic HR+/ HER2- breast cancer between January 2019 and December 2023 at Hacettepe University Hospital, Ankara Bilkent City Hospital, Ankara Etlik City Hospital, Gazi University Hospital, and Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital. Ribociclib-induced hepatotoxicity was evaluated using retrospective laboratory results. The Common Terminology Criteria for Adverse Events (CTCAE) v5.0 was utilized to grade the severity of the liver injury. The primary objective of our study is to consider ribociclib-induced hepatotoxicity, with a view to providing information about this less common adverse event. The secondary objective of our study is to compare survival rates between patients who developed grade 1–2 hepatotoxicity and those who developed grade 3–4 hepatotoxicity.Results845 patients were screened, and 78 (9.2%) were found to have developed ribociclib-induced hepatotoxicity. Of these, 5 (6.4%) had grade 4 toxicity, 19 (24.4%) had grade 3, and 54 (69.2%) had grade 1–2 toxicity. In patients with grade 4 toxicity, ribociclib was discontinued in all patients (one of whom was successfully re-challenged with ribociclib). In patients with grade 3 toxicity, dose reduction was applied in 12 patients, and ribociclib was discontinued in 5 patients (one of whom was successfully re-challenged with palbociclib). For patients with grade 1–2 toxicity, dose reduction was applied in 7 patients, and only 1 patient permanently discontinued ribociclib. In our study, a total of 9 patients (11.5%) permanently discontinued ribociclib. This group comprised four patients with grade 4 toxicity, four patients with grade 3 toxicity, and one patient with grade 1–2 toxicity. No fatal case of ribociclib-induced hepatotoxicity was observed. The median time from the initiation of ribociclib to the onset of ribociclib-induced hepatotoxicity was 13 (IQR = 7–27) weeks. The median time from the initiation of ribociclib to the final follow-up was 16 months. The findings of our study indicate that the one-year overall survival rate for patients with grade 1–2 hepatotoxicity is 90%, while the rate for patients with grade 3–4 hepatotoxicity is 76%.(p = 0.044).ConclusionsRibociclib is associated with an increased risk of hepatotoxicity, with the potential for grade 3–4 in a small number of patients. Our analysis suggested a potential association between grade 3–4 hepatotoxicity and reduced OS, warranting further investigation. Regular monitoring of liver function tests during ribociclib treatment may help clinicians identify high-risk patients requiring closer follow-up.