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Lymph node evaluation and survival after resection of colorectal cancer

Original Artcile

Lymph node evaluation and survival after resection of colorectal cancer

Lutfi Soylu, Oguz Ugur Aydin, Nedim Cekmen, Fuat Atalay

   

Abstract
Recent studies have demonstrated that lymph nodes ratio (LNR) might provide a significant prognostic role for colorectal cancer. We retrospectively analyzed the data of the patients with colorectal cancer and assessed a possible correlation between lymph node parameters and survival. We conducted a retrospective chart review of patients who underwent a radical colon surgery involving removal of mesocolic lymph nodes due to colorectal cancer. Prognostic significance of the removed lymph node number (LNs), metastatic LNs, lymph node ratio (LNR) and other factors were compared. This retrospective study included 190 patients (117 males and 73 females). The estimated survival period was found to be 87.70 months [confidence interval (CI) of 95% (80.64-94.76)]. LNR, LNs and N stage were found to have significant correlation with survival. Among these factors, LNR had the biggest correlation (r = 0 .138, P =0.028). Multivariate regression analysis of survival with lymph node parameters showed that LNR and N stage were significantly correlated with survival. However, LNR was found to be the most significant prognostic factor [P >0.0001, 95% CI; 3.12 (1.55-5.75)]. LNR is a better prognostic factor in patients with colorectal cancer compared to lymph node stage and number.

Key words: Colorectal cancer, prognostic factors, lymph node metastasis, lymph node ratio, survival analysis

Med-Science. 2017; 6(2): 182-8

 
Medicine Science Vol:6 Issue:2 Year:2017 PP:182-388

The value of indirect serum markers in predicting severity of fibrosis in treatment naive patients with non-cirrhotic hepatitis C virus infection

Original Artcile

The value of indirect serum markers in predicting severity of fibrosis in treatment naive patients with non-cirrhotic hepatitis C virus infection

Murat Afyon, Cumhur Artuk, Ercan Yenilmez, Berksan Simsek, Ayper Kaya

   

Abstract
We conducted this study for determining the value of indirect serum markers such as aspartate aminotransferase (AST), alanine aminotransferase (ALT), INR (International Normalized Ratio) and platelet counts and the roles of the scores such as AST-to-ALT ratio (AAR), AST-to-platelet ratio index (APRI), FIB-4 index, King’s score, Goteborg University Cirrhosis Index (GUCI) and FibroQ in predicting severity of fibrosis in treatment naive patients with non-cirrhotic hepatitis C virus (HCV) infection. Treatment naive non-cirrhotic chronic HCV patients who underwent percutaneous liver biopsy between 01 January 2012 and 01 June 2015 were included in the study. For evaluating the difference in variables, patients were divided into 2 groups such as no or minimal fibrosis group (fibrosis score

Key words: Hepatitis C virus, fibrosis, indirect serum markers, AAR, APRI, FIB-4 index, King’s score, GUCI, FibroQ.

Med-Science. 2017; 6(2): 189-94

 

Our clinical experiences in ultra-sound guided peripheral nerve blocks: a retrospective evaluation

Original Artcile

Our clinical experiences in ultra-sound guided peripheral nerve blocks: a retrospective evaluation

Ulku Ozgul, Mehmet Ali Erdogan, Muharrem Ucar, Nurcin Gulhas, Mahmut Durmus

   

Abstract
Peripheral nerve blocks are commonly used in extremity surgeries for anesthetic and/or postoperative analgesic purposes with general anesthesia. Ultra-sound (US) guided peripheral nerve blocks that have been used in recent years provide many superiorities in comparison with other conventional methods. The objective of this retrospective study was to carry out a retrospective evaluation of our experiences regarding 400 patients on whom US guided peripheral nerve was applied at the Inonu University Faculty of Medicine, Department of Anesthesiology and Reanimation during June 2012-March 2016. Demographic data of the patients, block type, purpose of block (for surgical or analgesic), type and volume of the local anesthetic, type of US probe, needle length, block success, toxicity finding and complications were all recorded. Blocks were performed for analgesia in 16% of the patients and for anesthesia in 84%. Lidocaine+bupivacaine combination, bupivacaine+prilocaine combination and bupivacaine were used on 82%, 13% and 5% of the patients as local anesthetic agent, respectively. Linear US probe (6-13 MHz) was used for all patients. In conclusion, US guided peripheral nerve blocks provide adequate depth of anesthesia and analgesia. It was found to be safe and useful and may be a good alternative to general anesthesia.

Key words: Keywords: aneshesia, nerve block, ultrasonography

Med-Science. 2017; 6(2): 195-8

 

Comparing mycobacterium tuberculosis complex susceptibility methods, a developing country’s experience

Original Artcile

Comparing mycobacterium tuberculosis complex susceptibility methods, a developing country’s experience

Yasemin Ay Altintop, Duygu Percin

   

Abstract
In spite of current diagnosis and treatment, Mycobacterium tuberculosis complex is still an important cause of mortality and morbidity. Uneffective drug combinations and patient incompliance lead to increasing drug resistance. This study by managing four different -non molecular- susceptibility methods was carried out to determine the susceptibility patterns of Mycobacterium tuberculosis complex isolates in central part of Turkey and to compare the methods. The susceptibility testing of 33 isolates were initially performed using the agar proportion method, the results of which were compared with the other three methods; BACTEC 460TB, MGIT 960, and Etest prospectively. According to the “gold standard” agar proportion method, none of the strains were resistant to STR or ETM, while two isolates were found to be resistant to both isoniazid and rifampicin. BACTEC 460 TB remains the reference method of choice, and for low-volume centers. The MGIT 960 system is more suited for high-volume laboratories but has a high risk of contamination. Etest may seem expensive and produces cumbersome results. Regardless of the test used, validation with the gold standard method should be performed periodically as well as in the event of a discordant result. There remains a need for further studies to establish whether available rapid tests will eventually become the gold standard.

Key words: Mycobacterium tuberculosis , susceptibility methods, drug resistance, Turkey

Med-Science. 2017; 6(2): 199-203

 

Relationship between thyrotropin and BMI in patients with subclinical hypothyroidism

Original Artcile

Relationship between thyrotropin and BMI in patients with subclinical hypothyroidism

Manuel Iván Hernández-Estala, Ana Marlend Rivas-Gómez, Gabriela María Loya-Gómez, Eliseo López-Hernández

   

Abstract
Subclinical hypothyroidism is an asymptomatic illness characterized by elevated serum thyrotropin and normal values of thyroid hormones. Currently, epidemiological studies have suggested a positive relationship between serum thyrotropin and body mass index, although the primary source of this relationship is unknown. The aim of this study was to determine whether serum thyrotropin concentrations are associated with body mass index in patients with subclinical hypothyroidism. This is an observational, cross-sectional and analytical study, carried out in the Mexican Social Security Institute’s General Hospital No. 1 in Chihuahua. Weight, height, concentrations of serum thyrotropin, age, sex and smoking status data were collected from the clinical records of 128 patients diagnosed with subclinical hypothyroidism. We found that in higher categories of BMI we found higher means of serum thyrotropin: 5.92 μIU/mL for normal BMIs, 6.14 μIU/mL for overweight, 6.41 μIU/mL for obesity class I, and 7.03 μIU/mL for obesity classes II and II, P for trend

Key words: Thyrotropin, TSH, BMI, subclinical hypothyroidism

Med-Science. 2017; 6(2): 204-7

 

Assessment of physicians’ knowledge in transfusion medicine in eastern part of Turkey

Original Artcile

Assessment of physicians' knowledge in transfusion medicine in eastern part of Turkey

Ali Fettah, Duygu Kara, Gökçe Pınar Reis, Alev Cansu Certel, Soner Sertan Kara

   

Abstract
Transfusion of blood and blood components is one of the most common medical procedures in the developed world. Knowledge of physicians about blood transfusion is the most important determinant of their approach towards blood transfusion. In this study, we aimed to assess clinicians’ basic knowledge regarding transfusion medicine through a questionnaire in a regional hospital. One hundred and one physicians including general practitioners, resident physicians, and specialists participated in the study. The participants were tested with a questionnaire consisting of 20 questions about transfusion medicine. Their scores were compared with regard to their departments, age and experience in medicine. The mean age of study population was 33.1±6 years. Of the total, 70 (69.3%) were male and the average year in medical practice was 7.3±5.8 years. Overall, 52% of the questions were correctly answered. The proportion of correct answers to the questions about basic knowledge, clinical use of blood, and transfusion reactions were as; 52.7%, 54.7%, and 47.3%, respectively. Thirty-four (33.7%) participants scored higher than 60 points, out of 100 points. The average score of total knowledge of participants about transfusion medicine was 52±10. The total knowledge scores of groups including internal departments, surgical departments, and emergency medicine were 55.7±10.2, 51.5±8.3, and 46±10.3, respectively and the differences between three groups were significant (p=0.001) . Also, a positive correlation has been shown between age, experience in medicine and total awareness score in transfusion medicine. The study yielded low/moderate levels of knowledge about transfusion medicine and it was concluded that additional education in transfusion medicine is necessary in all specialties and at each phases of medical practice.

Key words: Knowledge, physicians, education, transfusion medicine, blood products safety

Med-Science. 2017; 6(2): 208-12

 

Effects of the transcatheter closure of atrial septal defect on electrocardiographic and echocardiographic parameters six months after the closure

Original Artcile

Effects of the transcatheter closure of atrial septal defect on electrocardiographic and echocardiographic parameters six months after the closure

Halil Atas, Mehmet Cansel, Ertugrul Kurtoglu, Hasan Pekdemir, Ramazan Ozdemir

   

Abstract
Although percutaneous transcatheter atrial septal defect (ASD) closure (TCC) has been performed on adults for a long time there is limited data about the effects of the procedure in the literature and the majority of studies have been performed on children. The study purposed to evaluate the impact of TCC on cardiac remodeling, electrical changes and exercise capacity in adults. Transthoracic echocardiography and electrocardiography were performed one day before and six months after TCC in 27 consecutive patients who underwent successful TCC. Twenty-seven age and sex matched healthy subjects were used as control group. Right ventricular (RV) diameter (had decreased from 44±6.3 to 34±3.9; p

Key words: Atrial septal defect, percutaneous atrial septal defect closure, p wave dispersion

Med-Science. 2017; 6(2): 213-6

 

The effects of lack of melatonin in experimental rat model of Alzheimer’s Disease: relationship with FEZ1 gene expression

Original Artcile

The effects of lack of melatonin in experimental rat model of Alzheimer’s Disease: relationship with FEZ1 gene expression

Mehmet Demir, Umit Yilmaz, Cemil Colak, Yilmaz Cigremis, Fatma Ozyalin, Ibrahim Tekedereli, Ayten Kilincli, Suleyman Sandal

   

Abstract
Alzheimer’s Disease (AD), which is the most common reason for dementia, is an irreversible neurodegenerative brain disease. FEZ1 is a protein expressed in the brain. High expressions of FEZ1 mRNA have been interpreted as an indicator of high neural plasticity for memory and learning. This study was planned to determine the effect of melatonin deficiency (pinealectomy; PnX) on AD and to reveal its association with FEZ1. 30 male rats were used in the study. The rats were divided into three as SHAM, PnX+streptozotocin (STZ) and PnX+STZ+melatonin (MLT) groups. The pineal glands of rats were surgically removed (except SHAM group) and STZ was intracerebroventricularly (icv) administrated at the first and third days. MLT (10 mg/kg/day) was intraperitoneally (ip) injected 1 hour before the first STZ application and it was continued for 14 days. STZ and MLT solvents were applied to the rats in the SHAM group. At the end of the applications, Morris water maze (MWM) test was carried out the rats. At the end of MWM tests, the rats were sacrificed and their blood and hippocampus tissues were taken. FEZ1 gene expression and protein levels were determined from hippocampus tissue, while serum nonadrenaline, dopamine and serotonin levels were detected from blood samples. FEZ1 protein levels of PnX+STZ+MLT group were found to be statistically significantly lower than those of SHAM and PnX+STZ groups (p

Key words: FEZ1, Alzheimer’s Disease, pinealectomy, melatonin

Med-Science. 2017; 6(2): 217-23

 

The efficacy of clobetasol, dexpanthenol, and fucidic acid in the treatment of cetuximab-induced skin toxicity

Original Artcile

The efficacy of clobetasol, dexpanthenol, and fucidic acid in the treatment of cetuximab-induced skin toxicity

Didem Tastekin

   

Abstract
Cetuximab (CTX) is a monoclonal antibody against the epidermal growth factor receptor (EGFR). It is used as a monotherapy or in combination with cytotoxic chemotherapy in metastatic colorectal cancer (mCRC). Severe cutaneous reactions are frequent and major causes of discontinuation of CTX treatment. This open-label study evaluated the efficacy of a mixture drug topically applied to skin lesions in patients with mCRC who developed skin toxicity caused by CTX. Twenty patients with mCRC were included in this prospective, single-center, open-labeled trial. The patients had received CTX in addition to chemotherapy and developed grade 2 or 3 skin toxicity and were treated twice daily with an ointment mixture of clobetasol, dexpanthenol, and fucidic acid. The objective response rate was 100%, and no delay, dose reduction or discontinuation of CTX treatment due to skin toxicity were necessary. Skin toxicity relapsed in the following chemotherapy cycles in all patients after discontinuation of the ointment. Repeated administration of the ointment resulted in improvement of skin toxicity and allowed continuation of CTX treatment. This ointment mixture seems to be effective in the treatment of CTX-induced skin toxicity in patients with mCRC.

Key words: Topical treatment, cetuximab-induced skin toxicity, metastatic colorectal cancer

Med-Science. 2017; 6(2): 224-8

 

Assessment of satisfaction and anxiety levels of the patients who had cesarean section with general and spinal anesthesia

Original Artcile

Assessment of satisfaction and anxiety levels of the patients who had cesarean section with general and spinal anesthesia

Basak Altiparmak, Sezen Bozkurt Koseoglu

   

Abstract
The primary aim in our study is to obtain the most objective result by comparing the anesthesia satisfaction of women who had cesarean section both under general and spinal anesthesia. Our secondary aim is to assess the relation between patients’ preference of anesthesia technique and anxiety level. Total number of 94 ASA II women who hadcesarean section under general anesthesia within 5 years and scheduled to have elective cesarean section under spinal anesthesia, were included into the study. After 48 hours, all of the patients were asked to compare their previous general anesthesia experience with spinal anesthesia in regard of satisfaction and anxiety. Satisfaction scores were as “bad”, “average”, “good”, “very good” while patients were asked to use numbers from 1 to 10 to score their anxiety level. The mean age of the patients was 26.1±4.5 when they had general anesthesia and it was 29.7±4.6 when they had spinal anesthesia. When the satisfaction scores of anesthesia techniques were compared, spinal anesthesia was found to be statistically significantly high (p0.05). The patients who had cesarean section under both of the anesthesia techniques were more satisfied by spinal anesthesia. While no difference was found between preoperative anxiety levels.

Key words: General anesthesia, satisfaction, cesarean, spinal

Med-Science. 2017; 6(2): 229-32