Oncology mortality: weekend and summer vacation effect.

OBJECTIVES: In this study, we investigated the effect of the weekend and summer vacation on mortality in patients with cancer. METHODS: All patient data were obtained from their hospital registry records and the Death Notification System of the Ministry of Health. RESULTS: The majority of patients died in the hospital compared at home, 80.8% versus 19.2%, respectively. Patients aged <65 died mostly in hospital, which was the opposite of those aged ≥65, who died at home. While tumour location and histopathological type had no effect on the place of death, patients with metastasis (including single organ metastasis), diffuse metastases (diffuse metastases: multiple organ metastases) and patients with locally advanced stage disease were found to die more frequently in the hospital. Deaths in the hospital occurred most frequently in August, while deaths at home occurred most frequently in April and October. Deaths in the hospital occurred most frequently on Friday, Saturday and Sunday, while deaths at home occurred more frequently on Monday. It was determined that the deaths in the hospital were significantly higher at the weekend. CONCLUSION: This study contains data supporting the weekend effect in oncology patients. Moreover, it provides new data on the increased death rates in August, which coincides with the summer vacation leave month.

Radioprotective effects of α2-adrenergic receptor agonist dexmedetomidine on X-ray irradiation-induced pancreatic islet cell damage.

Comprehensive epidemiological analyses conducted in the last 30 years have revealed a link between radiation and DM. We aimed to determine the effects of dexmedetomidine pretreatment on radiation-induced pancreatic islet cell damage. Twenty-four rats were divided into three groups: group 1 (control group), group 2 (only X-ray irradiation group), and group 3 (X-ray irradiation + dexmedetomidine). We observed necrotic cells with vacuoles accompanying loss of cytoplasm in the islets of Langerhans, extensive edematous areas, and vascular congestions in group 2. In group 3, we observed a decrease in necrotic cells in the islets of Langerhans, and edematous areas and vascular congestion was also reduced. We determined a decrease in ß-cells, α-cells, and D-cells in the islets of Langerhans in group 2 compared to the control group. In group 3, ß-cells, α-cells, and D-cells were elevated compared to group 2. Ionizing radiation may induce DM. Dexmedetomidine appears to exert a radioprotective effect.

An urban legend: Malignant transformation caused by radiotherapy in patients with presacral ganglioneuroma. The necessity and first-time administration of radiotherapy. Case report and literature review.

Ganglioneuromas (GNs) are well-differentiated, rare benign tumors of neural crest origin and are, for the most part, considered to be the benign equivalent of neuroblastomas. There are very few cases of GN reported to be at presacral location in the literature. The standard form of treatment is the total surgical excision. However, total resection of GN is not always possible depending on the neuron, from which it originates, and its localization. Moreover, adjuvant radiotherapy (RT) or chemotherapy is not recommended even though patients are still symptomatic after subtotal resection. This view is based on the urban legend that it undergoes a malignant transformation although it is a benign tumor. Moreover, there are no data indicating that the GN cases reported in the literature have undergone RT. Therefore, articles about the suspicion that GN may undergo spontaneous or malignant transformation after RT are absolutely controversial. Based on our case, we present here, we believe that we will explain the valid necessity of application of RT that we administered for the first time and that with the clarification of this controversial topic, a significant gap will be closed in the literature.

Method to prevent the target volume from escaping out of the field in breast irradiation: Forming a "fall-off margin".

OBJECTIVES: We aimed to obtain data that would enable the selection of the appropriate radiotherapy technique for whole breast irradiation (WBI) based on patients' physical characteristics and to evaluate the benefit of the new fall-off (FO) margin technique. MATERIALS AND METHODS: Ten patients with left-sided breast-conserving surgery, treated for breast carcinoma between August 2016 and September 2017, were included. The FO margin was created in five different plans of which two were formed by expanding the target volume out of the skin. The dose evaluation planning was statistically compared by calculating the target volume dosimetric parameters and the doses received by the organs at risk (OARs) for each technique. The volumetric-modulated arc therapy (VMAT) and intensity-modulated radiation therapy plans were considered ideal for WBI homogeneity and conformity indices, while the three-dimensional conformal radiotherapy (3DCRT) plan was considered nonideal. RESULTS: The increase in the breast x-axis length values and equivalent spherical diameter (ESD) dimension decreased the ideal value, whereas the increase in y-axis length values and ESD dimension correlated significantly with the D98 increase. The techniques were significantly correlated with OARs, such as V5, heart max, left anterior descending artery maximum, ipsilateral lung V5 and V20, and contralateral breast V5. Monitor unit values were significantly low in the 3DCRT and VMAT plans. CONCLUSION: The new FO margin structure will have benefits for practical application because the head designs of linear accelerators and collimators and the target-Jaw/MLC distance are adjacent to the breast tissue, which moves during treatment.

Pelvic Radiation-Induced Testicular Damage: An Experimental Study at 1 Gray.

Therapeutic radiation of the pelvic region has been shown to cause damage to testicular germ cells. In this study we aimed to evaluate the effects of a low therapeutic dose of 1 Gy on the induction of cellular and histological damage in early-stage testicular germ cells and the impact of this radiation on offspring sex ratio. Unirradiated and irradiated male rats were mated with unirradiated female rats. Female rats were followed and the sex of the offspring was determined. The male rats were sacrificed at the end of the second week, and the testicular germ cells were subjected to genetic analysis along with cytological and histopathological examination. Sperm DNA was amplified with primers specific to testis-specific Y-linked protein, rat actin beta and testis-specific X-linked genes. The resulting products were separated by capillary electrophoresis. Histopathological changes were investigated by light microscopy along with the TUNEL assay and immunohistochemical staining for caspase-3. There was no significant difference between the two groups for sex ratio and size of offspring. The number of sperm cells bearing X or Y chromosomes' did not differ significantly between these two groups. However, a 1 Gy dose of radiation caused significant cytopathological and histopathological changes in the testicular tissue. In the irradiated group, edematous regions were evident. The number of caspase-3 positive cells in the germinal epithelium of the seminiferous tubules was also significantly higher in the irradiated group. Our results showed that low-dose radiation induced apoptosis and caused significant cyto- and histopathological changes in the testicular tissue. Further research is required to fully elucidate their contribution to apoptosis and if low-dose radiation may potentially lead to long-term effects in the offspring. These results may also lead us to develop a new technique using the caspase-3 staining to monitor the susceptibility to low dose radiation.

Interesting different survival status of musicians with malignant cerebral tumors.

Introduction: The education of a musician may have an effect on the neuronal functions and organization of the brain, promote brain plasticity, resulting in functional and structural changes. A variety of malign cerebral tumors have affected the musician, instrumentalist or singer, at some time during their lives. No comprehensive investigation for musicians with malignant tumors has been performed yet. The aims of the study are to investigate if there is a relationship between the performed music style (classic or pop/rock) and the malignancy of the tumor.Patients and methods: The key words were 'neurosurgery and music' and the names of composers. We used digital catalogs like 'Pubmed' as well as the libraries of universities. We investigated a list of people with brain tumors from the English Wikipedia. (https://en.wikipedia.org/wiki/List_of_people_with_brain_tumors).We divided musicians into two groups according to their performing of classic or rock-pop music, and their gender.Results: We found 27 classic and rock/pop musicians who suffered from malign cerebral tumors. The median survival time estimations were 18 (mean 22.33, 95% CI ranged from 7.49 to 37.17) months for pop-rock musicians and 8 (mean 8.67, 95% CI ranged from 4.13 to 12.19) months for classical music performers. However, in Cox regression analysis, performed classical music type was associated with an increased risk of early death, lesser survival time age associated with an adjusted hazard ratio (aHR) of 1.06 [95% confidence interval (CI) 1.020 to 1.111; p = .004),Conclusion: In musicians with malign cerebral tumors, music type performed by musician may affect the survival status, classical musicians have a worse outcome than rock-pop musicians.

Colorful Screams of Silent Emotions: A Study with Oncological Patients.

BACKGROUND: Art, as a product of human behavior, is the expression of emotions from inner states and may provide catharsis, purification, and release. Several branches of art, most notably music, dance, and painting, can be used for treatment purposes, especially in the case of psychological disorders. Cancer, which is defined as uncontrolled cell growth, has been an important health issue throughout history, but the recent increase in its frequency has made it one of the most significant public health problems. Both the physiological distress the disease subjects the body to and the accompanying emotional distress are important factors to be considered in cancer treatment. AIMS: In this study, the role of art in expressing emotions of oncological patients was investigated. MATERIALS AND METHODS: During the treatment period, patients were interviewed about their experiences, feelings, expectations and perceptions. The picture was used as an expression of emotions. RESULTS: Communication between the patient and doctor is one of the most important elements in the treatment process, and it has come to the fore in branches of medicine, such as oncology, because of its positive contribution to treatment compliance. In general, the study showed a pronounced positivity and expectations on the part of patients from the hope-life-healing process rather than oncological treatment. CONCLUSION: In this study, we aim to demonstrate how the artistic expression of emotions, in particular, through painting, has a positive effect on healing, hope, and the interactions between cancer patients under oncological treatment and medical professionals.

Radioprotective effect of endogenous melatonin secretion associated with the circadian rhythm in irradiated rats.

Purpose: We investigated the radioprotective effect of endogenous melatonin release at different times associated with the circadian rhythm on head and neck radiotherapy. Materials and methods: Two groups of animals were subjected daily to 8 Gy single fraction radiotherapy in the head and neck region from 5:00 to 6:00 (the morning group) or from 19:00 to 20:00 (the evening group). Corresponding untreated groups served as controls. Submandibular glands from rats sacrificed on the seventh day after irradiation were assessed biochemically and histopathologically. Melatonin, malondialdehyde and superoxide dismutase levels in blood collected immediately prior to irradiation were measured with rat-specific ELISA kits. Results: In irradiated rats, melatonin, malondialdehyde and superoxide dismutase levels were significantly higher in the evening group than in the morning group. In nonirradiated rats, melatonin and superoxide dismutase levels were significantly higher in the evening group than in the morning group. The areas of seromucous acinar cells were similar between the irradiated and nonirradiated evening groups, but the area was higher in the evening irradiated group than in the morning irradiated group. Conclusion: Consideration of endogenous melatonin secretion associated with the circadian rhythm may offer new therapeutic solutions for the complications of head and neck radiotherapy.

Wernicke's encephalopathy in a patient with unresectable gastric carcinoma and literature review.

Wernicke's encephalopathy (WE) is a disease classically associated with nutrition deficiency. It is characterized by typical symptoms like confusion, ataxia and ophthalmoparesis, and developes due to thiamine deficieny in alcoholic patients. Recently, it has been shown that WE could ocur in patients with gastric carcinoma without a history of alcohol use. In this paper, we have made some suggestions about early diagnosis, treatment and prevention of WE by discussing the development of WE in a patient with unresectable gastric carcinoma, who had been inpatient for a long time and given radiotherapy and chemotherapy.