Comparison of kinesiophobia in patients with rheumatoid arthritis and systemic lupus erythematosus.

OBJECTIVE: Patients with rheumatic disease often experience arthritis and chronic joint pain, which can lead them to avoid movement, known as kinesiophobia. This may result in decreased mobility and endurance, as well as social isolation and depression. This study aimed to assess and compare the prevalence of kinesiophobia among patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE), and its association with disease activity, functional status, fear of falling, and fatigue. PATIENTS AND METHODS: A cross-sectional study was conducted with 124 RA, 76 SLE patients, and 87 healthy controls. The tampa kinesiophobia scale (TKS) was used to assess kinesiophobia. The disease activity was assessed using Disease Activity Score 28 (DAS28) in RA, and systemic lupus erythematosus Disease Activity Index 2000 (SLEDAI-2K) in SLE patients. The Health Assessment Questionnaire (HAQ) was used to assess functional status, the Falls Efficacy Scale International (FES-I) was used to assess fear of falling, and the Fatigue Severity Scale (FSS) was used to assess fatigue levels. RESULTS: Kinesiophobia was significantly more prevalent in RA patients compared to SLE patients [77.4% vs. 63.2%, odds ratio (OR): 2, 95% CI: 1.07-3.75; p<0.05]. The mean TKS score was 41.42±6.95 in RA patients, and 37.84±8.85 in SLE (p=0.005). TKS scores were positively correlated with DAS28 in RA patients; however, no correlation was found between SLEDAI-2K in SLE patients. A positive correlation was observed between TKS scores and the HAQ, FSS, and FES-I, both in RA and SLE patients. CONCLUSIONS: RA patients exhibited significantly higher kinesiophobia scores compared to SLE patients. The higher rate of kinesiophobia levels in RA patients compared to SLE patients suggests an association between kinesiophobia and the more destructive course of RA, indicating that tight control of the disease is important. Kinesiophobia was associated with functional impairment, fear of falling, and fatigue. Timely identification and intervention for patients with kinesiophobia are essential to prevent progression, mitigate long-term consequences, and maintain functional capacity.

The effect of climatic and seasonal factors on the microbial keratitis profile.

PURPOSE: To compare retrospective data on microbial keratitis (MK) from two different climatic regions in Turkey over 11 years. STUDY DESIGN: Retrospective cohort. METHODS: This retrospective cohort study included patients diagnosed with presumed MK at two referral centers. Center A was located in the subtropical region of Turkey, whereas Center B was located in a continental temperate climate zone. Clinical and laboratory data were also recorded. The results were evaluated for seasonal variations. RESULTS: This study included data from 665 patients with presumed MK (351 and 314 patients from centers A and B, respectively). The most common predisposing factors were ocular trauma in Center A, prior ocular surgery, and systemic disease in Center B. Severe keratitis was related to prior ocular surgery, presence of systemic disease, and fungal infection at presentation. The culture positivity rate was higher in spring and lower in summer at both centers. Gram-positive bacteria were the most commonly isolated bacteria in both centers in all seasons. The fungal and mixed keratitis ratios were higher in Center A than in Center B. In Center A, filamentous fungi were common pathogens that were found year-round, and peaks were observed in July and October. CONCLUSION: The results of this study show that climatic and seasonal factors may affect the microbial profile of keratitis. Fungal keratitis appears to be a climatic disease. Understanding the regional profile of MK can aid clinicians in their disease management.

Favorable outcome with sentinel lymph node biopsy alone after neoadjuvant chemotherapy in clinically node positive breast cancer at diagnosis: Turkish Multicentric NEOSENTI-TURK MF-18-02-study.

PURPOSE: Factors affecting local outcome were evaluated in patients with clinically node-positive (cN+) breast cancer at diagnosis, who underwent sentinel lymph node biopsy (SLNB) alone after neoadjuvant chemotherapy (NAC). METHODS: Between 2004 and 2018, 303 cytopathology-proven cN (+) patients in a multicentric registry, who received NAC and underwent SLNB alone were analysed. All patients had regional nodal irradiation. RESULTS: Median age was 46 (23-70). Of those, 211 patients had ypN0 disease (69.6%), whereas 92 patients had ypN (+) disease including 19 (20.6%) isolated tumor cells (ITC), 33 micrometastases (35.9%) and 40 macrometastases (43.5%). At a median follow-up of 36 months (24-172), one patient (0.3%) with macrometastatic SLN was found to have locoregional recurrence as chest wall and supraclavicular LN metastases at the 60th month. Five-year disease-free survival (DFS) and disease specific survival (DSS) rates were 87% and 95%, respectively. Patients with cT3/4 (HR = 2.41, 95% CI; 1.14-5.07), non-luminal molecular pathology (HR = 2.60, 95% CI, 1.16-5.82), and non-pCR in the breast (HR = 2.11, 95% CI, 0.89-5.01) were found to have an increased HR compared to others in 5-year DFS. However, no difference could be found between ypN0 and ypN ITC and micrometastasis (HR = 1.23, 95% CI, 0.44-3.47), whereas there was a slight increase in HR of patients with ypN macrometastasis versus ypN0 (HR = 1.91, 95% CI, 0.63-5.79). CONCLUSION: ALND could be avoided in meticulously selected cN (+) patients who underwent SLNB after NAC having breast and/or nodal pCR, cT1-2, or low volume residual nodal disease with luminal pathology, as long as axillary radiotherapy is provided.

mFOLFOX-based Chemotherapy Can Augment Survival in Advanced Gastric Cancer Patient with Disseminated Intravascular Coagulation

ABSTRACT Although gastric cancer is a frequent cancer type, disseminated intravascular coagulation is a very rare but serious complication of this disease. We report a 65-year-old man who complained of weight loss, nausea and vomiting, fatigue and dyspnoea for three days. He was diagnosed as having advanced gastric cancer complicated with disseminated intravascular coagulation, which was successfully treated with mFOLFOX chemotherapy regimen. After one cycle of mFOLFOX therapy, thrombocytopenia was improved and serum lactate dehydrogenase levels decreased. Remarkable remission was seen. After 12 cycles of chemotherapy, remarkable remission was seen in the primary tumour and multiple metastatic bone lesions.

Protective effect of adenosine triphosphate against sunitinib-related skin damage in rats.

Cutaneous side effects associated with sunitinib use are a major problem in patients receiving cancer treatment. The aim of this study was to investigate the protective effect of adenosine triphosphate (ATP) against possible skin damage resulting from sunitinib use in rats. Thirty Albino Winstar rats were divided into the following three groups: healthy controls (HCs, n = 10), sunitinib (SUN, n = 10), and sunitinib + ATP (SAT, n = 10). ATP was injected intraperitoneally at a dose of 2 mg/kg. One hour subsequent to the administration of ATP and 0.9% NaCl, the SAT and SUN groups were orally administered a dose of 25 mg/kg sunitinib to the stomach. Macroscopic evaluation of the skin indicated lower levels of skin damage in the SAT group than in the SUN group. As an indicator of oxidative stress, malondialdehyde (MDA), total oxidant status (TOS), and oxidative stress index (OSI) levels were significantly higher in the SUN group than in the HC group, while total glutathione (tGSH) and total antioxidant status (TAS) levels were significantly lower. However, MDA, TOS, and OSI levels were significantly lower in the SAT group than in the SUN group, while tGSH and TAS levels were significantly higher. Histopathological examination revealed keratin plugs with edema, vasopathology, and inflammatory cell infiltration in the SUN group. The SAT group showed less necrotic epithelium, keratin plugs, edema, and vasopathology than the SUN group. ATP can be effective in preventing skin damage caused by sunitinib use by reducing oxidative stress.

Relationship between mental health of nursing students and coping, self-esteem and social support.

AIM: The aim of this study was to investigate the relationship between the mental health of Turkish nursing students and the stress experienced during their education, their ways of coping, self-esteem, social support and individual factors. BACKGROUND: Studies on nursing students have shown that students who were not in possession of effective coping strategies were at risk of presenting psychiatric symptoms when under stressful conditions. METHODS: This was a cross-sectional, case-control study. The sample consisted of 516 nursing students who were studying in an undergraduate program in Turkey. Participants provided data on sociodemographic characteristics by completing the Nursing Education Stress Scale, Coping Behavior Inventory for Nursing Students, Multidimensional Scale of Perceived Social Support, Rosenberg Self-Esteem Scale, and the General Health Questionnaire. RESULTS: The main factors which were considered to affect the mental health of nursing students, including "total stress" and "self-esteem" scores, "general health" evaluation, "satisfaction with school life" and "presence of a negative event within the last year", were included in all models of the General Health Questionnaire analysis. Analysis of the data indicated that these factors had strong relationship with mental health of the nursing students. DISCUSSION: It is recommended that the mental health of students be monitored throughout the nursing education period and that preventive practices should be established in order to forestall mental health problems amongst nursing students. CONCLUSION: The stress levels of nursing students should be monitored in order to facilitate their ability to cope with stressful situations during their training, and components for coping with stress should be included in the curricula of nursing departments.

Pertuzumab, trastuzumab and taxane-based treatment for visceral organ metastatic, trastuzumab-naïve breast cancer: real-life practice outcomes.

PURPOSE: In this study, we aimed to describe the real-life practice outcomes of pertuzumab-trastuzumab-taxane (PTT) combination in visceral organ metastatic, trastuzumab-naive breast cancer (BC) patients. METHODS: This study was conducted by Turkish Oncology Group and included 317 patients' data from 36 centers. RESULTS: Median age was 51 (22-82). Median PFS was 28.5 months, while median OS was 40.3 months. Patients with brain metastases (n: 13, 4.1%) had worse PFS (16.8 m vs. 28.5 m; p = 0.002) and OS (26.7 m vs. 40.3 m; p = 0.009). Patients older than 65 years of age (n: 42, 13.2%) had significantly lower OS results (19.8 m vs. 40.3 m; p = 0.01). Two hundred sixty-eight patients (86.7%) received docetaxel while 37 patients (11.7%) received paclitaxel. PFS and OS were similar between taxane groups. In eight patients (2.5%), 5-40% ejection fraction decrement from baseline was detected without any clinical sign of heart failure. CONCLUSIONS: Our RLP trial included only visceral metastatic, trastuzumab-naïve BC patients including cases with brain involvement who received PTT combination in the first-line treatment. Regardless of negative prognostic characteristics, our results are in parallel with pivotal trial. Further strategies for brain metastasis should be developed to improve outcomes despite encouraging results with PTT treatment. Taxane selection can be personalized and endocrine maintenance may further improve outcomes after taxanes were discontinued. To our knowledge, this is the largest scale real-life clinical practice study of pertuzumab-trastuzumab-taxane therapy to date.

Alexithymia and perception of illness in patients with cancer.

This study aimed to determine how alexithymia affects the perception of illness in patients with cancer. This was a descriptive study conducted at the Atatürk University Health, Research and Practice Hospital and the Erzurum Regional Training and Research Hospital's Medical Oncology Clinic and Chemotherapy Unit. The study data were collected between July 2013 and January 2014. In total, data were collected from 283 patients with cancer. The data were collected using questionnaires enquiring about demographic and medical information: the IPQ and TAS-20. The study concluded that 50.5% of the participating patients had alexithymia. It was found that the alexithymic patients with cancer perceived the negative outcomes of their illness more strongly, and their negative feelings about the illness were more intense. This study suggests that further research should be carried out on alexithymia in patients with cancer and that their positive beliefs about the illness could be enhanced using psychosocial interventions.

Quality of life after thyroid surgery.

PURPOSE: The purpose of this study was to inquire how patients' quality of life is affected after thyroid surgery and the factors involved. METHODS: A semi-structured questionnaire and the World Health Organization Quality of Life Scale (WHOQOL-BREF) were applied to 101 patients prior to surgery. Thereafter data was collected in the early and again in the late post-operative period. RESULTS: Mean general health score for pre-operative quality of life was 6.72 ± 1.53 (3-10), mean physical field score was 22.81 ± 2.77 (17-31), mean psychological field score was 21.69 ± 2.78 (15-28), mean social field score was 11.10 ± 1.94 (5-15) and mean environmental field score was 27.86 ± 4.30 (18-39). In the early post-operative period, mean general health score was 7.05 ± 1.45 (4-10), mean physical field score was 22.84 ± 2.83 (14-29), mean psychological field score was 21.67 ± 2.32 (16-27), mean social field score was 10.89 ± 1.96 (5-15) and mean environmental field score was 28.56 ± 4.18 (18-40). In the late post-operative period, the general health score for quality of life was 7.43 ± 1.34 (4-10), mean physical field score was 23.59 ± 2.70 (17-35), mean psychological field score was 21.75 ± 2.34 (14-29), mean social field score was 11.23 ± 1.94 (6-15) and mean on-field environment score was 29.30 ± 3.96 (16-40). The pre-operative levels of symptoms were found to be higher than early and late post-operative periods. CONCLUSIONS: Quality of life increased after total thyroidectomy and statistically significant improvement was observed in late post-operative stage.

The relationship between educational stress, stress coping, self-esteem, social support, and health status among nursing students in Turkey: A structural equation modeling approach.

BACKGROUND: Nursing education can be a stressful experience. To fully benefit from this experience and develop a positive professional identity, it is essential for nursing students to effectively cope with education-related stress. PURPOSE: The aim of the study was to investigate the relationships between nursing students' education-related stress and stress coping, self-esteem, social support, and health status. METHOD: This study utilized a cross-sectional, descriptive, and correlational design. The sample consisted 517 nursing students from a bachelor program in Turkey during the 2014-2015 academic year. Participants provided data on sociodemographic characteristics as well as completing the following instruments: Nursing Education Stress Scale, Coping Behavior Inventory for Nursing Students, Multidimensional Scale of Perceived Social Support, Rosenberg Self-Esteem Scale, and General Health Questionnaire. Relationships were examined using multivariate structural equation modeling. RESULTS: Results indicated that nursing students' stress coping levels were affected by self-esteem and social support. Additionally, this interaction appears to affect general health status. Although the direct effect of stress on coping was non-significant, its overall effect was significant within the model. CONCLUSION: It is necessary to conduct further intervention studies examining the role of self-esteem and social support in facilitating nursing students' stress-related coping during their education.

Efficiency of some soil bacteria for chemical oxygen demand reduction of synthetic chlorsulfuron solutions under agiated culture conditions.

This study searches the efficiency of certain soil bacteria on chemical oxygen demand (COD) reduction of synthetic chlorsulfuron solutions under agitated culture conditions. It also aims to determine the turbidity of liquid culture medium with chlorsulfuron during bacterial incubation for 120 hours. As a result the highest and lowest COD removal efficiency of bacteria was determined for Bacillus simplex as 94% and for Micrococcus luteus as 70%, respectively at the end of the 96th hour. It was found that COD removal efficiency showed certain differences depend on the bacterial species. It was also observed that B. simplex had the highest COD removal efficiency and it was a suitable bacterium species for bioremediation of a chlorsulfuron contaminated soils.

Intraocular Pressure Changes During Oral Glucose Tolerance Tests in Diabetic and Non-diabetic Individuals.

BACKGROUND: Hyperglycaemia in diabetic patients may lead to elevated intraocular pressure. Different reasons have been suggested in previous studies to explain the increase in intraocular pressure. The purpose of the present study was to investigate the change in intraocular pressure during oral glucose tolerance tests in diabetic and non-diabetic subjects. PATIENTS AND METHODS: 51 individuals who fulfilled the inclusion criteria of the study and were scheduled for oral glucose tolerances tests based on the recommendations of World Health Organization (WHO) underwent clinical examinations. Biochemical parameters associated with metabolic syndrome, insulin resistance (HOMA-IR) and systolic and diastolic blood pressure were also measured. A complete ophthalmologic examination was performed before the test. During the test, intraocular pressure was measured twice in the fasting state and at the first and second hours after oral glucose administration using rebound tonometry (ICARE). RESULTS: The mean age of the 51 patients was 46.19±9.13 years. The participants were categorized as non-diabetic (n: 24) and diabetic (n: 27). The baseline glucose levels were higher in the diabetic patients (p<0.001). The first-hour intraocular pressures (IOP1-0) changes in the right eye were significant in the diabetic and non-diabetic participants, and the first-hour intraocular pressure changes in the left eye (IOP1-0l) in the diabetic group were significant (p=0.017, p=0.017, p<0.001, respectively). CONCLUSION: The relation between diabetes mellitus and glaucoma has been addressed in many studies, but no clear underlying mechanisms have been identified. In our study of diabetic and non-diabetic individuals, hyperglycaemia during an oral glucose tolerance test was found to be positively related to intraocular pressure, which suggests that hyperglycaemia may represent a possible mechanism by which elevated IOP occurs.

Capacity of a newly isolated fungus Pleurotus eryngii from Tunceli, Ovacik for chemical oxygen demand reduction and biodecolorization of Azo-Dye Congo Red.

Biodecolorization of Congo red dye in both agar—plate and agitated liquid culture mediums by newly isolated white rot fungus Pleurotus eryngii has been studied. This fungus isolated from Tunceli—Ovacik province of Turkey. We have also examined the chemical oxygen demand reduction after decolorization under agitated liquid culture medium. For agar plate screening the decolorization capacity of P. eryngii, growth and decolorization halos were determined on saboroud dextrose agar (SDA) plates containing 0.05, 0.1, 0.5, 1 and 2 g/l of Congo red. P. eryngii showed certain decolorization capacities and was able to decolorize all studied concentrations of Congo red, but not to the same extent. Our results indicated that the new isolate P. eryngii had maximum decolorization (87% at 100 mg/l initial dye concentration) and chemical oxygen demand reduction (82% at 25 mg/l initial dye concentration) activities after 7 days under agitated submerged culture conditions. This new isolate could be an effective bioremediation tool for treatment of Congo red containing textile wastewater.

Essential oil composition, antioxidant and antifungal activities of Salvia sclarea L. from Munzur Valley in Tunceli, Turkey.

The essential oil composition and in vitro antioxidant and antifungal activity of the Salvia sclarea L. from Munzur Valley in Tunceli, Turkey were evaluated in this research. The in vitro antifungal activity of ethanol, hexane and aqueous extracts of S. sclarea against pathogen fungi Epicoccum nigrum and Colletotrichum coccodes were investigated. The essential oil of aerial parts of S. sclarea was obtained by hydrodistillation and was analysed by GC and GC­MS. Total antioxidant status was determined by using Rel assay diagnostics TAS assay kit (Lot.RL024) by Multiscan FC (Thermo). 33 compounds were identified representing the 85.0% of the total oil. The most abundant components (>5%) of the S. sclarea essential oils were caryophyllene oxide (24.1%), sclareol (11.5%), spathulenol (11.4%), 1H-naphtho (2,1,6) pyran (8.6%) and b­caryophyllene (5.1%). The best antifungal and antioxidant effect was seen in ethanolic S. sclarea extract. It can be said that Salvia sclerae could be used as natural antioxidant.

Evaluation of antioxidant properties, elemental and phenolic contents composition of wild nettle (Urtica dioica L.) from Tunceli in Turkey.

Wild nettle (Urtica dioica L.) types were sampled from different geographical regions in Tunceli (Turkey) to determine their mineral, vitamin, phenolic contents and their antioxidant properties. The total phenol varied from 37.419 ± 0.380 to 19.182 ± 1.00 mg of GAEs g(-1) of dry nettle. The highest radical scavenging effect was observed in Mazgirt parting of the ways 7.5 km with 33.70 ± 0.849 mg mL(-1). The highest reducing power was observed in the nettles from Mazgirt parting of the ways 7.5 km. Among the various macronutrients estimated in the plant samples, potassium was present in the highest quantity followed by calcium and phosphate. Kaempferol and resveratrol were not determined in some nettle samples but rutin levels were determined in all samples. Vitamin A concentrations were ranged between 13.64 ± 1.90 and 5.74 ± 1.00 (mg kg(-1) dry weight). These results show that Urtica dioica L. collected from Tunceli in Turkey could be considered as a natural alternative source for food, pharmacology and medicine sectors.

Resveratrol prevents high-fructose corn syrup-induced vascular insulin resistance and dysfunction in rats.

Dietary intake of fructose and sucrose can cause development of metabolic and cardiovascular disorders. The consequences of high-fructose corn syrup (HFCS), a commonly consumed form of fructose and glucose, have poorly been examined. Therefore, in this study, we investigated whether HFCS intake (10% and 20% beverages for 12 weeks) impacts vascular reactivity to insulin and endothelin-1 in conjunction with insulin receptor substrate-1(IRS-1), endothelial nitric oxide synthase (eNOS) and inducible NOS (iNOS) mRNA/proteins levels in aorta of rats. At challenge, we tested the effectiveness of resveratrol (28-30 mg/kg body weight/day) on outcomes of HFCS feeding. HFCS (20%) diet feeding increased plasma triglyceride, VLDL, cholesterol, insulin and glucose levels, but not body weights of rats. Impaired nitric oxide-mediated relaxation to insulin (10⁻9 to 3×10⁻6 M), and enhanced contraction to endothelin-1 (10⁻¹¹ to 10⁻8 M) were associated with decreased expression of IRS-1 and eNOS mRNA and protein, but increased expression of iNOS, in aortas of rats fed with HFCS. Resveratrol supplementation restored many features of HFCS-induced disturbances, probably by regulating eNOS and iNOS production. In conclusion, dietary HFCS causes vascular insulin resistance and endothelial dysfunction through attenuating IRS-1 and eNOS expressions as well as increasing iNOS in rats. Resveratrol has capability to recover HFCS-induced disturbances.

Pomegranate seed extract attenuates chemotherapy-induced liver damage in an experimental model of rabbits.

The aim of this study was to determine whether antioxidant pomegranate seed extract (PSE) has a preventive effect on cisplatin-induced hepatotoxicity. Rabbits were divided into 3 groups (n=6):1­Control group (0.9 % saline. i.p) 2­Cisplatin group (a single dose of cisplatin (5 mg/kg, i.p) 3­ A single dose of cisplatin (5 mg/kg, i.p) + PSE (250 mg/kg/day, i.p) for 6 consecutive days before and 6 consecutive days after a single intraperitoneal dose of 5 mg/kg body weight cisplatin. Liver function enzymes and malondialdehyde (MDA) levels were found significantly higher in cisplatin group compared to control. Liver catalase (CAT) and glutathione peroxidase (GSH-PX) activities decreased with cisplatin treatment but glutathione (GSH) level was increased. In cisplatin + PSE group, liver function enzyme activities and tissue MDA levels were found lower than cisplatin group. PSE ameliorated cisplatin-induced pathological changes. As a result it was demonstrated that PSE has protective effects against cisplatin hepatotoxicity in rabbit.