ZAP70 Activation Compensates for Loss of Class IA PI3K Isoforms Through Activation of the JAK-STAT3 Pathway.

BACKGROUND/AIM: Tyrosine kinases have crucial functions in cell signaling and proliferation. The phosphatidylinositol 3-kinase (PI3K) pathway is frequently deregulated in human cancer and is an essential regulator of cellular proliferation. We aimed to determine which tyrosine kinases contribute to resistance elicited by PI3K silencing and inhibition. MATERIALS AND METHODS: To mimic catalytic inactivation of p110α/ß, specific p110α (BYL719) and p110ß (KIN193) inhibitors were used in addition to genetic knock-out in in vitro assays. Cell viability was assessed using crystal violet staining, whereas cellular transformation ability was analyzed by soft-agar growth assays. RESULTS: Activated zeta chain of T-cell receptor-associated protein kinase 70 (ZAP70) generated resistance to PI3K inhibition. This resistance was via activation of the Janus kinase/signal transducer and activator of transcription 3 (JAK/STAT3) axis. We demonstrated that activated ZAP70 has a high transforming capability associated with the formation of malignant phenotype in untransformed cells and has the potential to be a tumor-initiating factor in cancer cells. CONCLUSION: ZAP70 may be a potent driver of proliferation and transformation in untransformed cells and is implicated in resistance to PI3K inhibitors in cancer cells.

Analysis of YouTube as a source of information for restless leg syndrome / Análise do YouTube como fonte de informação para a síndrome das pernas inquietas

ABSTRACT Background: YouTube is one of the major resources for health related videos around the world. Objective: The aim of this study was to evaluate the quality of information available on YouTube about restless leg syndrome (RLS). Methods: A YouTube search was carried out on https://www.youtube.com for videos pertaining to "restless leg syndrome" by using the keyword "restless leg syndrome". The first 100 relevant videos were included in the study. The videos were accepted as "useful" if they provided scientifically correct information about any aspect of RLS. The videos containing scientifically unproven information are defined as "misleading". The overall quality of all videos was subjectively graded using the global quality scale (GQS), a 5-point Likert scale. Results: The median video length for the included videos was 3.39 (0.11-85) minutes, and the median views were 6,055 (32-2351490). The median GQS of useful videos was 3 (1-5). The median number of likes and the median number of comments of personal experience videos were significantly higher than that of the useful and misleading videos. Videos uploaded by the university hospitals frequently issued pharmacological treatment of the RLS; however, those uploaded by practitioners, individual users, and TV or social media accounts were about the non-pharmacological treatment of the RLS. Conclusions: This study demonstrates that 77% of the videos uploaded on YouTube regarding RLS are in the useful category, whereas only 16 videos were providing misleading information. However, even videos in the useful category do not provide a full and complete description of the RLS.

RESUMO Introdução: O YouTube é um dos principais recursos no mundo para vídeos relacionados à saúde. Objetivo: O objetivo deste estudo foi avaliar a qualidade das informações disponíveis no YouTube sobre a síndrome das pernas inquietas (SPI). Métodos: Realizou-se uma busca no YouTube (https://www.youtube.com) para vídeos pertencentes à 'síndrome das pernas inquietas' usando a palavra-chave 'síndrome das pernas inquietas'. Os primeiros 100 vídeos relevantes foram incluídos no estudo. Foram aceitos como 'úteis' vídeos que fornecessem informações cientificamente corretas sobre qualquer aspecto da SPI. Os vídeos que contêm informações não comprovadas cientificamente são definidos como 'enganosos'. A qualidade geral de todos os vídeos foi avaliada subjetivamente usando a escala de qualidade global (GQS), uma escala Likert de 5 pontos. Resultados: A duração média dos vídeos incluídos foi de 3,39 (0,11-85) minutos e as visualizações médias foram de 6.055 (32-2.351.490). A GQS média dos vídeos úteis foi 3 (1-5). O número médio de curtidas e o número médio de comentários de vídeos de experiências pessoais foram significativamente maiores do que os de vídeos úteis e enganosos. Vídeos enviados por hospitais universitários frequentemente divulgam tratamento farmacológico da SPI; no entanto, aqueles carregados por profissionais, usuários individuais e contas de TV ou mídia social eram sobre o tratamento não farmacológico da SPI. Conclusões: Este estudo demonstrou que 77% dos vídeos carregados no YouTube sobre a SPI estão na categoria útil, enquanto apenas 16 vídeos forneceram informações enganosas. No entanto, mesmo os vídeos na categoria útil não fornecem uma descrição extensa e completa da SPI.

Quality of Life, Psychological Burden, and Sleep Quality in Patients With Brain Metastasis Undergoing Whole Brain Radiation Therapy.

BACKGROUND: Patients with brain metastasis (BM) usually suffer from poor quality of life (QOL), anxiety, depression, and sleep disorders in their reduced lifespan. OBJECTIVES: The aim of this study was to evaluate QOL, anxiety, depression, and sleep characteristics in patients with BM at the beginning and end of whole brain radiation therapy (WBRT) and three months after treatment. METHODS: Thirty-three patients undergoing WBRT for BM were featured in this study. The authors used the Karnofsky Performance Status (KPS) scale to measure performance status, the Hospital Anxiety and Depression Scale (HADS) to evaluate anxiety and depression, the SF-36® to evaluate health-related QOL, and the Pittsburgh Sleep Quality Index to evaluate sleep disorders at the start of WBRT, the end of WBRT, and three months after WBRT. FINDINGS: Statistically significant improvements were noted in KPS scores from baseline evaluation to the end of WBRT and to three months after WBRT. No significant differences were observed in SF-36 and HADS scores between the start and the end of WBRT. Anxiety scores were negatively correlated with survival at the end of WBRT. Overall survival was better in those who reported better sleep. WBRT improves KPS scores and does not worsen sleep quality or mood, even in patients with poor performance status. When changes in mood and sleep quality are observed, survival and QOL may improve in patients with BM; consequently, nurses should be responsive to these changes.

Evaluation of Tpeak-Tend interval and Tpeak-end/QT ratio in patients with Sarcoidosis.

UNLABELLED: rdiogram (ECG), can be used as a marker of transmural dispersion of repolarization. Also, Tp-e/QT and Tp-e/QTc ratios are used as an index of arrhythmogenesis. Prolonged Tp-e interval and Tp-e/QT ratio was found associated with sudden cardiac death in different clinical conditions. Novel ventricular repolarization parameters, Tp-e interval, Tp-e/QT and Tp-e/QTc ratios have not been evaluated in patients with sarcoidosis without cardiac symptoms previously.Therefore, we investigated Tp-e interval in patients with pulmonary sarcoidosis. METHODS: Sixty-one consecutive patients diagnosed with biopsy-proven pulmonary sarcoidosis were retrospectively reviewed. The 12-lead ECG examinations were performed at speed of 25 mm/s while the patients were in supine position.  QT dispersion, Tp-e intervals and Tp-e/QT ratio were measured. RESULTS: Comparison of ECG parameters between two groups showed a significantly higher average heart rate (p< 0.05) in the patients with sarcoidosis than controls. QT dispersion was higher in patients group. Tp-e interval was significantly prolonged in the study group compared to the control group (92±21 ms and 85±14 ms, respectively; p< 0.05). Tp-e/QT and Tp-e/QTc ratios were significantly higher in patients with sarcoidosis compared to control subjects (all p values < 0.05). CONCLUSIONS: The novel repolarization parameters Tp-e interval, Tp-e/QT and Tp-e/QTc ratios are increased in patients with sarcoidosis without any cardiac symptoms. These parameters might be used as a marker for predicting the ventricular arrhythmias and sudden cardiac death in patients with sarcoidosis.

Predictive value of platelet-to-lymphocyte ratio in exacerbation of chronic obstructive pulmonary disease.

AIM: We aimed to assess the platelet-to-lymphocyte ratio (PLR) and platelet parameters in patients with chronic obstructive pulmonary disease (COPD). METHODS: A total of 60 stable COPD patients, 50 acute exacerbation COPD patients and 50 healthy controls were enrolled in this study. RESULTS: The platelet distribution width and PLR were higher and the mean platelet volume was lower in the COPD patients during acute exacerbation compared with the stable patients and controls. The PLR was negatively correlated with the forced expiratory volume in 1 s. CONCLUSION: The PLR may be used as a useful and easily accessible tool for evaluating the ongoing inflammation during stable period and the disease severity during acute exacerbations in COPD patients.

Evaluation of New Biomarkers in the Prediction of Malignant Mesothelioma in Subjects with Environmental Asbestos Exposure.

INTRODUCTION: The purpose of this study was to investigate the potential value of certain biomarkers in predicting the presence of malignant pleural mesothelioma (MPM) in individuals environmentally exposed to asbestos. METHODS: This prospective study investigated three groups; a control group composed of 41 healthy subjects, an asbestos exposure group consisting of 48 individuals, and a MPM group consisting of 42 patients. Serum levels of soluble mesothelin-related peptide (SMRP), thioredoxin-1 (TRX), epidermal growth factor receptor (EGFR), fibulin-3, syndecan-1 (SDC-1), and mesothelin were determined. RESULTS: Benign pleural plaques were present in 27 (58.3 %) of the individuals in the asbestos exposure group. The asbestos exposure group had significantly higher mean TRX, SMRP, and mesothelin levels compared to the control group (p = 0.023, p = 0.011, and p < 0.001, respectively). Compared to the asbestos exposure group, the MPM group had significantly higher mean EGFR, TRX, SMRP, and fibulin-3 levels (p = 0.041, p = 0.023, p = 0.002, and p = 0.001, respectively), and significantly lower mean SDC-1 levels (p = 0.002). Unlike the other biomarkers, SMRP and TRX levels increased in a graded fashion among the control, asbestos exposure, and MPM groups, respectively. Area under the curve values for SMRP and TRX were 0.86 and 0.72, respectively (95 % CI 0.79-0.92 and p < 0.001 for SMRP, and 95 % CI 0.62-0.81 and p < 0.001 for TRX). The cut-off value for SMRP was 0.62 nmol/l (sensitivity: 97.6 %, specificity: 68.9 %, positive predictive value (PPV): 56.2 %, and negative predictive value (NPV): 98.3 %) and for TRX was 156.67 ng/ml (sensitivity: 92.9 %, specificity: 77.6 %, PPV: 41.4 %, and NPV: 92.1 %). The combination of the biomarkers reached a sensitivity of 100 %, but had lower specificity (as high as 27.7 %). CONCLUSIONS: Serum biomarkers may be helpful for early diagnosis of MPM in asbestos-exposed cases. SMRP and TRX increased in a graded fashion from the controls to asbestos exposure and MPM groups. These two seem to be the most valuable biomarkers for the diagnosis of MPM, both individually and in combination.

The Protective Effects of Caffeic Acid Phenethyl Ester on Acetylsalicylic Acid-induced Lung Injury in Rats.

AIM: We aimed to investigate the protective effect of caffeic acid phenethyl ester (CAPE) on acetylsalicylic acid (ASA)-induced lung damage in rats in the present study. METHODS: A total of 40 rats were randomly divided into five groups, with eight rats in each group-group 1: control, not receiving any medication; group 2: ASA (50 mg/kg/day); group 3: ASA (50 mg/kg/day) plus CAPE (20 µg/kg/day); group 4: ASA (100 mg/kg/day); and group 5: ASA (100 mg/kg/day) plus CAPE (20 µg/kg/day). ASA and CAPE were given via orogastric gavage for 5 days. The total oxidant status (TOS), total antioxidant capacity (TAC), oxidant stress index (OSI), and paraoxonase-1 (PON-1) activity of the blood samples and lung tissues were determined. Histopathological examinations of the lung tissues were performed by using light microscopic methods. RESULTS: CAPE treatment significantly increased antioxidant PON-1 level both in the lung tissue and plasma (p < .05). Plasma antioxidant marker (TAC, PON-1) levels significantly increased and oxidant marker (TOS, OSI) levels significantly decreased in CAPE-treated rats (groups 3,5) compared to ASA given no-CAPE groups (group 2,4) (p < .05). Treatment with CAPE improved pulmonary interstitial inflammation and eosinophil accumulation due to ASA histopathologically. CONCLUSION: Eosinophil-rich inflammation and oxidative stress play important roles in ASA-induced lung toxicity, and CAPE may protect against ASA-induced lung toxicity by reduction of oxidative damage and inflammation in rats.

Relationship between metabolic syndrome and epicardial fat tissue thickness in patients with chronic obstructive pulmonary disease.

OBJECTIVE: An increase in epicardial fat tissue (EFT) thickness was found to be associated with metabolic syndrome (MS) and ischemic heart disease. MS is a comorbidity of chronic obstructive pulmonary disease (COPD) resulting from the accompanying systemic inflammation. The aim of our study was to investigate the usefulness of EFT thickness to predict MS in COPD patients. METHODS: COPD patients admitted to our clinic during January-December 2014 and healthy controls were included in this prospective case control study. Patients with comorbidities, COPD exacerbation, and malignancies were excluded. Patients and controls were compared in terms of anthropometric measurements, MS-related examination and laboratory findings, pulmonary function tests, and EFT thickness. The correlations between EFT thickness and markers of MS in COPD were evaluated using the Student's t-test and logistic regression analysis. RESULTS: COPD patients and controls were composed of 82 and 84 individuals, respectively. MS was diagnosed in 31 (37.8%) COPD patients. The EFT thickness was significantly higher in COPD patients than in the controls and was also higher in COPD patients with MS than in those without MS (all p<0.001). Each 1-mm increment of EFT raised the risk of MS two-fold (p=0.011, OR=2.08, 95% CI: 1.18-3.68). Increase in triglyceride level (p=0.004, OR=1.02, 95% CI: 1.01-1.03) and reduction in forced vital capacity (p=0.025, OR=0.26, 95% CI: 0.08-0.84) were found to be associated with increased MS risk. The cut-off value for EFT thickness in the prediction of MS in COPD patients was 6.75 mm (sensitivity: 83%, specificity: 65%). CONCLUSION: EFT thickness is a non-invasive and easily available parameter, which is valuable in the prediction of increased MS risk in COPD patients. Early diagnosis of patients at risk of MS may help to prevent ischemic heart disease in these patients.

Histopathological and Biochemical Effects of Ecballium elaterium on Sepsis-Induced Lung Injury.

PURPOSE: The aim of this study was to investigate the role of Ecballium elaterium (EE) on sepsis-induced lung injury. MATERIALS AND METHODS: A total of 30 male rats were divided into three groups as follows: control, sepsis, and treatment groups (sepsis + EE) with each group containing 10 rats. A rat model of sepsis induced by cecal ligation and puncture (CLP) was used. In the treatment group, rats were injected intraperitoneally with 2.5 mg/kg EE after CLP. Interleukin-6 (IL-6), tumor necrosis factor (TNF)-α, total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI) values after a 24-hr period were measured via cardiac puncture. Animals were harvested after the procedure and biochemical analysis was done and histopathological changes of the tissue sections of lungs were examined thereafter. RESULTS: A statistically significant decrease was observed in the IL-6 (p < .05), TNF-α (p < .05), and TOS (p < .01) levels in the sera of the treatment group compared to those of the sepsis group. Following the treatment, the TOS (p = .01) and OSI (p < .05) levels in the lung tissue of rats indicated a statistically significant decrease compared to those of the sepsis group. The histopathological follow-up undertaken after the administration of the EE treatment to septic rats showed significantly lower values of alveolar wall thickness (p < .001), interstitial edema (p = .018), and neutrophil infiltration (p = .047). CONCLUSION: EE treatment may have beneficial effects on sepsis-induced lung injury, and therefore has potential for clinical use.

The impact of anti-smoking laws on high school students in Ankara, Turkey / O impacto das leis antifumo em alunos do ensino médio em Ancara, Turquia

ABSTRACT OBJECTIVE: To determine the factors affecting the smoking habits of high school students, their thoughts about changes resulting from anti-smoking laws, and how they are affected by those laws. METHODS: In this cross-sectional study, 11th-grade students at eight high schools in Ankara, Turkey, were invited to complete a questionnaire. RESULTS: A total of 1,199 students completed the questionnaire satisfactorily. The mean age of the respondents was 17.0  0.6 years; 56.1% were female, of whom 15.3% were smokers; and 43.9% were male, of whom 43.7% were smokers (p < 0.001). The independent risk factors for smoking were male gender, attending a vocational school, having a sibling who smokes, having a friend who smokes, and poor academic performance. Of the respondents, 74.7% were aware of the content of anti-smoking laws; 81.8% approved of the restrictions and fines; and 8.1% had quit smoking because of those laws. According to the respondents, the interventions that were most effective were the (television) broadcast of films about the hazards of smoking and the ban on cigarette sales to minors. The prevalence of smoking was highest (31.5%) among students attending vocational high schools but lowest (7.5%) among those attending medical vocational high schools. Although 57.1% of the smokers were aware of the existence of a smoking cessation helpline, only 3.7% had called, none of whom had made any attempt to quit smoking. CONCLUSIONS: Although most of the students evaluated were aware of the harmful effects of smoking and approved of the anti-smoking laws, only a minority of those who smoked sought professional help to quit.

RESUMO OBJETIVO: Determinar os fatores que afetam os hábitos de fumar de estudantes do ensino médio, seus pensamentos sobre as mudanças resultantes das leis antifumo e como eles são afetados por essas leis. MÉTODOS: Neste estudo transversal, alunos do 11º ano de oito escolas de ensino médio em Ancara, Turquia, foram convidados para preencher um questionário. RESULTADOS: Preencheram o questionário 1.199 estudantes de forma satisfatória. A média de idade dos participantes foi de 17,0  0,6 anos; 56,1% eram mulheres; das quais 15,3% eram fumantes; e 43,9% eram homens, dos quais 43,7% eram fumantes (p < 0,001). Os fatores de risco independentes para o tabagismo foram ser homem, frequentar escola técnica, ter um irmão/irmã que fuma, ter um amigo que fuma e ter baixo desempenho acadêmico. Dos participantes, 74,7% conheciam o conteúdo das leis antifumo; 8,1% aprovavam as restrições e multas, e 8,1% haviam cessado o tabagismo devido a essas leis. Na opinião dos participantes, as intervenções mais efetivas foram a exibição de curtas na TV sobre os malefícios do tabagismo e a proibição da venda de cigarros a menores. A prevalência do tabagismo foi maior (31,5%) nos estudantes de escolas técnicas, mas menor (7,5%) nos estudantes de escolas técnicas médicas. Embora 57,1% dos fumantes soubessem da existência de um serviço telefônico de ajuda para a cessação tabágica, somente 3,7% haviam ligado para esse serviço, mas nenhum tentou parar de fumar. CONCLUSÕES: Embora a maioria dos alunos avaliados conhecesse os efeitos deletérios do tabagismo e aprovasse as leis antifumo, apenas uma minoria dos fumantes procurou ajuda profissional para a cessação tabágica.

Effects of Distant Reiki On Pain, Anxiety and Fatigue in Oncology Patients in Turkey: A Pilot Study.

BACKGROUND: Fatigue, stress and pain are common symptoms among cancer patients, affecting the quality of life. The purpose of the present study was to determine the effect of distant Reiki on pain, anxiety and fatigue in oncology patients. MATERIALS AND METHODS: Participants in the control group received usual medical and nursing care during their stay. The intervention group received usual care plus five distant Reiki sessions, one each night for 30 min. A face to face interview was performed and patient personal and illness related characteristics were evaluated using the Patient Characteristics form. Pain, stress and fatigue were evaluated according to a numeric rating scale. RESULTS: The experimental group was predominantly composed of women (71.4%), married individuals (40%), and primary school graduates (40%). The control group was predominantly male (72.7%), married (60%), and primary school graduates (60%). The control group demonstrated greater levels of pain (p=0.002), stress (p=0.001) and fatigue (p=0.001). The Reiki group pain score (p<0.0001), stress score (p<0.001) and fatigue score were also significantly lower. CONCLUSIONS: The results of this study indicate that Reiki may decreasepain, anxiety and fatigue in oncology patients.

Fibulin-3 as a diagnostic biomarker in patients with malignant mesothelioma.

BACKGROUND: New tumour biomarkers are being intensely investigated for malignant mesothelioma (MM). Fibulin-3 is produced in MM but its role remains uncertain. The aim of this study was to evaluate the validity of measuring serum fibulin-3 in the diagnosis and prognosis of MM. MATERIALS AND METHODS: This prospective study was performed on 43 patients and 40 healthy controls who were admitted to our hospital between January 2012 and January 2014. Data from MM patients, including demographic and clinical features, routine laboratory data, levels of serum fibulin-3, and treatment outcomes were defined as potential prognostic factors. The receiver operating characteristic (ROC) curve for fibulin-3 was used to detect the cut-off value with highest sensitivity and specificity. Univariate survival analysis was performed using the Kaplan-Meier method in patients with MM. Afterwards, the possible factors identified with univariate analyses were entered into the cox regression analysis. RESULTS: Our results revealed that patients with MM had significantly higher serum levels of fibulin-3 than controls. The results showed that the best cut-off point was 36.6 ng/ml with an AUC (area under the curve)=0.976, sensitivity=93.0% and specificity=90.0. In our study, the initial significant poor prognostic factors were advanced stage, high white blood cell count, high platelet count, high C-reactive protein (p<0.05 for each variable). Later, according to multivariate analysis the results showed only advanced stage as significant parameter (p=0.040). CONCLUSIONS: We determined that real use for serum fibulin-3 was not for prognosis but for diagnosis in MM. Also advanced stage was associated with poor MM prognosis.

The impact of anti-smoking laws on high school students in Ankara, Turkey.

OBJECTIVE: To determine the factors affecting the smoking habits of high school students, their thoughts about changes resulting from anti-smoking laws, and how they are affected by those laws. METHODS: In this cross-sectional study, 11th-grade students at eight high schools in Ankara, Turkey, were invited to complete a questionnaire. RESULTS: A total of 1,199 students completed the questionnaire satisfactorily. The mean age of the respondents was 17.0  0.6 years; 56.1% were female, of whom 15.3% were smokers; and 43.9% were male, of whom 43.7% were smokers (p < 0.001). The independent risk factors for smoking were male gender, attending a vocational school, having a sibling who smokes, having a friend who smokes, and poor academic performance. Of the respondents, 74.7% were aware of the content of anti-smoking laws; 81.8% approved of the restrictions and fines; and 8.1% had quit smoking because of those laws. According to the respondents, the interventions that were most effective were the (television) broadcast of films about the hazards of smoking and the ban on cigarette sales to minors. The prevalence of smoking was highest (31.5%) among students attending vocational high schools but lowest (7.5%) among those attending medical vocational high schools. Although 57.1% of the smokers were aware of the existence of a smoking cessation helpline, only 3.7% had called, none of whom had made any attempt to quit smoking. CONCLUSIONS: Although most of the students evaluated were aware of the harmful effects of smoking and approved of the anti-smoking laws, only a minority of those who smoked sought professional help to quit.

Two cases of extrapulmonary onset granulomatosis with polyangiitis which caused diffuse alveolar haemorrhage.

Granulomatosis with polyangiitis (GPA) is a rare form of vasculitis. Multidisciplinary therapeutic approach and early diagnosis assume vital importance in management of patients with diffuse alveolar haemorrhage caused by GPA, which is a rare complication. The purpose of this study was to present the diagnostic and therapeutic challenges experienced by clinicians in management of two severe cases of GPA with insidious extrapulmonary manifestations which rapidly progressed into acute kidney injury, alveolar haemorrhage and acute respiratory failure.

Effect of Reiki on symptom management in oncology.

Reiki is a form of energy therapy in which the therapist, with or without light touch, is believed to access universal energy sources that can strengthen the body's ability to heal itself, reduce inflammation, and relieve pain and stress. There is currently no licensing for Reiki nor, given its apparent low risk, is there likely to be. Reiki appears to be generally safe, and serious adverse effects have not been reported. So in this article provides coverage of how to use Reiki in oncology services.

A comparison of men and women's experiences of chemotherapy-induced alopecia.

PURPOSE: The effect of alopecia on men and women has not been fully documented in the literature, especially for Turkish cancer patients. The aim of this study was to determine the incidence of chemotherapy-related alopecia and how it affects the body image and quality of life of Turkish male and female cancer patients, in order to identify variables that may be important in the perception of this problem. METHODS: This descriptive study was carried out between November 2010 and June 2011 at Istanbul University Institute of Oncology; 201 men and 204 women attended. A face-to-face interview was performed during chemotherapy, and the effects of alopecia on cancer patients were assessed using the Patient Information Form, Body Image Scale, and Nightingale Symptom Assessment Scale. RESULTS: The study group consisted of 55.1% female and 44.9% male patients. Most of the patients experienced partial or total alopecia during chemotherapy. There were no differences between men and women with regard to body image in respect of degree of alopecia, but the body image of the male and female patients who had partial or complete alopecia was lower than that in patients who had no alopecia; psychological well-being of women was lower than that in men, because the incidence of alopecia was higher in women. CONCLUSIONS: This study contributes new knowledge on the cultural characteristics of Turkish patients, which may assist other researchers working with different international populations. Alopecia is a difficult side effect for both men and women. Health professionals should assess and educate patients differently from the current standard.

Complementary and alternative therapies used by Turkish breast cancer patients undergoing chemotherapy.

BACKGROUND: Most breast cancer patients use complementary and alternative medicine (CAM), usually in parallel with their conventional treatments. This study was planned to determine the prevalence and determining factors for use of CAM by breast cancer patients undergoing chemotherapy. PATIENTS AND METHODS: This descriptive study was carried out between October 2010 and May 2011, and included 96 patients at the Istanbul University Institute of Oncology. The Patient Characteristics form and Complementary and Alternative Medicine Scale were used for data collection. Descriptive and non-parametric tests were performed, and logistic regression analysis was used to predict factors affecting CAM use. RESULTS: Praying was the most frequently used form of CAM, and most of the herbal supplements used by patients were harmless. Herbal use was higher among patients who had local disease (relative risk (RR) 4.48%, 95% confidence interval (CI) 1.12-17.95), and worship was more common among those who had not undergone surgery (RR 4.66%, 95% CI 1.64-13.20). CONCLUSION: The CAM approaches used by patients were found to be safe. However, sage and flax seed usage for estrogen-and progesterone-positive patients and exercise for patients with spinal metastasis can be inappropriate approaches. It is important to question and inform patients about CAM use during treatment.