Nucleosome assembly protein 1-like 1 (NAP1L1) in gastric cancer patients: a potential biomarker with diagnostic and prognostic utility.

BACKGROUND: The nucleosome assembly protein 1-like 1 (NAP1L1) is suggested to have an oncogenic role in several tumors based on its overexpression. However, its diagnostic and prognostic role in gastric cancer remains unclarified. This study aimed to evaluate the diagnostic and prognostic utility of NAP1L1 in gastric cancer patients. METHODS: A total of 85 patients [mean (SD) age: 60.9 (1.6) years, 49.4% were males] with newly-diagnosed gastric cancer and 40 healthy individuals [mean (SD) age: 60.7 (1.7) years, 52.5% were males] were included. Data on patient demographics (age, gender), TNM stages and tumor size, and the serum NAP1L1 levels were recorded. RESULTS: Serum NAP1L1 levels were significantly higher in gastric cancer patients than in control subjects [12 (9.5-13.8) vs. 1.8 (1.5-2.4) ng/mL, p < 0.001]. Also, certain tumor characteristics such as tumor size of >4 vs. <4 cm (p < 0.001), M1 vs. M0 stage (p < 0.001), N2 vs. N0 and N1 stage (p < 0.001), and T4 vs. lower T stage (p < 0.001) were associated with significantly higher serum NAP1L1 levels in gastric cancer patients. CONCLUSIONS: Our findings revealed for the first time that serum levels for NAP1L1 were overexpressed in the gastric cancer, as also correlated with the disease progression. NAP1L1 seems to be a potential biomarker for gastric cancer, providing clinically important information on early diagnosis and risk stratification.

This study aimed to investigate serum levels for nucleosome assembly protein 1-like 1 (NAP1L1) in patients with gastric cancer in relation to healthy controls and tumor pathology.It was demonstrated for the first time that serum levels for NAP1L1 were overexpressed in the gastric cancer, as also correlated with the disease progression.These findings seem to implicate the potential role of serum NAP1L1 as a distinct diagnostic and prognostic factor in patients with gastric cancer, offering clinically important information on early diagnosis and risk stratification.

The Four Horsemen of the Apocalypse: Cancer, Depression, Vitamin D Deficiency, and Obesity: An Observational Study.

Objective: Studies aiming at illuminating the complex relationships between cancer, obesity, 25-hydroxy vitamin D (25-OHD) deficiency, and body fat percentage are ongoing. The objective of this study was to investigate the relationships between 25-OHD deficiency, visceral fat tissue, and the Beck Depression Inventory (BDI) in cancer patients. Methods: This study was conducted from 2013 to 2022. Patients' demographic data, such as age, sex, and body mass index (BMI), and laboratory parameters, including prealbumin, albumin, calcium, phosphorus, parathyroid hormone, 25-OHD, magnesium, hemoglobin, fat percentage, and C-reactive protein, were recorded. The Beck Depression Inventory was used to determine depression levels. Results: A total of 223 colon cancer patients aged 19-84 undergoing chemotherapy at our clinic were included in this prospective study. The male patients' mean BMI was 22.91 ± 3.74 kg/m2, whereas that of the female patients was 26.17 ± 3.75 kg/m2. The difference was statistically significant (p < 0.001). The mean total Beck Depression Inventory score was 13 ± 9. In this patient population, 105 (47.09%) patients had minimal depression, 69 (30.94%) had mild depression, 35 (15.70%) had moderate depression, and 14 (6.28%) had severe depression. The Beck Depression Inventory score was negatively and strongly associated with BMI and moderately and negatively associated with albumin levels. Conclusion: This study reveals a significant correlation between 25-OHD levels and the Beck Depression Inventory scores among cancer patients. We believe that 25-OHD levels may be used to determine the presence of depressive symptoms in cancer patients. However, further comprehensive multicentre studies are needed to draw more definitive conclusions.

B7-H3: A Useful Emerging Diagnostic Marker for Colon Cancer.

Background: Colon cancer is the second most common malignancy causing the majority of cancer-related deaths. B7-H3 concentrations have drawn major interest as possible diagnostic biomarkers of cancer. The aim of this study was to measure the preoperative serum B7-H3 levels and to determine those that are replaced in colon cancer. Method: We measured preoperative serum B7-H3 concentrations of 90 patients aged 57-69 years diagnosed with colon cancer and 50 age-matched healthy individuals. B7-H3 levels were determined using the sandwich enzyme-linked immunosorbent assay (ELISA). Patients were categorized by stage based on the TNM staging system, and the serum levels of B7-H3 were compared between patients with different TNM stages. Result: No statistically significant difference was found between the patient and control groups in terms of age and gender. Preoperative serum B7-H3 levels were statistically significantly higher in patients with colon cancer than in the healthy group (p < 0.001). Preoperative serum B7-H3 concentration of the stage IV patients was significantly higher than those of the patients with stage I and stage II disease. In addition, higher serum B7-H3 levels were associated with lymph node status and distant metastasis in colon cancer. Conclusion: We showed that B7-H3 is highly expressed in colon cancer and can be used as a candidate diagnostic biomarker and a potential target in colon cancer in future.

Nidogen-2: A new biomarker in colon cancer patients.

AIM: In the present study, we followed Nidogen-2 levels and clinicopathological parameters of patients with colon cancer. MATERIAL AND METHODS: Eighty-eight patients (F/M, 43/45; Mean age ± SD, 57.86 ± 1.78 years) were included. The results of serum Nidogen-2 levels were shown with respect to stage, gender, age, and metastasis. Nidogen-2 levels in the sera of colon cancer patients and healthy donors were analyzed with ELISA. RESULTS: The expression levels were significantly higher in patients (1010.8 ±184.36 pg/mL) than in healthy subjects (51.85 ± 1.44 pg/mL; p<0.001). Moreover, the Nidogen-2 expression significantly increased in the clinical stages of colon cancer (p<0.01). The Nidogen-2 levels did not vary by patient age or gender. DISCUSSION: Under normal conditions, Nidogen-2 is a basal membrane protein. Nidogen-2 is primarily expressed in the extracellular matrix. Nidogen-2 has been defined as a major means to analyze the molecular pathways involved in cancer development and progression. Besides its important functions, it has been hypothesized that secreted Nidogen-2 may be a diagnostic biomarker for cancer detection. CONLUSION: These findings suggest that increased expression of Nidogen-2 may have great pathological importance in the development of colon cancer and may also show a diagnostic value for colon cancer. KEY WORDS: Angiogenesis, Metastasis, Nidogen-2.

A real-time analysis of intraoperative interruptions in relation to use of simple preventive measures including a sign on the door and a checklist-based team brief.

This study aimed to evaluate intraoperative interruptions by frequency, type, interference and source, and preventive measures. The interruptions in the operating theatre were evaluated for 52 surgical procedures based on real-time recordings and divided into routine operative procedures (ROP, n = 26, without intervention) and intervened operative procedures (IOP, n = 26, observed after team brief and placement of a warning sign for unnecessary door openings) groups. Intervened operative procedures vs. routine operative procedures was associated with a significantly lower number of interruptions (p = 0.014). Implementation of preventive measures was associated with a significantly lower number of entrances and exits (p = 0.001) and equipment issues (p = 0.003), interruptions that affected the circulating nurse or anaesthesia technician/associate (p = 0.003) and those caused by team members other than assisting surgeon and scrub nurse (p-value ranged from 0.015 to 0.009). Our findings revealed significantly reduced interruptions after a simple preventive measure including team brief and the placement of a warning sign for unnecessary door openings.

Comparison of Platelet-Rich Plasma-Impregnated Suture Material with Low and High Platelet Concentration to Improve Colonic Anastomotic Wound Healing in Rats.

OBJECTIVE: This study was designed to investigate the impact of using suture material impregnated with platelet-rich plasma (PRP) in different platelet concentrations on colonic anastomotic wound healing in rats. METHODS: A total of 24 Sprague Dawley female rats were separated into 3 groups (n = 8 for each) including the control group (CON; standard vicryl suture repair), the low platelet concentrate PRP group (L-PRP; suture material impregnated with PRP containing average 2.7-fold (range, 2.0 to 3.1) higher amount of platelets vs. control), and the high platelet concentrate PRP group (H-PRP; suture material impregnated with PRP containing average 5.1-fold (range, 4.8 to 5.4) higher amount of platelets vs. control). Rats were sacrificed on the postoperative 7th day for analysis of colonic anastomosis region including macroscopic observation, measurement of anastomotic bursting pressure (ABP), and the hydroxyproline levels and histopathological findings in colon tissue samples. RESULTS: Total injury scores were significantly lower in the L-PRP and H-PRP groups than those in the control group (median (range) 13.00 (7.00) and 11.50 (6.00) vs. 15.50 (4.00), p < 0.05 and p < 0.01, respectively). ABP values (180.00 (49.00) vs. 124.00 (62.00) and 121.00 (57.00) mmHg, p < 0.001 for each) and tissue hydroxyproline levels (0.56 (0.37) vs. 0.25 (0.17) and 0.39 (0.10) µg/mg tissue, p < 0.001 and p < 0.05, respectively) were significantly higher in the L-PRP group as compared with those in the control and H-PRP groups. CONCLUSION: In conclusion, our findings revealed PRP application to colonic anastomosis sutures to promote the anastomotic healing process. The platelet concentration of PRP seems to have a significant impact on the outcome with superior efficacy of L-PRP over H-PRP in terms of bursting pressures and collagen concentration at the anastomotic site.

Evaluation of the Effects of Preoperative Dexamethasone Administration on Postoperative Patient Comfort in Laparoscopic Cholecystectomy.

Objective Postoperative recovery process following laparoscopic cholecystectomy depends on many factors such as pain, fatigue and exhaustion. The objective of this study was to investigate whether the administration of dexamethasone, a glucocorticoid, has positive effects of postoperative patient comfort in patients who underwent laparoscopic cholecystectomy in our clinic. Methods Patients who presented to the general surgery clinic of our hospital and scheduled for laparoscopic cholecystectomy due to cholelithiasis were included in this study. Patients in Group 1 received dexamethasone 90 minutes before the skin incision, while patients in Group 2 were given placebo (normal saline). Pain scores, presence of nausea and vomiting in the postoperative period were compared between the study and control groups. Results No statistically significant difference was observed between the groups in terms of incisional pain at rest and in motion and visceral pain at rest at postoperative 6th, 12th and 24th hours. Although there was a difference between the groups in terms of visceral pain in motion at the postoperative 12th and 24th hours, this was not statistically significant (p > 0.05). Although the need for additional analgesics and antiemetic drugs was lower in the study group compared to the control group, the difference between the groups was not statistically significant (p > 0.05). Conclusion We can expect better results with the use of multimodal analgesic and anti-emetic combination instead of a single agent in studies to be performed about the prevention of postoperative pain, nausea and vomiting.

Quality and reliability of information available on YouTube and Google pertaining gastroesophageal reflux disease.

BACKGROUND: Evaluation of the accuracy, quality and reliability of written and visual health contents on the internet by healthcare professionals. AIMS: The objective of this study was to evaluate gastroesophageal reflux health contents in Google search engine and videos on YouTube, in terms of quality, actuality, treatment diversity, accuracy and reliability. METHODS: A total of 77 YouTube videos and 57 Google contents related to gastroesophageal reflux disease were included in the study. The contents were assessed by two independent reviewers. Quality of the content included in this study was evaluated using DISCERN, which is commonly used for the assessment of health information on the internet, JAMA and video power index scores. RESULTS: Among YouTube videos; 44.7 % (n = 34) were uploaded by experts, 44.7 % (n = 34) by non-experts, 9.0 % (n = 7) by media and 2.7 % (n = 2) by academic institutions, while 10.5 % (n = 6) of the Google contents were uploaded by experts, 59.6 % (n = 34) by non-experts and 22.4 % (n = 17) by academic institutions. The mean total DISCERN score (5-80 points) of reflux related YouTube was found as 37.2 ±â€¯16.5. The mean total DISCERN scores of the evaluated Google contents was found as 42.1 ±â€¯15.6. The mean JAMA score (0-4 points) was found as 2 ±â€¯0.9 for YouTube videos and 2 ±â€¯0.9 for Google contents. There was a strong correlation between all scores given by the two reviewers. CONCLUSIONS: Overall quality of YouTube videos and Google contents about reflux was low. Healthcare professionals and organizations should be encouraged to provide more beneficial material and animated videos to people who seek reliable information on the internet.

Quality of Information Available on YouTube Videos Pertaining to Thyroid Cancer.

The purpose of the present study was to assess the quality of information available on YouTube videos pertaining to thyroid cancer. A search of YouTube (http://www.youtube.com) was performed on February 12, 2018, using the search terms "thyroid cancer" and "thyroid cancer treatment." The first 50 videos that appeared on each search were reviewed and 52 videos were included in the analysis. Videos were independently analyzed by two authors for video characteristics including publishing source of upload, continent of origin, presence of animation, and numbers of views, likes, and dislikes. The quality of information provided was assessed using the DISCERN and JAMA benchmark scores, while video power index was also calculated. The median (min-max) DISCERN score was 19.5 (4-71) for reviewer 1 and 20.0 (4-72) for reviewer 2. The median (min-max) JAMA benchmark score was 2.0 (1-4) for both reviewers. JAMA scores were positively correlated with video power index in both reviewer 1 (r = 0.310, p = 0.025) and reviewer 2 (r = 0.356, p = 0.010) assessment. JAMA and DISCERN scores were positively correlated with duration of videos in both reviewer 1 (r = 0.454, p = 0.001 and r = 0.533, p < 0.001, respectively) and reviewer 2 (r = 0.541, p < 0.001 and r = 0.519, p < 0.001, respectively) assessment. In conclusion, our findings revealed poor quality of information provided by YouTube videos pertaining to thyroid cancer based on DISCERN and JAWA scores. Videos with longer duration and higher video power index seem to be associated with higher quality scores, whereas no impact of using animation was shown on quality scores as well as no association between video duration and video power index.

Factors considered by patients in provider selection for elective specialty surgery: A questionnaire-based survey.

BACKGROUND: This study was designed to comprehensively evaluate the factors considered by patients in provider selection for elective specialty surgery. MATERIALS AND METHODS: A total of 200 patients (mean age 44.4 (range, 18.0-70.0) years, 51.0% were males), who were admitted to a tertiary care center for an elective surgery, participated on a voluntary basis in this cross-sectional questionnaire survey. The questionnaire form elicited items on sociodemographic characteristics of patients, characteristics of operation, factors contributing to physician selection by patients (physician-related factors, healthcare service/access related factors) and patients' view on factors contributing to physician selection. RESULTS: Amongst the physician-related factors, attitude of physician (all items considered very important by majority of patients) was the factor most significantly contributed to physician selection as followed by reputation (recommendation of physician by former patients considered very important by 58.5%) or professional experience (presence of subspecialty certificate in surgery considered very important by 67.5%) and social media presence of the physician (comments and ratings of users about the physician considered very important by 26.5% of patients) of the physician. Patients considered hospital hygiene (75.5%) as the most significant healthcare service/access related factor in physician selection. Physician selection was considered to be of utmost importance in the treatment outcome by 95.5% of patients, while getting information about the physician before contacting her/him was considered important and actually performed for the current admission by 74% of patients. CONCLUSION: In conclusion, our findings revealed that communicative skills of the physician, presence of subspecialty certificate in surgery, recommendations by former patients and comments and ratings of users were the leading factors contributed to physician selection by patients; being related to attitude, professional experience, reputation and social media presence of the physician, respectively. Hospital hygiene was the most significant healthcare service/access related factor contributed to physician selection.

Evaluation of Oxidative Stress in Sheep Infected with Psoroptes Ovis using Total Antioxidant Capacity, Total Oxidant Status, and Malondialdehyde Level.

INTRODUCTION: The study aimed at evaluating oxidative stress using malondialdehyde (MDA), total antioxidant capacity (TAC), total oxidant status (TOS), and oxidative stress index (OSI) markers in sheep naturally infected with Psoroptes ovis(Acari). MATERIAL AND METHODS: The study was performed on 40 sheep divided into two equal groups: a healthy group (group I) and a group naturally infected with Psoroptes ovis (group II). The sera were obtained by centrifuging blood samples collected from the vena jugularis and serum MDA level changes in the samples were measured spectrophotometrically. Commercially available test kits were used for the measurement of TAC and TOS levels. The percentage ratio of TOS level to TAC level was accepted as OSI. RESULTS: The serum malondialdehyde, total oxidant status levels, and oxidative stress index increased significantly (P < 0.01) in group II, while the serum total antioxidant capacity levels decreased significantly (P < 0.01) in this group. Negative correlations between total antioxidant capacity and total oxidant status and total antioxidant capacity and malondialdehyde, and a positive correlation between total oxidant status and malondialdehyde were found in infected sheep. CONCLUSION: The obtained results indicated the relationship between oxidant/antioxidant imbalance and Psoroptes ovis infection in sheep. Their MDA, TAC, TOS, and OSI markers may be used to determine the oxidative stress in natural infections with Psoroptes ovis.

Thirty-minutes infusion rate is safe enough for bevacizumab; no need for initial prolong infusion.

Bevacizumab (Bev) is a vascular endothelial growth factor-A monoclonal antibody that targets tumor angiogenesis. The transfusion rate of Bev is 90 min in the first dose, 60 min in the second and than from the third dose it is 30 min if no hypersensitivity reaction occurs in the first two doses. The purpose of this study determines whether these initial prolonged infusions are really necessary or not. Between 2007 and 2009, we were using the standard schedule for Bev infusions. In July 2009, we reviewed our medical reports, nursing orders and adverse drug reaction forms to identify the Bev used patients and possible hypersensitivity reactions (HSRs). Depending on that information between August 2009 and July 2014, we started to make Bev infusions in 30 min from the first dose of the therapy. In this study, we documented the findings of these 30-min infusion used patients. From August 2009 to July 2014, we treated 145 patients with 1,145 Bev infusions each one in 30 min. Out of 145 patients, 12 of them received only single dosage of Bev infusion treatment. Bev doses were 5 mg/kg for 87 patients, 7.5 mg/kg for 64 patients, 10 mg/kg for four patients and 15 mg/kg for only one patient. No HSRs were reported during these transfusions. Initial prolonged infusion times are unnecessary for Bev. Thirty-minute infusion rates can be used safely for all courses.