Comparison of clinical features and the impact of reproductive factors on by age at diagnosis young and elderly breast cancer patients in the middle Anatolian region of Turkey.

OBJECTIVE: Reproductive risk factors have been shown to influence breast cancer etiology for women of different origin worldwide; most studies in young/older patients have been limited to analyzing survival or tumor characteristics within their age group. This study aimed to compare the clinicopathological characteristics, treatment regimens, survival outcomes, and the impact of reproductive risk factors on young and elderly breast cancer patients. PATIENTS AND METHODS: The data were collected retrospectively between October 2015 and March 2021, where 77 young patients (≤ 40 years) and 107 elderly patients (>65 years) were included out of a total of 567 patients undergoing treatment at Kayseri City Training and Research Hospital General Surgery Clinic, Turkey. Logistic regression analysis was performed to assess the impact of risk factors according to age. RESULTS: Luminal-like tumors were in the majority in both age groups; there was no difference in diagnostic stages and survival between groups. The nulliparity ratio, total breastfeeding duration, number of biological children, first full-term pregnancy age, body mass index (BMI), and breast density distribution were significantly statistically different between groups. According to the multiple binary logistic regression analysis results for age, the most significant factors with risk effects were variables age of menarche OR= 3.36 (95% CI: 1.44-7.86) and child number OR= 2.58 (95% CI: 1.75-3.79), respectively. CONCLUSIONS: The importance of looking at the impact of different risk factors on breast cancer risk lies in the potential to develop valid risk prediction models that can allow targeted screening and preventive interventions for high-risk women. By identifying more influential risk factors in different geographical profiles, risk-based screening, and targeted prevention efforts can be encouraged, and these factors can be included in risk prediction models.

QSAR and pharmacophore analysis on amides against drug-resistant S. aureus.

Considering the worth of developing new antibacterial agents against drug-resistant Stapylococcus aureus, the present study explores the structure-activity relationships analysis of N-(2-hydroxy-4(or 5)-nitro/aminophenyl)benzamide and phenylacetamide derivatives using classical QSAR and 3D-common-feature pharmacophore hypothese approaches. QSAR analysis revealed that the compounds possessing a methylene group between the phenyl and the carboxyamido moiety played a role for decreasing the activity. On the other side, substituent effects on position R1 was found important for the activity and holding a substituent possessing a minimum width property on this position like as alkyl groups enhanced the activity. Moreover, substituting position R3 with a group enhancing the electron-donor capability of the phenolic ring system increased the potency. 3D-common-feature pharmacophore approach considered that the conformational properties of the compounds were important for the activity against drug-resistant S. aureus and compounds possessing a benzamide moiety rather than phenylacetamide structure increased the activity. Furthermore, holding NO2 and OH groups on the phenyl ring attached to the benzamide moiety was important for improving the potency against drug-resistant S. aureus.

Prognostic value of plasma D-dimer levels in patients with colorectal cancer.

OBJECTIVE: Plasma D-dimer levels have been shown to be increased in patients with various solid tumours including lung, prostate, cervical, ovarian, breast and colon cancer. The purpose of this prospective study was to estimate the plasma D-dimer level of patients with colorectal cancer before surgery and to assess whether it has a prognostic value. METHOD: The study comprised 51 patients with colorectal cancer. Variables including demographic, clinical, operative and pathological findings and routine laboratory tests were recorded. In addition, tumour markers, coagulation tests and plasma D-dimer levels were evaluated. RESULTS: Histological types other than well-differentiated adenocarcinoma, relatively advanced tumour stage and a high preoperative plasma D-dimer level were the prognostic factors that were associated with shorter postoperative survival according to univariate analyses. The presence of vascular invasion was associated with higher preoperative D-dimer levels. However, there was no statistically significant relationship between postoperative survival and the presence of vascular invasion. CONCLUSION: Postoperative survival was significantly shorter in colorectal cancer patients with elevated preoperative D-dimer levels. Evaluation of preoperative D-dimer level can be used to predict postoperative survival.

Effects of gender difference in early cytokine levels in trauma patients.

BACKGROUND: Experimental studies conducted on laboratory animals have demonstrated that gender differences affect the outcome following trauma-hemorrhage but, it is not clear yet whether the manipulation of sex steroids during clinical trauma affects the outcome. This study was designed to determine whether gender based changes occur in cytokine responses after trauma-hemorrhage. METHODS: Plasma cytokine, estradiol, and prolactin levels of 100 consecutive abdominal trauma patients admitted to an emergency unit were measured to determine if there is a gender based difference. RESULTS: There was no significant difference in trauma severity between male and female patients. Plasma interleukin-1beta levels were found to be significantly higher in male patients compared to females following trauma hemorrhage (p = 0.003). On the other hand, there was no significant difference in plasma interleukin-6, tumor necrosis factor-*, and prolactin levels between the male and female patients (p > 0.05). CONCLUSION: These results suggest that the role of sex steroids on immunomodulatory processes following trauma-hemorrhage should be further investigated before studies are undertaken to evaluate the effect of hormonal manipulation in patients with trauma (Tab. 1, Fig. 1, Ref. 26).

Liposarcoma of the thyroid gland: a case report.

Primary liposarcoma of the thyroid gland is exceedingly rare with only five previous reports in the literature. We report a case of a 40-year-old male patient with nodular goitre with the suspicion of malignancy in Fine Needle Aspiration Biopsy. Total thyroidectomy was performed. The histopathological examination revealed a well-differentiated thyroid liposarcoma. The patient recovered uneventfully. Postoperatively, radiotherapy was given to the neck region. During a 2-year follow-up period, no recurrence of the disease occured.

Reliability and validity of the Geriatric Depression Scale in depression in Parkinson's disease.

The objective of this study was to investigate reliability and validity of the self rated 30 item Geriatric Depression Scale (GDS) in screening and diagnosis of depression in Parkinson's disease (PD). The study sample comprised 109 non-demented patients with PD admitted to the movement disorders outpatient unit. The reference diagnosis of depression was made according to DSM-IV criteria. Discriminant validity and internal consistency of the total scale were studied. Sensitivity, specificity, and positive and negative predictive values (PPV and NPV) were calculated for different cutoff scores. Receiver operating characteristics (ROC) analysis was also carried out. The sample comprised 56 patients with and 53 without depression. In the discriminant validity analysis, the mean total GDS score of subjects with depression was significantly higher compared with those without depression. The Cronbach's alpha score was 0.92 and the split half correlation coefficient 0.91. The cutoff score of 13/14 provided the highest sum of sensitivity and specificity level. The sensitivity of this cutoff score was 0.78 and specificity 0.85, while PPV was 0.84 and NPV 0.79. The area under the curve value in the ROC analysis was 0.891. Sensitivity and specificity analysis showed that cutoff scores of 8/9 or 9/10 could be useful for screening and 14/15 or 15/16 for diagnostic purposes. This study showed that the 30 item GDS, with its high discriminant validity, internal consistency, and reasonably clear cutoff scores, could be a useful screening or diagnostic self rated depression scale in patients with PD.

Comparison of quality-of-life outcomes of Stoppa vs bilateral Lichtenstein procedure.

Hernia repair is one of the most frequent procedures in surgery. The aim of this study is to compare the early and long-term health status and clinical outcomes of patients in the postoperative period of Stoppa and bilateral Lichtenstein hernia repair in bilateral groin hernias. The Stoppa group consisted of 22 patients, and the bilateral Lichtenstein group had 23 patients. Both groups were similar with respect to age, gender, ASA score, and postoperative follow-up periods. A multidimensional measure of health status, the Short Form-36 (SF-36), was administered at 15 days and 6 months postoperatively. Although there is no difference between the two groups in the early postoperative period, three of eight health concepts measured with SF-36 (physical functioning, role limitation-physical, general health perception) showed a significant difference in long-term health status. We conclude that long-term quality of life following Stoppa operations is superior to bilateral Lichtenstein hernia repair in bilateral groin hernias.

Reliability, validity, and factor structure of the geriatric depression scale in Turkish elderly: are there different factor structures for different cultures?

The purpose of this study was to examine the Geriatric Depression Scale (GDS) translated into Turkish for its reliability, discriminant validity, and factor structure in a sample of 276 community-dwelling elderly and 30 patients with major depression. One item (Item 5) was discovered to have conceptual difficulty for Turkish elderly and was transformed to negative form. Item 2 was transformed to positive form to keep the number of positive and negative items equal to that in the original GDS. A reasonable time stability with 1-week interval (r: .74) and a high level of internal consistency (alpha=.91) were observed. Student's t test resulted in a significant discriminant validity for the scale total score. Factor study with principal component analysis and varimax rotation gave rise to a structure with seven factors. Results of the same analysis with two factors were found to be easier to interpret. The first factor was composed of 19 items reflecting "depressive affect and thought content." The other 11 items representing "decrease in motivation and cognitive functions" loaded in the second factor. In conclusion, the Turkish GDS was found to have reasonable time reliability, high internal consistency, and discriminant validity for Turkish elderly. Its two-factor structure can be used as an informative instrument for epidemiological studies, reflecting two main dimensions of depression in the elderly.

The FEAR: a rapid screening instrument for generalized anxiety in elderly primary care attenders.

OBJECTIVE: To develop a shorter version of the Anxiety Disorder Scale (ADS) for use as a rapid screening instrument in primary care. DESIGN: Two-stage screening design. Primary care attenders aged 65 and over were screened for generalized anxiety in the surgery with the 11-item generalized anxiety subscale of the ADS (ADS GA), a selected subsample then proceeding to a clinical validation interview. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Scores on the ADS GA, non-hierarchical ICD-10 caseness for generalized anxiety established by brief clinical interview by an old age psychiatrist. RESULTS: The prevalence rate of generalized anxiety was 16% using the established cutpoint and showed an age-related decline. A cutpoint of 2-3/11 appeared to give optimal performance in this small sample (sensitivity 85%, specificity 77%, positive predictive value 52%), suggesting that 36% of elderly general practice attenders might be diagnosed as having generalized anxiety. A reduced four-item version gave a predicted sensitivity of 77%, a specificity of 83% and a positive predictive value of 63% (cutpoint 1-2/4). CONCLUSIONS: A four-item version of the ADS GA, the FEAR (frequency of anxiety; enduring nature of anxiety; alcohol or sedative use; restlessness or fidgeting), has potential as a rapid screening instrument for use in primary care.