Central nervous system metastatic epithelial ovarian cancer. Clinical parameters and prognostic factors: a multicenter study of Anatolian Society of Medical Oncology.

Central nervous system (CNS) metastasis is a rare event in the course of late stage epithelial ovarian cancer (EOC); however its incidence is increasing in parallel with prolonged survival of patients. OBJECTIVE: The authors assessed the clinical parameters and potential prognostic features in patients with CNS metastatic disease. MATERIALS AND METHODS: Clinical data of the 33 patients from the participating centers were retrospectively collected and analyzed. Median age at the time of CNS metastasis was 57 years. Median time from the diagnosis of primary EOC until CNS metastatic disease was 22 months. Nearly half (45.5%) of the patients had single CNS metastatic lesions and all patients in the study group except two received radiotherapy as palliative treatment. Median overall survival (OS) from the time of CNS metastasis was 15 months (0-66). At univariate analysis only number of brain metastatic lesions (p = 0.001) and presence of extracranial disease (p = 0.004) were strongly associated with OS whereas multimodal treatment, size of metastatic lesions, platinum sensitivity, age, grade, and disease stage at presentation were not. Development of CNS metastasis carries a poor prognosis, however patients with single metastatic lesions and only intracranial metastatic disease can have prolonged survival after appropriate palliative management of their disease.

Anaerobic fermentation of organic solid wastes: volatile fatty acid production and separation.

Anaerobic fermentation of organic municipal solid waste was investigated using a leach-bed reactor (LBR) to assess the volatile fatty acid (VFA) production efficiency. The leachate recycle rate in the LBR affected the VFA composition of the leachate. A six-fold increase in the recycle rate resulted in an increase of the acetic acid fraction of leachate from 24.7 to 43.0%. The separation of VFAs via leachate replacement resulted in higher total VFA production. VFA separation from synthetic VFA mix and leachate of a fermented organic waste was assessed via a counter-current flow polytetrafluoroethylene (PTFE) membrane contactor. Acetic and propionic acid permeation fluxes of 13.12 and 14.21 g/m(2).h were obtained at low feed pH values when a synthetic VFA mix was used as a feed solution. The highest selectivity was obtained for caproic acid compared to that of other VFAs when synthetic VFA mix or leachate was used as a feed solution. High pH values and the presence of suspended solids in the leachate adversely affected the permeation rate.

Quality of life and difficulties of patients encountered after autologous stem cell transplantation.

PURPOSE: To assess the quality of life (QoL) and difficulties of patients encountered after (at least day 100+) autologous stem cell transplantation (ASCT). METHODS: Patients from 4 bone marrow transplantation (BMT) centers in Ankara formed the study group. Data were collected via a socio-demographic form, the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30 (QLQ-C30), the Long-term BMT recovery questionnaire and a specific questionnaire adapted from Bush BMT Symptom Inventory for measuring symptom severity and symptom distress related to ASCT. Out of 114 eligible patients 67 (58.8%) responded the questionnaires and were included in the study. RESULTS: The mean time elapsed since transplantation was 16.1 months (range 4-43). Sixteen (23.9%) patients returned to work after transplantation; the mean time from transplantation to active work was 8 months. The symptoms experienced most, interfering with the patients' daily activities related to ASCT were fatigue, dental problems, hair loss, tingling sensation /numbness in hands and feet, mouth/throat problems, taste alterations, cough and skin problems. The majority of them reported fear of infection and disease relapse. Sexual dysfunctions, difficulty of concentration and difficulties of maintaining religious activities were also reported. 76% of patients reported their current QoL was the same or better than before transplantation and rated their current health-related QoL as good to excellent (mean 64.5). Financial difficulties, fatigue, sleeping problems, and pain were the factors most rated affecting QoL. CONCLUSION: Fear of disease relapse, economical problems and difficulties with physical activities were reported as the most difficult factors to deal with after transplantation, showing the importance of creating multidisciplinary teamwork for these groups of patients.

The relation of oxidative stress and apoptosis to histopathologic alterations in the lungs as a result of global cerebral ischemia.

Heart attack and oxygen deficiency may cause necrosis in the brain and other tissues. We investigated the histopathological effects of nitric oxide (NO) on ischemia/reperfusion in lung and hippocampus using a rat brain bilateral occlusion ischemia model. Male rats were assigned to sham (SH), ischemic preconditioning (PC), global ischemia (GI) and ischemic reperfusion (IR) groups. Before ischemia was induced, blood was drawn to induce hypovolemic hypotension and for blood gas testing. After sacrifice, samples of hippocampus were harvested. Sections were examined using hematoxylin and eosin (H & E) staining and immunostaining using primary antibodies for GFAP, S100ß, iNOS, eNOS and the TUNEL method. Following ischemia, we found evidence of gliosis induced oxidative stress and apoptosis in the hippocampus. No significant differences were detected between the SH and PC groups. In the GI and IR groups, apoptosis and necrosis were observed in the hippocampus. Lung sections were stained with H & E and Masson's trichrome (MT) and immunostained for iNOS and eNOS. The TUNEL method was used to detect apoptosis. Interstitial edema, vascular congestion, intra-alveolar hemorrhage, perivascular edema, neutrophil infiltration and disruption of alveoli were observed after global ischemia and ischemic reperfusion. Inflammatory cells were detected in the connective tissue. The IR and GI groups exhibited significantly more apoptotic cells than the SH or PC groups. Free radicals, such as nitric oxide (NO), that appear following ischemia and reperfusion in the brain may also injure the lungs. Increased NO in both lung and brain tissue suggests that apoptosis in these organs can be induced by reactive nitrogen species.

Removal of heavy metals from leaching effluents of sewage sludge via supported liquid membranes.

Heavy metal content of sewage sludge is one of the factors preventing its agricultural use. Leaching processes have been used to solubilize heavy metals and thus reduce metal content of the sludge through chemical or biological routes. Subsequent to leaching processes, metal removal from the supernatant is attractive in terms of decreasing metal content of the effluent and recovering metals. This paper investigates application of supported liquid membrane (SLM) technology for metal removal from leaching effluents. SLM system was first optimized using synthetic metal mixtures. Optimized system was then used for the anaerobic bioleaching and chemical leaching effluents and metal removal efficiencies of 27.1 ±â€¯1.3% and 46.0 ±â€¯4.3% were obtained, respectively. Considering integrated leaching and membrane separation processes, metal removal efficiencies obtained in this study are valuable as it will decrease the metal content of sludge and increase the metal solubilization during leaching process. Future integration of metal leaching and removal technologies would make it possible to develop a sustainable system involving heavy metal removal from sewage sludge, land application of the sludge with a low metal content, and metal recovery.

Ammonia removal from chicken manure digestate through vapor pressure membrane contactor (VPMC) and phytoremediation.

Ammonia removal from synthetic ammonia solutions and chicken manure digestate via vapor pressure membrane contactor through Polytetrafluoroethylene (PTFE) membrane was investigated. The highest ammonia mass flux, separation factor, and removal efficiencies of 28.6 ±â€¯0.2 g N/m2 h, 53.9 ±â€¯10.7, and 97.6 ±â€¯0.7% were observed for synthetic solutions, respectively. Ammonia removal efficiency of 93.6 ±â€¯1.9% through membrane contactor was observed for chicken manure digestate decreasing the total ammonia concentration from 3643.5 ±â€¯67.2 to 230.9 ±â€¯46.2 mg N/L. Phytoremediation via Lemna minor species was used as a polishing step to remove remaining ammonia from the membrane contactor effluent. Total ammonia concentration was then decreased below 2 mg N/L through evaporation, nitrification, and plant uptake processes occurring in the phytoremediation containers. This study reveals that ammonia can be successfully removed via VPMC and phytoremediation systems and the process is implementable as it can be coupled to anaerobic digestion processes to recover ammonia and to prevent ammonia inhibition.

Effects of pilates exercises on functional capacity, flexibility, fatigue, depression and quality of life in female breast cancer patients: a randomized controlled study.

BACKGROUND: There are very few randomized controlled studies on exercise in cancer patients. Consequently, there are no guidelines available with regard to the exercises that can be recommended and difficulties are encountered in the clinical practice as to which exercise is more suitable to the patients. AIM: The purpose of this study was to investigate the impact of pilates exercises on physical performance, flexibility, fatigue, depression and quality of life in women who had been treated for breast cancer. DESIGN: Randomized controlled trial. SETTING: Out patient group, Department of Physical Medicine and Rehabilitation and Medical Oncology Department, University Hospital. POPULATION: Fifty-two patients with breast cancer were divided into either pilates exercise (group 1) and control group (group 2). METHODS: Patients in Group 1 performed pilates and home exercises and patients in group 2 performed only home exercises. Pilates exercise sessions were performed three times a week for a period of eight weeks in the rehabilitation unit. MAIN OUTCOME MEASURES: Subjects were assessed before and after rehabilitation program, with respect to, 6-min walk test (6MWT), modified sit and reach test, Brief Fatigue Inventory (BFI), Beck Depression Index (BDI) and the European Organisation for Research and Treatment of Cancer Quality of Life C30 (EORTC QLQ-C30) and EORTC QLQ BR23. RESULTS: After the exercise program, improvements were observed in Group 1 in 6-minute walk test, BDI, EORTC QLQ-C30 functional, and EORTC QLQ-C30 BR23 functional scores (P<0.05). In contrast, no significant improvement was observed in Group 2 after the exercise program in any of parameters in comparison to the pre-exercise period (P>0.05). When the two exercise groups were compared, there were significant differences in 6MWT in pilates-exercise group (P<0.05). CONCLUSION: Pilates exercises are effective and safe in female breast cancer patients. There is a need for further studies so that its effect can be confirmed. CLINICAL REHABILITATION IMPACT: This study addressed the effects of pilates exercise, as a new approach, on functional capacity, fatigue, depression and quality of life in breast cancer patients in whom there are doubts regarding the efficacy and usefulness of the exercise.

Needs of lay caregivers of bone marrow transplant patients in Turkey: a multicenter study.

The purpose of this research was to identify the needs of lay caregivers of bone marrow transplant (BMT) patients throughout the BMT trajectory. The sample consisted of 58 lay caregivers of BMT patients (5 of which were inpatients) from the 4 BMT units in Ankara, Turkey. Data were collected through a demographic data form and the Psychological and Social Needs Scale. Data analysis was performed using SPSS 10.0 for Windows. Among the descriptive statistics, frequencies and percentages were used to define the characteristics of lay caregivers and responses related to information. Mean values, standard deviations, and the Pearson correlation coefficients were also calculated for the results of the subscales. Most of the lay caregivers were spouses. The rest were other family members: brother/sister, mother, son/daughter, or father. Only one lay caregiver was a friend. The most common type of BMT was autologous. Most of the surveys were completed by the lay caregivers whose patients had been out of the hospital for 100+ days after BMT. The lay caregivers were educated on the BMT process by various sources, and 67.24% of them expressed satisfaction with the information that they were given. A majority of them preferred face-to-face communication with a healthcare professional. The categories of the information provided were diagnosis and treatment, homecare after discharge, follow-ups and laboratory tests, and nutrition. They indicated a need for more information, particularly regarding homecare after discharge and diagnosis. Fear was the highest scoring psychological needs/problems of lay caregivers, whereas leisure activity deficit was highest among the social needs/problems. The information gathered from this study led us to reevaluate our healthcare services for both patients and lay caregivers to improve physical, psychological, and social aspects of the nursing care as a whole.