TF, Cerrahi Tıp Bilimleri Bölümü Koleksiyonu

Causes of diagnostic and treatment delays in locally advanced breast cancer: a nationwide multicenter survey and electronic health records analysis in Turkiye

Wed, 01 Jan 2025 00:00:00 GMT

Causes of diagnostic and treatment delays in locally advanced breast cancer: a nationwide multicenter survey and electronic health records analysis in Turkiye Karadeniz Çakmak, Güldeniz; Tali, Ufuk; Balbaloğlu, Hakan; Taşdöven, İlhan; Özkurt, Enver; Karanlık, Hasan; Zihni, İsmail; Doğan, Lütfi; Akçay, Müfide; Günay, Semra; Basım, Pelin; Küçük, G. Ozan; Pergel, Ahmet; Maralcan, Göktürk; Uğurlu, M. Ümit; Gürleyik, Günay; Akan, Arzu; Uzunkoy, Ali; Yıldırım, Emine; Köksal, Hande; Haberal, Elifcan; Gülçelik, M.Ali; Morkavuk, Barış; Kıvılcım, Taner; Uçar, B. İmge; Koçer, H. Belma; Gümüşay, Özge; Uras, Cihan; Varlı, Metin; Ersoy, Yeliz; Özçınar, Beyza; Kafadar, Tolga; Badak, Bartu; Dağ, Ahmet; Sezer, Atakan; Özkan Gürdal, Sibel; Ağcaoğlu, Orhan; Cantürk, N. Zafer; Yıldız, O. Eren; Dalcı, Kubilay; Altınok, Ayşe; Aktaş, Ayşegül; Kebudi, Abut; Dilege, Ece; Batu, H. Figen; Vural, Veli; Sakman, Gürhan; Bölükbaşı, Yasemin; Emiroğlu, Selman; Cabioğlu, Neslihan; Deniz, Oğuzhan; Filiz, A. İlker; Yıldırım, A. Cihat; Bayır, Duygu; Ölmez, Özgür; Bakkal, Bekir H.; Bahadır, Burak; Alıcıoğlu, Banu; Büyükuysal M. Çağatay; Özaydın, Yiğit; Kaya, Hamide; Bakır, Nurullah; Cömert, Mustafa; Özmen, Vahit Delays in breast cancer (BC) diagnosis and treatment negatively impact survival outcomes. Understanding patient- and provider-related factors behind these delays is crucial. This study aimed to identify nationwide reasons for delayed diagnosis and treatment of locally advanced BC in Turkiye. A prospective, multicenter hospital-based survey was conducted across 35 institutions between 2023 and 2024. Patient- and provider-related delays were assessed via a structured 61-item face-to-face survey, supplemented by clinical data from electronic health records. Delays exceeding 3 months were clinically categorized as significant. A total of 1322 women participated from seven regions across Turkiye. Factors contributing to diagnostic delays on a national level included economic reasons (5.5%), lack of family support (3.3%), lack of knowledge (12.4%), lack of time due to household work (3.8%), difficulty in finding an appointment (6.7%), pregnancy-related reasons (1.1%), fear of losing the breast (8.9%), fear of death (9.8%), and transportation difficulties (5.1%). Provider-related delays were infrequent. About 89.3% of the patients had the initial doctor appointment and 89.6% had the first specialist consultation within one month. Treatment planning was predominantly based on a multidisciplinary team decision in 88.3% of patients. Regarding treatment initiation, 93.2% started required treatment within 1 month of decision. Patient-related factors are the major causes of diagnostic delay in Turkiye. On the other hand, from the provider's perspective, the presence of multidisciplinary teams, including dedicated breast surgeons, represents a key factor in ensuring the timely implementation of diagnostic procedures and treatment strategies.

GDF-15 levels in gouty arthritis and correlations with decreasing renal function: a clinical study

Wed, 01 Jan 2025 00:00:00 GMT

GDF-15 levels in gouty arthritis and correlations with decreasing renal function: a clinical study Cüre, Osman; Yiğit, Ertuğrul; Yiğit, Merve Hüner; Uzun, Hakkı Background/Objectives: Gouty arthritis (GA) is a chronic inflammatory disorder frequently linked to systemic inflammation and impaired kidney function. Growth differentiation factor-15 (GDF-15) has been suggested as a potential biomarker involved in both inflammatory responses and renal dysfunction. Studies on GDF-15 serum levels and renal function decline in GA patients are limited. This study aimed to investigate serum GDF-15 levels in patients with GA and to evaluate the relationship between GDF-15 and renal function parameters. Methods: This prospective case-control study included 60 (intercritical group: 30; acute attack group: 30) patients with gout arthritis and 60 healthy controls, matched for body mass index and sex. The enzyme-linked immunosorbent assay measured serum GDF-15, and renal function and inflammatory markers were also assessed. Group comparisons used non-parametric tests, Spearman's analysis evaluated correlations, and receiver operating characteristic (ROC) analysis assessed diagnostic performance. Results: Serum GDF-15 levels were significantly higher in GA patients than controls (p < 0.001), especially during acute attacks. GDF-15 correlated moderately with renal function markers. ROC analysis showed high diagnostic accuracy for both acute (area under the curve (AUC) = 0.98) and intercritical gout phases (AUC = 0.96). Conclusions: Serum GDF-15 levels are increased in patients with gouty arthritis and are associated with impaired renal function. GDF-15 may serve as a helpful biomarker for disease activity and renal involvement in GA, but its interpretation should be considered in conjunction with other clinical and laboratory parameters.

Spontaneous tracheal fistulization of a progressive bronchogenic cyst: a four-year conservative follow-up case report

Wed, 01 Jan 2025 00:00:00 GMT

Spontaneous tracheal fistulization of a progressive bronchogenic cyst: a four-year conservative follow-up case report Şentürk Topaloğlu, Elvan; Topaloğlu, Ömer ....

The relationship between type D personality and quality of life in atrial fibrillation patients

Wed, 01 Jan 2025 00:00:00 GMT

The relationship between type D personality and quality of life in atrial fibrillation patients Kayhan, Semiha Alkan; Dizdar, Ebru; Hanedan, Muhammet Onur; Karakişi, Sedat Ozan Aim: This study aims to examine the relationship between type D personality and quality of life in atrial fibrillation (AF) patients. Background: AF patients are highly prone to psychological problems such as anxiety and stress. AF patients are more likely to exhibit type D personality traits, characterized by social inhibition, a tendency toward negative emotions, and negative affectivity, this personality type should be considered a key factor in determining poor quality of life in AF patients. Design: The study was conducted as a descriptive design. Method: This multicenter, descriptive study included 98 AF patients. Data were collected using a patient information form, the type D personality scale, and the Atrial Fibrillation Impact Questionnaire (AFImpact). Results: Type D personality traits were present in 63.3 % of AF patients. The mean total scores for the AFImpact, along with the vitality and sleep subscale scores, were significantly higher in AF patients with type D personality traits compared to those without (p < 0.05). Conclusion: The study results indicate that AF patients with type D personality traits experience a lower quality of life.