The Turkish version of nursing practice readiness scale: Cross-cultural adaptation and psychometric evaluation

AIM

This study aims to adapt the "Nursing Practice Readiness Scale" to Turkish culture, and evaluate its psychometric properties.

BACKGROUND

New graduates' nursing practice readiness can impact their work adaptation and performance.

DESIGN

The research employed a methodological design.

METHODS

Data were collected between May and July 2022. The sample consisted of 436 newly graduated nurses. Content validity, construct validity and criterion validity were evaluated. Reliability was examined with adjusted item-total correlation, Cronbach's a coefficient, composite-reliability and split-half reliability.

RESULTS

The Turkish version of Nursing Practice Readiness Scale was found to have good content and criterion validity. As a result of confirmatory factor analysis, the original five-factor structure of the scale was also confirmed for the Turkish version. The scale's overall Cronbach's α coefficient was determined to be 0.96, with subscale coefficients ranging from 0.73 to 0.94. The composite reliability values of the subscales were found between 0.75 and 0.94. In split-half reliability, the correlation coefficient between half was 0.952, with a Spearman-Brown Coefficient (Unequal Length) of 0.976.

CONCLUSIONS

The Turkish version of Nursing Practice Readiness Scale is a valid and reliable measurement tool for evaluating the nursing practice readiness of newly graduated nurses.

The relationship between thorax computed tomography findings and prognosis in patients diagnosed with COVID-19

OBJECTIVE

This study aimed to demonstrate the relationship between thorax computed tomography (CT) findings at the time of admission and prognosis using a semiquantitative CT severity scoring system in patients diagnosed with coronavirus disease 2019 (COVID-19) who tested positive for reverse transcriptase polymerase chain reaction (RT-PCR).

PATIENTS AND METHODS

A total of 305 patients aged 18 years and older who were diagnosed with COVID-19 confirmed by RT-PCR and underwent thorax CT at the time of admission, were included in the study between March and July 2020. The demographic data of the patients, their presenting complaints at the time of admission, RT-PCR results, and thorax CT images were scanned retrospectively from electronic medical records. Lesions on thorax CT were evaluated for the presence of ground glass opacity, consolidation, and septal thickening and scoring.

RESULTS

No significant relationship was found between mortality and CT score or other parameters. A significant relationship was found between admission to the intensive care unit and CT scoring (p=0.014), aortic diameter (p=0.032), chronic pulmonary disease (p=0.004), halo sign (p=0.031), mortality (p<0.001), fever (p=0.038), and dyspnea (p=0.031). A statistically significant difference was detected in the score parameter between discharged patients and intensive care unit patients who survived and those who died (p<0.001). In the parameter of the number of lobes, a statistically significant difference was found only between discharged patients and intensive care unit patients who survived (p=0.016).

CONCLUSIONS

Thorax CT is an advisor for early diagnosis, treatment, and prognosis assessment of the disease. Semiquantitative CT severity scoring can provide valuable information about the prognosis of the patient.

Beta Elemene induces cytotoxic effects in FLT3 ITD-mutated acute myeloid leukemia by modulating apoptosis

OBJECTIVE: β-Elemene, a sesquiterpene with a broad anti-cancer spectrum, is particularly effective against drug-resistant and complex tumors. It can also be efficient against FLT3-expressed acute myeloid leukemia. This research aims to determine whether β-Elemene has cytotoxic effects on FLT3 ITD-mutated AML cells. MATERIALS AND METHODS: Cytotoxicity, cell morphology, mRNA analysis with apoptotic markers, and analysis of 43 distinct protein markers related to cell death, survival, and resistance were all performed to elucidate its mechanism. Additionally, in order to understand how β-Elemene and FLT3 interact, molecular docking, molecular dynamics simulations, and computational ADME investigations were performed. RESULTS: β-Elemene exhibited cytotoxic activity against FLT3-mutated MV4-11 and FLT3 wild-type THP-1 cells, with an IC50 of around 25 µg/ml. The molecular studies revealed that β-Elemene inhibited cell proliferation by inducing p53, and the involvement of p21, p27, HTRA, and HSPs were also demonstrated. The interactive inhibition in proliferation was confirmed via molecular docking and dynamics analyses. β-Elemene occupied the FLT3 enzymatic pocket with good stability at the FLT3 active site. CONCLUSIONS: We concluded from our observations that β-Elemene causes cell death in ITD mutant AML cells, together with the effects of stress factors and inhibiting cell division.

Synthesis and molecular modelling of thiadizole based hydrazone derivatives as acetylcholinesterase and butyrylcholinesterase inhibitory activities

Some novel substituted thiazolylhydrazine derivatives were designed, synthesized and their inhibitory effects on acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE) enzymes and antioxidant activities were investigated. The structures of the synthesized compounds were determined using different spectroscopic techniques such as ¹H-NMR, ¹³C-NMR, and HRMS. According to the enzyme inhibition results, the synthesized compounds showed selectivity against BuChE enzyme inhibition. Compounds 5e, 5g, 5i and 5j displayed significant BuChE inhibition potencies. Among them, compound 5i was found to be the most effective derivative with an IC₅₀ value of 56.01 ± 0.054 µM. In addition, their antioxidant properties were evaluated in vitro through the 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay. For compounds 5e, 5g, 5i and 5j in silico molecular docking and 100 ns molecular dynamics simulations studies against the BuChE enzyme were performed to determine possible protein-ligand interactions and stability. DFT-D3 study was performed to stabilize of compounds 5e, 5g, 5i and 5j both in gas and solvent medium and investigated their electronic properties. Of all geometries, that of DMSO is the lowest one.

Effects of Gundelia tournefortii L. on biochemical parameters, antioxidant activities and DNA damage in a rat model of experimental obesity

The present study was designed to investigate the effects of Gundelia tournefortii L. plant extract on different tissues in terms of DNA damage, biochemical and antioxidant parameter values in rats with high-calorie diets. With this aim, Wistar albino male rats were divided into 4 groups containing 6 rats each and the study was completed over 12 weeks duration. At the end of the implementation process over the 12 weeks, rats were sacrificed and blood and tissue samples were obtained. Analyses were performed on blood and tissue samples. According to results for DNA damage (8-OHdG), in brain tissue the OG2 group was significantly reduced compared to the NC group. For MDA results in liver tissue, OG1 and OG2 groups were determined to increase by a significant degree compared to the control group, while the OG2 group was also increased significantly compared to the obese group. In terms of the other parameters, comparison between the groups linked to consumption of a high calorie diet (HCD) and administration of Gundelia tournefortii L. in terms of antioxidant activities and serum samples obtained statistically significant results. Gundelia tournefortii L. plant extracts had effects that may be counted as positive on antioxidant parameter activity and were especially identified to improve DNA damage and MDA levels in brain tissues. Additionally, consumption of Gundelia tournefortii L. plant extract in the diet may have antiobesity effects; thus, it should be evaluated for use as an effective weight-loss method and as a new therapeutic agent targeting obesity.

Effect of newly developed interspecific hybrid rootstocks on mineral nutrient composition and fruit quality in tomato (Solanum lycopersicum L.)

Tomato (Solanum lycopersicum L.) is one of the important vegetables in the world due to large production area and consumer interest. Biotic and abiotic stresses have negative effect on tomato production. Utilisation of rootstocks conferring resistance to biotic stresses can be considered as the most effective and environment friendly solution in tomato production to overcome this problem. Although wild tomato species is a good rootstock candidate due to its resistance to multiple plant diseases, effects of wild tomato species as rootstock on mineral nutrient composition and fruit quality are not clear. In the present study, effects of interspecific hybrids derived from two wild tomato species (Solanum habrochaites and Solanum penellii) as rootstock on tomato fruit mineral nutrient composition (phosphor (P), potassium (K), calcium (Ca), magnesium (Mg), iron (Fe), zinc (Zn), manganese (Mn), and copper (Cu)) and fruit quality traits (soluble solids content (SSC), pH, percent titratable acidity (TA), and lycopene content) were evaluated. In the study, Amaron, Armstrong, and Arazi commercial rootstocks were used as control and AK0004 F1 (candidate tomato hybrid) was used as a source of scion. As result, only lycopene content was affected by different rootstocks. S. penellii was found to be with more potential for lycopene content. For mineral nutrient composition, all hybrids and controls had similar contents of potassium, phosphor, calcium, and magnesium. Manganese and copper contents decreased in all plants. S. habrochaites had more potential regarding nitrogen, iron, and zinc contens than S. penellii. This is the first study to evaluate two interspecific hybrids derived from S. habrochaites and S. penellii, and the results might be useful to understand effects of rootstocks derived from wild tomato species on mineral nutrient content and fruit quality.

The predict of metacognitive awareness of nursing students on self-confidence and anxiety in clinical decision-making

PURPOSE

This study was conducted to investigate the affect that metacognitive awareness in nursing students has on self-confidence and anxiety with respect to clinical decision-making.

DESIGN AND METHODS

The sample for this descriptive, correlational, and cross-sectional study consisted of 186 nursing students who voluntarily participated. Data were collected using the Metacognitive Awareness Inventory and Nursing Anxiety and Self-Confidence with Clinical Decision-Making Scale. Correlation and regression analyses were then performed on the data.

FINDINGS

Nursing students' metacognitive awareness level explained the three subdimensions of self-confidence in clinical decision-making by 26.7% (r²  = 0.267, p < 0.01), 24.6% (r²  = 0.246, p < 0.01), and 26.8% (r²  = 0.268, p < 0.01), respectively. Nursing students' metacognitive awareness level explained the three subdimensions of anxiety in clinical decision-making by 3.7% (r²  = 0.037, p < 0.01), 3.2% (r²  = 0.03, p < 0.05), and 2.4% (r²  = 0.024, p < 0.05), respectively.

IMPLICATIONS FOR NURSING PRACTICE

Clinical decision-making skills can be supported by increasing students' metacognitive awareness.

Factors affecting nurses' professional commitment during the COVID-19 pandemic: A cross-sectional study

Aim

This study aims to investigate the factors affecting nurses' professional commitment during the COVID‐19 pandemic.

Background

Commitment to a profession requires doing the best for that profession. In the case of the nursing profession, professional commitment gains greater importance in times of crisis, like the COVID‐19 pandemic.

Methods

This cross‐sectional study was conducted with 389 nurses in the Turkish state hospital. Institutional permissions, ethical approval and written consents from the participants were obtained before carrying out the study.

Results

The participants’ mean Perceived Organizational Obstruction Scale score was 20.07 ± 8.06 (min = 5.0, max = 35.0), and their mean Nursing Professional Commitment Scale score was 71.20 ± 11.94 (min = 30.0, max = 103.0). Socio‐demographic variables and perception of organisational obstruction predicted 36.7% of the variance in the professional commitment (p < .001).

Conclusion

A road map based on the study results was developed for hospitals and nurse managers to maintain and increase nurses' professional commitment.

Implications for Nursing Management

The results of this study may help institutions and nurse managers understand the factors affecting professional commitment during the pandemic as a whole, as well as determine primary strategies based on the importance of these factors.

Non-Hodgkin's Lymphomas of the Tonsil: A Retrospective Analysis of Twenty-Eight Patients with Primary Tonsillary Lymphoma

Aims

To analyze the clinical and therapeutic aspects of patients with primary tonsillary non-Hodgkin's lymphoma.

Methods

Twenty-eight patients with primary tonsillary non-Hodgkin's lymphoma who had been followed in the Hacettepe Oncology Institute between 1974 and 1992 were retrospectively analyzed. Fifteen patients were male, 13 were female. Median age was 55 years.

Results

Constitutional symptoms were present in 10 patients (35.7%). Stages according to the Ann Arbor classification were I and II in 12 and 16 patients, respectively. According to the Rappaport classification, poorly differentiated lymphocytic was the most common pathologic subgroup (42.9%). Grades according to the Working Formulation were low, intermediate and high in 3, 22 and 3 patients, respectively. Twenty-two patients had received chemotherapy. Cyclophosphamide, vincristine and prednisone (CVP), and cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) were the regimens most commonly employed. Eighteen patients received radiotherapy to Waldeyer's ring and neck. Eight patients achieved remission with chemotherapy plus radiotherapy, 7 patients with chemotherapy alone, and 5 patients with radiotherapy alone. In addition to the 20 patients who achieved complete remission, 3 patients achieved partial remission; the overall response rate was 82.1%. The response rates and survival attained with the combined modality, chemotherapy, or radiotherapy alone were not statistically different (P > 0.05). The median follow-up was 14 months. Overall and disease-free survival at 5 years were 62.6% and 77.6%, respectively. Pathologic grade was the most important prognostic factor influencing overall survival in the Cox multivariate model.

Conclusions

Poorly differentiated lymphocytic lymphomas were the most common pathologic subtype, and pathologic grade was the most important prognostic factor to influence survival in the present study. Although combined modality treatment did not appear to be superior to chemotherapy or radiotherapy alone, a larger number of patients is needed to draw definite conclusions.

Ifosfamide and Etoposide in Previously Treated Patients with Advanced Breast Cancer

Aims and background

Ifosfamide is an active alkylating agent in the treatment of breast cancer, as a first-line therapy and in advanced disease. Since the combination of etoposide with an alkylating agent produces a synergistic and tolerable activity in various malignancies, in the present study, ifosfamide and etoposide were administered to patients with advanced breast cancer to evaluate the response characteristics and the toxicity profile.

Study design

The combination of ifosfamide, mesna and etoposide was prospectively administered to 41 previously treated patients with stage IV breast carcinoma. The treatment schedule consisted of ifosfamide, 1500 mg/m2, infused over 24 hrs with 1500 mg/m2 mesna on days 1 to 5 and 120 mg/m2 etoposide, infused over 1 hr on days 1 to 3, to be repeated every 4th week.

Results

After a median follow-up of 10 months, an objective response rate of 23% (overall 2.5% complete remission and 20.5% partial remission) and a median response duration of 5.3 months were obtained in 39 assessable patients. The non-responder group consisted of 28.3% stable disease and 48.7% progressive disease. The prior status of chemotherapy was the only significant prognostic factor with an impact on the response rate. The overall toxicity was generally mild, with grade 3 myelotoxicity encountered in 25.7% of patients.

Conclusions

The tolerable side effect profile of the ifosfamide and etoposide combination might be advantageous as regards the quality of life. To improve the rate and/or the duration of response and to clarify the precise role of the ifosfamide-etoposide combination in previously treated advanced breast cancer, further trials are warranted.

The burden and epidemiology of community-acquired central nervous system infections: a multinational study

Risk assessment of central nervous system (CNS) infection patients is of key importance in predicting likely pathogens. However, data are lacking on the epidemiology globally. We performed a multicenter study to understand the burden of community-acquired CNS (CA-CNS) infections between 2012 and 2014. A total of 2583 patients with CA-CNS infections were included from 37 referral centers in 20 countries. Of these, 477 (18.5%) patients survived with sequelae and 227 (8.8%) died, and 1879 (72.7%) patients were discharged with complete cure. The most frequent infecting pathogens in this study were Streptococcus pneumoniae (n = 206, 8%) and Mycobacterium tuberculosis (n = 152, 5.9%). Varicella zoster virus and Listeria were other common pathogens in the elderly. Although staphylococci and Listeria resulted in frequent infections in immunocompromised patients, cryptococci were leading pathogens in human immunodeficiency virus (HIV)-positive individuals. Among the patients with any proven etiology, 96 (8.9%) patients presented with clinical features of a chronic CNS disease. Neurosyphilis, neurobrucellosis, neuroborreliosis, and CNS tuberculosis had a predilection to present chronic courses. Listeria monocytogenes, Staphylococcus aureus, M. tuberculosis, and S. pneumoniae were the most fatal forms, while sequelae were significantly higher for herpes simplex virus type 1 (p < 0.05 for all). Tackling the high burden of CNS infections globally can only be achieved with effective pneumococcal immunization and strategies to eliminate tuberculosis, and more must be done to improve diagnostic capacity.

Traction Radiography for the Diagnosis of Scapholunate Ligament Tears

The diagnosis of scapholunate ligament injury by traction radiography was investigated within a consecutive study. The right wrists of 25 healthy volunteers and 22 wrists with arthroscopically proven complete scapholunate ligament tears were examined. Traction radiography was performed under fluoroscopy with a force of 5 kg applied to the thumb. In the normal wrists, this led to selective widening of the scapholunate joint space whereas the lunotriquetral distance remained unchanged. In 25 healthy right wrists, the median scapholunate distance measured 2.1 (range 1.3–2.6) mm on resting radiographs and 2.2 (range 1.7–3.5) mm on the stress radiographs. For the 22 wrists with complete scapholunate ligament tears, the median scapholunate distance was increased from 2.0 (range 1.0–3.0) mm to 3.8 (range 3.0–5.5) mm by traction (median difference of 1.8 (range 1.0–3.0) mm). In conclusion, a scapholunate distance of 3.0 mm or more in unloaded wrists or widening of the scapholunate interval by 1.0 mm or more under thumb traction should both be considered as pathological findings. We recommend traction radiography as a simple and valuable diagnostic procedure for suspected scapholunate ligament injury.

Impact of tumor HPV status on outcome in patients with recurrent and/or metastatic squamous cell carcinoma of the head and neck receiving chemotherapy with or without cetuximab: retrospective analysis of the phase III EXTREME trial

BACKGROUND

Tumor human papillomavirus (HPV) status is an important prognostic factor in locoregionally advanced squamous cell carcinoma of the head and neck (SCCHN). Prognostic value in recurrent and/or metastatic (R/M) disease remains to be confirmed. This retrospective analysis of the EXTREME trial, comparing chemotherapy plus cetuximab with chemotherapy first line in R/M SCCHN, investigated efficacy and prognosis according to tumor p16 and HPV status.

PATIENTS AND METHODS

Paired tissue samples were used: p16INK4A expression was assessed by immunohistochemistry, and HPV status determined in extracted DNA samples using oligonucleotide hybridization assays.

RESULTS

Altogether, 416 of 442 patients had tumor samples available for p16 and HPV: 10% of tumors were p16 positive and 5% were HPV positive. Adding cetuximab to chemotherapy improved survival, irrespective of tumor p16 or HPV status. This pattern remained in a combined analysis of p16 and HPV. p16 positivity and HPV positivity were associated with prolonged survival compared with p16 negativity and HPV negativity. Subgroup analysis of patients with oropharyngeal cancer demonstrated a similar pattern to all evaluable patients.

CONCLUSION

The results from this analysis suggest that p16 and HPV status have prognostic value in R/M SCCHN and survival benefits of chemotherapy plus cetuximab over chemotherapy alone are independent of tumor p16 and HPV status.

Increasing performance of a hospital-based cancer registry: Hacettepe University hospitals experience

PURPOSE

High-quality hospital-based cancer registry systems are the key elements of a healthy population-based cancer data. The purpose of this study was to present a recent history of establishing a valuable and reliable hospital- based cancer registry in a university hospital in Turkey, and the data gathered by this system in the last 9 years.

METHODS

This study included the cancer registry records of Hacettepe University Hospitals between 1-Jan-2003, and 31-Dec-2011. The study cohort included data of 39351 cancer patients and the cancer registry system was based on active data acquisition method.

RESULTS

Most frequent departments of reference were Medical Oncology, Radiation Oncology, General Surgery, Urology, and Pediatrics. The annual number of records gradually increased from 2675 in 2003 to 5152 in 2011. The 5 cancer types most frequency seen in adults were lung (15.5%), prostate (13.5%), stomach (6.6%), bladder (6.2%), and colon (5.8%) in men; and breast (32.7%), ovary (6.4%), uterine corpus (6.2%), uterine cervix (5.6%), and thyroid (5.0%) in women. Childhood cancers were classified according to the International Classification of Childhood Cancers, 3rd Edition (ICCC-3), and the most frequent 5 cancer types in children were tumors of the central nervous system (20.1%), lymphomas (14.6%), leukemia (14.1%), retinoblastoma (9.4%), and tumors of the sympathetic nervous system (7.7%).

CONCLUSION

Active data acquisition from departments that deal with oncologic patients in a hospital is the precise method for establishing a high-quality cancer registry system that is able to resemble the general population. Hospital- based cancer registry systems also provide highly critical information for planning, monitoring, and measuring the cancer-related services, research, and education.

Cytochemistry of peripheral blood leukocytes in thoroughbred foals

We attempted to characterize the cytochemical staining patterns of leukocytes and to determine the percentages of alpha-naphthyl acetate esterase (ANAE) and acid phosphatase (ACPase) positive lymphocytes in peripheral blood of thoroughbred foals at different ages. Blood samples were obtained from the jugular veins of 60 healthy thoroughbred foals, 1 day, 3 days and 1 year old. Each age group included 10 male and 10 female animals. Peroxidase (PO) activity was detected in neutrophils, eosinophils and monocytes. Lymphocytes were negative for PO staining. Periodic acid-Schiff (PAS) staining was observed in neutrophils and monocytes; eosinophils were negative. The majority of lymphocytes were negative, but a few cells showed granular PAS positivity. Monocytes were strongly positive for ANAE and ACPase, and the enzymatic reaction was common in lymphocytes. Neutrophils showed a weakly positive reaction for ANAE and ACPase. Eosinophil granules were negative or weakly positive for ANAE and usually negative for ACP, but intergranular areas were positive. Mean ANAE positive peripheral blood lymphocytes (PBL) were 67.70, 73.10 and 49.20% in females; 64.00, 70.53, and 50.60% in males 1 day, 3 days, and 1 year old, respectively. ACPase positive PBL were 27.33, 32.83, and 37.40% in females; 29.67, 31.67, and 38.40% in males 1 day, 3 days, and 1 year old, respectively. For both enzymes, the differences between mean values for the genders were not statistically significant, but significant differences were found with regard to age. We provide comparative hematological data as a guide for identifying blood cells in thoroughbred foals.

Prenatal Diagnosis and Postnatal Follow-up of congenitally corrected transposition of the great arteries and recurrent supraventricular tachycardia

The prenatal sonographic diagnosis of congenitally corrected transposition of the great arteries (ccTGA), a rare form of congenital heart disease is very difficult. A24-year-old woman was referred to our center at 28 weeks' gestationbecause of suspected fetal cardiac anomalies. We report a case of ccTGA with supraventricular tachycardia, ventricular septal defect, pulmonary valve stenosis, tricuspid valvar displacement and moderate tricuspid regurgitation during her pregnancy. The combined presence of SVT and ccTGA are occasionally present in the literature.

The role of zinc supplementation in the inhibition of tissue damage caused by exposure to electromagnetic field in rat lung and liver tissues

BACKGROUND

The objective of the present study was to examine the effects of zinc supplementation on the oxidant damage in lung and liver tissues in rats exposed to a 50-Hz frequency magnetic field for 5 minutes every other day over a period of 6 months.

METHODS

The study included 24 adult male Sprague-Dawley rats, which were divided into the three groups in equal numbers: Group 1, the control group (G1); Group 2, the group exposed to an electromagnetic field (G2); and Group 3, the group, which was exposed to an EMF and supplemented with zinc (G3). At the end of the 6-month procedures, the animals were decapitated to collect lung and liver tissue samples, in which MDA was analyzed using the "TBARS method (nmol/g/protein)", GSH by the "biuret method (mg/g/protein)" and zinc levels by atomic emission (µg/dl).

RESULTS

MDA levels in lung and liver tissues in G2 were higher than those in G1 and G3, and the levels in G3 were higher than those in G1 (p<0.01). As for GSH levels, G3 had GSH levels higher than G1 and G2, and G2 had GSH levels higher than G1 (p<0.01). Zinc values in the liver and lung tissues were the highest in the Group 3 and the lowest in the Group 2 (p<0.01).

CONCLUSION

Results of the study indicated that exposure to an electromagnetic field caused cellular damage in lung and liver tissues and zinc supplementation inhibited the inflicted cellular damage. Another important result of this study that needs emphasis was that exposure to an electromagnetic field led to a significant decrease in zinc levels in lung and liver tissues (Tab. 3, Ref. 23).

Histological and enzyme histochemical investigation of the hemal nodes of the hair goat

We investigated the structure of the hemal node in six healthy hair goats using histological and enzyme histochemical methods. After processing, tissue sections were stained with Crossman's trichrome, Gordon-Sweet's silver and Pappenheim's panoptic stains. Alpha-naphthyl acetate esterase (ANAE) and acid phosphatase (ACP-ase) were demonstrated in frozen sections. Hemal nodes were encapsulated by connective tissue and few smooth muscle cells. Several trabeculae originated from the capsule and extended into the hemal node. A subcapsular sinus was present beneath the capsule and was continuous with the deeper sinuses. Subcapsular and deep sinuses were filled with erythrocytes. The parenchyma consisted of lymphoid follicles, diffuse interfollicular lymphocytes and irregular wide lymphoid cords. Cortical and medullary regions were not distinct. ANAE (+) and ACP-ase (+) cells were located mainly in the germinal centers of the lymphoid follicles and also were scattered equally in the interfollicular region and lymphoid cords. Monocytes, macrophages and reticular cells displayed a diffuse positive reaction, whereas localized granular positivity was observed in lymphocytes. We demonstrated that the general structure of the hair goat hemal nodes is similar to that of other ruminant species.

Frequency of comorbid illnesses in cancer patients in Turkey

PURPOSE

Comorbidities in cancer patients can adversely affect the management and outcome of their primary illnesses at all levels from diagnosis to therapy. We sought to examine comorbid conditions of cancer patients, treated at 4 university hospitals, each representing a different geographic location in Turkey.

METHODS

A total of 769 consecutive cancer patients presenting to outpatient clinics were recruited between November 2007 and May 2008. The patients filled in a questionnaire on comorbidities. Based on the questionnaire, Charlson Comorbidity Index (CCI( was calculated.

RESULTS

The patient median age was 55 years (range 21-87) and 456 (59.3%) were female. Breast (36.5%), colorectal (21.4%) and lung cancers (13.9%) were the 3 most frequent malignancies. Of the patients, 59.3% had at least one comorbid disease and 46.3% were using at least one medication daily. The most frequent comorbidities were hypertension (25.3%), diabetes mellitus (13.1%) and peptic ulcer (7.7%). Increasing age positively correlated with the extent of comorbidities (r=0.30, p<0.001), number of medications (r=0.32, p<0.001) and the CCI (r=0.20, p<0.001).

CONCLUSION

It is crucial to remember that comorbid illnesses are not rare and many patients are treated for conditions unrelated to their cancer, which potentially may affect various stages of their clinical management.

The role of the KRAS G13D mutation in patients with metastatic colorectal cancer (mCRC) treated with first-line chemotherapy plus cetuximab

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Background: The CRYSTAL and OPUS studies showed that adding cetuximab (cet) to first-line chemotherapy (CT) significantly improved clinical benefit in patients (pts) with KRAS wild-type (wt) mCRC. Pts with KRAS codon 12 or 13 mutations are excluded from cet treatment. Studies suggest that not all KRAS mutations are equivalent in their biologic effects. Occasional responses and prolonged disease stabilization have been recorded following cet treatment of tumors with mainly KRAS codon 13 mutations. We investigated the influence of the most common KRAS codon 13 mutation (G13D) on clinical outcome compared with pts with other KRAS mutations or wt tumors in the CRYSTAL and OPUS trials.

Methods: KRAS mutations were detected in tumor DNA from archival material using a PCR clamping and melting curve technique. Treatment arms were compared by KRAS mutation status for progression-free (PFS) and overall survival (OS).

Results: In the CRYSTAL study of 1,063 evaluable pts 63% were KRAS wt, 6% were G13D mutant (mt) and 32% had other mutations. In the OPUS study of 315 evaluable pts, 57% were KRAS wt, 7% were G13D mt, and 36% had other mutations. Compared with KRAS wt pts those with G13D mutations did not benefit from the addition of cet to CT (Table). Data of comparisons of the G13D mutation with other KRAS mutations in these studies will be presented.

Conclusions: Patients with KRAS G13D mt tumors did not appear to benefit from the addition of cet to first-line CT for mCRC. This analysis confirms the current practice of KRAS mutation testing as the standard diagnostic tool for determining first-line treatment of mCRC pts.

[Table: see text]

[Table: see text]

Early infection of discus Symphysodon aequifasciatus altricial larvae by Sciadicleithrum variabilum (Monogenea)

The occurrence of Sciadicleithrum variabilum on the gills of discus Symphysodon aequifasciatus larvae 7 days after hatching is reported for the first time. This suggests that altricial larvae are susceptible to Monogenea following gill differentiation and before complete yolk resorption.

Flexor tendon repair using a new suture technique: a comparative in vitro biomechanical study

INTRODUCTION

The purpose of this experimental study was to evaluate the biomechanical characteristics of two new four-strand core suture techniques for flexor tendon repair.

MATERIALS AND METHODS

The two new suture techniques (Marburg 1, Marburg 2) are characterized by four longitudinal stitches which are anchored by a circular or semicircular suture. They were compared with three commonly used core suture techniques (modified Kessler, Tsuge, Bunnell). Fifty porcine flexor tendons were randomly assigned to one of the five core suture techniques. Outcome measures included ultimate tensile strength, maximum of lengthening, mode of failure and 1 mm gap formation force.

RESULTS

The highest ultimate tensile strength was found for the modified Kessler technique (115 N). Both new techniques showed an ultimate load exceeding 50 N (57 N for Marburg 1, 54 N for Marburg 2). The Marburg 1 technique showed the highest gap resistance of all tested suture techniques. The Bunnell and Tsuge core suture techniques produced the poorest mechanical performance.

CONCLUSION

From these experimental results, the new Marburg 1 core suture technique can be considered for flexor tendon repair in a clinical setting with the use of active motion protocols.

Effects of dietary boron supplementation on some biochemical parameters, peripheral blood lymphocytes, splenic plasma cells and bone characteristics of broiler chicks given diets with adequate or inadequate cholecalciferol (vitamin D3) content

(1) The effects of 5 and 25 mg/kg boron supplementation of diets with inadequate (6.25 microg/kg) or adequate (50 microg/kg) cholecalciferol (vitamin D3) content on some biochemical parameters, tibia characteristics, peripheral blood lymphocyte and splenic plasma cell counts of broilers were investigated. (2) Supplementation of the diet with boron affected plasma concentrations of boron, iron, copper and zinc and also tibia boron, zinc and calcium concentrations but did not have any effect on tibia iron or copper concentrations or tibia ash and tibia weight values. (3) Boron supplementation caused significant increases in splenic plasma cell count but decreased the proximal and distal tibia growth plate widths. There was no effect of boron supplementation on peripheral blood alpha-naphthyl acetate esterase (ANAE) content. Whole blood haematocrit and haemoglobin counts were significantly increased by boron supplementation but there were no effects on leucocyte ratios such as eosinophil, basophil, monocyte, lymphocyte and thrombocyte. (4) In general, the findings of the present study support the hypothesis that boron has an important biological role that affects the mineral metabolism of animals by influencing both biochemical and haematological mechanisms.

Introduction and methodology - Guidelines on Parenteral Nutrition, Chapter 1

Guidelines for Parenteral Nutrition were prepared by the German Society for Nutritional Medicine (http://www.dgem.de/), in collaboration with other medical associations to provide guidance for quality assurance for parenteral nutrition (PN) practice, and to promoting health and quality of life of patients concerned. A coordination team proposed topics, working group leaders who along with working group members performed systematic literatur searches and drafted recommendations in a nominal group process. Recommendations were discussed and agreed upon in a structured consensus conference process, followed by a Delphi consensus. The current English version of the guidelines was written and updated during the period between the last quarter of 2007 and the first quarter of 2009. The recommendations of the guidelines should be reviewed, and if necessary updated five years after publication.

Crystal structure of 7-acetyl-5-benzoyl-6-phenyl-8-methyl-4,7-dihydropyrazolo[1,5-c]-1 H-pyrimidine-2-one

The title compound, C22H19N3 crystallizes in the triclinic space group P1 with a= 8.310(1) Å, b= 9.890(1) Å, c= 12.007(1) Å, α =92.17(1)°, β= 97.32(1)°, γ =106.72(1)°; Z=2; Dx=1.3270(3) (gcm-3); R=0.068 for 1618 observed reflections [I ≥ 2σ (I)]. The angle between the least squares planes formed by the N1–C2–N3 and C4–C5–C6 atoms of the pyrimidine ring is 30.1(3)°. The dihydropyrimidine ring adopts a distorted boat conformation. The dihedral angle between the two phenyl rings is 48.4(1)°. The pyrazole ring in the title compound is distorted from planarity with a maximum deviation of 0.153(3) Å for C4. Two molecules form a dimere with 1. There are the shortest four inter- and two intramolecular hydrogen bonds in the structure and {four intermolecular [N1–H1= 0.860(3) Å, N1...O2i= 2.902(3) Å, H1...O2i= 2.129(2) Å, N1–H1...O2i=.149.3(2)°, C4–H4=.0.981(3) Å, C4...O70= 2.895(4) Å, H4...O70= 2.460(2) Å, C4–H4...O70= 106.5(2)°; C65–H65= 0.930(3) Å, C65...O70ii= 3.346(4) Å, H65...O70ii= 2.540(2) Å, C65–H65...O70ii= 145.2(2)° and C71–H71A= 1.02(3) Å, C71...O50= 3.188(6) Å, H71A...O50= 2.51(3) Å, C71–H71A...O50=123(2)°; (i) ≡ 1-x,2-y, -z, (ii) ≡ -x, 2-y, -1-z] and two intramolecular [C4–H4= 0.980(3) Å, C4...O70= 2.895(3) Å, H4...O70= 2.460(2) Å, C4–H4...O70= 106.5(2)° and C71–H71A= 1.026(3) Å, C71...O50= 3.189(5) Å, H71...O5= 2.51(3) Å, C71–H71A...O50= 123(2)°]}.

Frequency of co-morbid illnesses in cancer patients in Turkey

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Background: Co-morbidities in cancer patients can adversely affect the management of their primary illnesses at multiple levels from diagnosis to therapy. We saught to examine co-morbid conditions in cancer patients treated at 3 university hospitals in Turkey representing three different geographic locations. Methods: A total of 622 consecutive cancer patients presenting to outpatient clinics were recruited to the study from November 2007 to May 2008. Each patient answered a questionnaire consisting of questions on co-morbidities and drugs taken. Based on the questionnaire, Charlson Comorbidity Index (CCI) was calculated. Results: Their median age was 55 years (minimum-maximum: 21–87) and 376 (62%) were female. Breast cancer (39%), colon and rectum (19%) and lung cancer (14%) were the 3 most frequent cancers. Of the patients, 60% had at least 1 co-morbid disease and 49% were using at least one medication daily. The most frequent comorbid diseases were hypertension (25%), other cardiovascular disorders (15%) and diabetes mellitus (13%). Incidence of comorbid diseases were increasing by age; 65% in patients between 60–69 years and 76% in patients older than 70 (r=0.25, p<0.001). Similarly, of those over 70 years, 65% was on at least 1 medication (r=0.29, p<0,001). CCI scores were calculated as 0 in (71%), 1 (23%) and 2 (5%) and it also worsened by increasing age (r=0.15, p<0.001). Conclusions: It is crucial to remember that co-morbid illnesses are not infrequent and many patients take medications for conditions unrelated to their cancer, which potentially may affect multiple stages of clinical management.

No significant financial relationships to disclose.

Predictive biomarkers to improve treatment of metastatic colorectal cancer (mCRC): Outcomes with cetuximab plus FOLFIRI in the CRYSTAL trial

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Background: KRAS oncogene mutation status is predictive of efficacy of cetuximab alone or combined with chemotherapy (CT) in mCRC. Previous data from the phase III CRYSTAL trial showed that adding cetuximab to FOLFIRI in first-line mCRC significantly improved the overall response rate (ORR) and progression-free survival (PFS) in pts with KRAS wild-type (wt) tumors. The serine-threonine kinase BRAF is a direct downstream effector of KRAS. Here, we report the influence of KRAS and BRAF status on mature overall survival (OS) data. Methods: DNA was extracted from archived tumor material where available from randomized pts. KRAS and BRAF mutation status (wt or mutant [mt]) was determined by quantitative PCR. Treatment arms were compared using two-sided log-rank tests (5% significance level) for PFS and OS, and the CMH test for best ORR. Results: The KRAS-evaluable cohort (n=540; 64.4% KRAS wt) was similar to the overall ITT group. In KRAS wt pts, adding cetuximab to FOLFIRI significantly increased the odds for tumor response nearly 2-fold, reduced the risk of progression by 32% and extended median OS from 21.0 months (mo) to 24.9 mo (details in Table ). KRAS mt pts did not benefit from cetuximab. Data on the impact of BRAF mutations on cetuximab activity will be presented at the meeting. In the FOLFIRI and cetuximab + FOLFIRI arms, 31.2% and 36.1% of pts, respectively, received no further line of therapy, while 25.4% and 6.2%, respectively, received EGFR antibody therapy. Conclusions: The benefits of adding cetuximab to CT were greater in KRAS wt pts than ITT pts for all clinically relevant endpoints. KRAS is a key biomarker for selecting a targeted therapy combined with standard CT in first-line mCRC.

[Table: see text]

[Table: see text]