Objectives: Lung cancer is the most common cause of cancer-related deaths worldwide. The use of tobacco and tobacco products is among the leading risk factors with proven association with lung cancer, although various environmental and dietary factors have been also implicated. Vitamin D deficiency has been identified as a poor prognosticfactor in advanced stage colon cancer and breast cancer. The aim of the present study was to compare 25-hydroxyvitamin D [25(OH)D] levels between patients with non-small cell lung cancer (NSCLC) at the time of diagnosis and healthycontrols and to evaluate the differences in serum 25(OH)D levels across the subgroups and stages of NSCLC.Methods: A total of 462 patients with NSCLC who were followed and treated in three participating centers were compared retrospectively with and age- and sex-matched 462 healthy controls who underwent testing for serum calcium,lactate dehydrogenase (LDH), magnesium, phosphorus, creatinine, and vitamin D levels in the between January 2016and June 2018. The patients with NSCLC were further classified according to the histological subtype.Results: The mean age was 63.46±8.86 years. The patient group was composed of 58 females (12.6%) and 404 males(87.4%). Serum 25(OH)D, calcium, LDH, and magnesium levels were significantly different between the patient andthe control group (p=0.0001, p=0.0001, p=0.0001, p=0.0001, respectively). Among patients with NSCLC, serum 25(OH)D was significantly lower in patients with adenocarcinoma subtype than in patients with squamous-cell carcinomasubtype (p=0.001). There was a significant correlation between advanced stage with decreased serum 25(OH)D andincreased LDH levels (p=0.0001, p=0.0001, respectively).Conclusion: The study is the most extensive study in our region in terms of the number of participating patients.Demonstration of a difference in serum 25(OH)D levels between histological subtypes also contributes to the literature.

Objectives: The aim of this study was to investigate the temporomandibular joint mobility, cervical mobility, head position, and kinesiophobia in individuals who were seperated into different groups according to the Research DiagnosticCriteria for Temporomandibular Disorders, and were diagnosed with only one.Methods: Individuals with temporomandibular disorders were divided into 3 groups according to the Research Diagnostic Criteria for Temporomandibular Disorders. After obtaining sociodemographic information of individuals, cervical mobility and head position with a goniometer, temporomandibular joint mobility with a ruler, and kinesiophobiawith a Tampa Scale for Kinesiophobia were assessed.Results: In the statistical analysis among the groups; values for the Tampa Scale for Kinesiophobia of individuals ingroup 3 were higher than the others with temporomandibular disorders (p=0.002); while head position, temporomandibular joint mobility and cervical mobility values did not differ (p>0.05).Conclusion: It is considered that craniocervical symptoms can different in subgroups of temporomandibular disordersat the beginning. However, these symptoms were same in all groups, except kinesiophobia. On this basis, it is need forfurther study with high level of evidence.

Objectives: We aimed to investigate the effects of bariatric surgery on the sexual functions in both genders by comparing Female Sexual Function Indexes (FSFI) and International Index of Erectile Function (IIEF) scores with the physical, hormonal and biochemical findings after the Laparoscopic Adjustable Gastric Band (LAGB) procedure of morbidlyobese male and female patients.Methods: Obese patients between 18 and 65 years of age who underwent bariatric surgery and continued their followup visits were included in the study. At the postoperative 6th month, FSFI and IIEF surveys were performed to the LAGBpatients. Biochemical and hormonal tests were evaluated.Results: At the postoperative period, a significant decrease was detected in the BMI levels of both male and femalegroups in comparison to the preoperative period (p<0.01). There was no significant difference in the FSFI, IIEF, IIEF-5and IIEF-6 scores (p>0.05); however, there was a quantitative increase at the score levels. A negative correlation wasdetected between BMI and FSFI, IIEF, IIEF-5 and IIEF-6 scores.Conclusion: Although there was no significant difference in the sexual functions of the patients who underwent LAGBoperation in the early period, the long-term follow-up of the patients was become more of an issue.

Objectives: The aim of the study was to evaluate reliability, efficiency and side effects of two different combinationsthat are ketamine-propofol and fentanyl-propofol, in pediatric hematology patients undergoing lumbar puncture (LP).Methods: A total of 100 paediatric cases, aged 4-14 years, who were planned to undergo LP procedure were administered two different sedo-analgesia protocols. An anesthetist administered ketamine 1 mg/kg intravascularly (iv) to theketamine group (K), then after 1 min 2 mg/kg propofol was administered iv. In the fentanyl group (F), 1 mcg/kg fentanylwas given and after 1 min 2 mg/kg propofol was administered iv. All patients were monitorized and the heart rate,blood pressure, oxygen saturation, number of LP attempts, the side effects and also additional doses and the physiciansatisfaction were recorded.Results: The requirement for additional doses was higher in Group F (p<0.001) and the physician satisfaction was lowerin Group F (p=0.021). When hemodynamic parameters were compared, the reduction in F group was determined asgreater than that in K group (p<0.01).Conclusion: Safe and effective sedation has been obtained with both protocols during LP. However, the ketaminepropofol combination had a lower requirement for additional doses and the physician satisfaction level was higher.

Objectives: Elastofibroma dorsi is a benign and infrequent tumor of uncertain etiology usually located at the subscapular region. We present our experience in the treatment of elastofibroma dorsi.Methods: We conducted a retrospective study of 20 marginal excisions in 14 patients with the diagnosis of elastofibroma dorsi during a period of seven years. All patients underwent a marginal excision and also had flat silicone suctiondrains in the surgery site with pressure wound dressing to avoid seroma. Clinical parameters including age, gender,body mass index, type and duration of symptoms, radiological method of diagnosis, side and size of tumor, extent ofsurgical margin, complications and recurrence were examined.Results: The patients are 4 male and 10 female with a median age of 54.2 years. Six patients presented with bilaterallesions. Symptoms are pain during movement and snapping scapula lasting for approximately nine months. The overall mean of tumor volume is 332.2 cm3. Overall free surgical margin has an average of 1.14 cm. The only postoperativecomplication is a seroma in one (5%) patient. No patient had recurrence.Conclusion: Current treatment modality of elastofibroma dorsi is a marginal excision. Flat suction drains in the surgerysite and pressure wound dressing is of particular importance to prevent the most common postoperative complication.

Objectives: Lung cancer accounts for 20% of cancer-related deaths worldwide. Several studies have shown that Vitamin D levels at the time of diagnosis are prognostic in lung cancer. In this study, we evaluated the relationship betweenpre-diagnosis Vitamin D replacement levels and platinum-based chemotherapy results.Methods: In this cross-sectional study, we retrospectively analyzed archive records of all 247 patients diagnosed withlung cancer from an oncology center in Turkey, between 2012-2018. The chemotherapy outcomes, Vitamin D levels andreplacement doses of these patients up to 6 months ago were recorded.Results: Vitamin D levels of 153 patients were below 15 ng/mL, 65 patients had a level of 15-30 ng/mL, and 29 patientshad a vitamin D level higher than 30 ng/mL. In the study population, 215 had a replacement below 300.000 IU whereas32 had a replacement above 300.000 IU. When the patients were evaluated based on their chemotherapy responses, nodifference was observed between the patients with below and above 300.000 IU. In our study, Vitamin D and replacement level at the time of diagnosis did not change the chemotherapy response.Conclusion: Vitamin D replacement levels were not significantly associated with chemotherapy outcomes in our study.

Objectives: The aim of our study is reducing the healthcare workers’ duration of exposure to the cytotoxic agentswithout increasing the unused dose wasting during preparation by making changes in vial sizes of cytotoxic drugs.Methods: Wasted doses and preparation time (potential exposure time) of the selected antineoplastic drugs weremeasured for six months. The usage of small dose vials which causes prolongation in preparation time has been avoided and larger dosage forms were preferred in last trimester. Wasted drug dose amounts and preparation periods wererecorded. Subsequently, the data compared between the trimesters.Results: The total preparation period in the first trimester was 1407 minutes while it was 1058 minutes in the secondtrimester. There was no significant changes between the first and the last trimester of the study in terms of patientsnumbers that receiving chemotherapy and the rate of unused drug doses extermination (p>0.05). On the other hand,drug preparation time, in other words the health employee's exposure period to cytotoxic drugs was reduced 24.81%.Conclusion: In the study, it has been shown that by making rational choices about drug usage can reduce thehealthcare workers duration of exposure to the cytotoxic agents.

Objectives: This study aims to describe the characteristics of epidermal growth factor receptor (EGFR) mutations incorrelation with clinical features of Vietnamese non-small cell lung cancer (NSCLC), and identify the predictive factorfor the incidence of EGFR mutations.Methods: A total of 1.548 newly diagnosed NSCLC patients were selected for this retrospective study. EGFR mutationswere detected in the tumor, lymph node tissue and pleural fluid by the pyrosequencing method.Results: EGFR mutations were detected in 623 patients (40.2%). Mutations were more frequent in the female patient(p<0.001), in adenocarcinoma (p=0.004), in pleural effusion sample (p=0.002), in the low-intermediate grade of thetumor (p<0.001), and in those with CK7-positive (p=0.001) and TTF1-positive result (p<0.001). Notably, the low gradeof the tumor (p<0.001), TTF1-positive marker (p=0.001) and pleural fluid (p=0.002) were detected as independent factors for the higher incidence of EGFR mutations in multivariable analysis. In addition, CK7 marker played the role as anindependent factor when TTF1 marker was not applied (p=0.011).Conclusion: EGFR mutations occur with high frequency in Vietnamese NSCLC patients. Histologic grade, TTF1 marker,and sample type are independent factors for the incidence of EGFR mutations.

Pharmacogenomics (PGx) is the study of the correlation between an individual’s genome and their response to specificmedications. While different individuals respond differently to drugs, it has only been since the documentation of thehuman genome in 2003 that researchers have been able to make a tighter genetic connection with their metabolism.This study explores the current state of the PGx as of 2019 with an emphasis on its clinical usefulness. We analyzed datafrom the Food and Drug Administration (FDA), the Clinical Pharmacogenetics Implementation Consortium (CPIC) andPharmGKB, three key organizations that support pharmacogenomics in the US. A supported literature review was performed from PubMed and ClinCalc. We identified 27 drug-biomarker pairs on the highest ratings of confidence basedon FDA, CPIC, and PharmGKB and chose 9 exemplary drugs to tabulate the association study (GWAS), PharmGKB dosingand FDA PGx actionability.

Cancer is a complex pathophysiological condition that produces an important number of death around the world.At present, there are different ways to treat cancer: chemotherapy, radiotherapy and surgery. Cancer chemotherapyused today in many cases is effective, but it is very toxic too. The endocannabinoid system is implicated in a varietyof physiological and pathological processes, including cancer. Many studies have shown, since 1975, that both phytocannabinoids Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD) offer an antioneoplastic activity. Latter, other researchers have displayed that endocannabinoids as anandamide (ANA) and 2-arachidonoylglycerol (2-AG) alsopresent the same potential activity. Phytocannabinoids and endocannabinoids act through CB1 and CB2 receptors toproduce that effect. However, THC -the main phytocannabinoid presenting anticancer action- as well as anandamideemployed in pharmacological doses, produce important phycotropic effects, but these cannabinoid compounds donot produce major adverse reactions like conventional antineoplastic drugs. On this basis, scientists have to developanalogs or derivatives of cannabinoids/endocannabinoids that cannot induce psychotropic effects. It is important tostudy more deeply chronopharmacological aspects of cannabinoids/endocannabinoids in cancer therapy, althoughsome is known today.

Intradural extramedullary hemangiopericytomas (HPCs) are extremely rare and a hemangiopericytoma located at thecraniovertebral junction might present radiologic features similar to those of meningioma or schwannoma. To the bestof our knowledge, this report is among a few reported cases of HPC at the craniovertebral junction. Although they arevery rare, HPCs should kept in mind in the differential diagnosis of the intradural extramedullary lesion due to differences in treatment such as adjuvant radiotherapy.

Vertebral arteries (VAs) arise as the first branch of the ipsilateral subclavian artery. Recently, varying number of aberrantVA types has been reported; extraordinarily, in our case, both VAs have derived directly from the aortic arch at whichdistal to the origin of the left subclavian artery (LSA). In our case, the fourth branch of the aortic arch was the left VAand the fifth branch was the right VA. To the best of our knowledge, this is the second report in the literature showingan abnormal origin of both the right and left VAs originating distal to the origin of the LSA. We have presented here anextremely rare case of aberrant right and left VAs in one patient.

Nested stromal-epithelial tumor (NSET) is a very rare mesenchymal liver tumor, which is originated from non-hepatocyte cells in the liver. NSET has been defined as a non-hepatocytic and non-biliary tumor of the liver with epithelial andspindled cells with associated myofibroblastic stroma and variable intralesional calcification and ossification. It is oftenseen in young women and can be represented as large masses. This article is aimed to present the clinical and imagingfindings of a 77-year-old male patient with a massive NSET including coarse calcification, with literature comparison.

Objectives: Although, currently, it turns to speculate on infectious etiology of Crohn’s disease (CD), many studies haveattributed a lower prevalence of Helicobacter pylori infection in patients with inflammatory bowel disease (IBD). The aimof this retrospective study was determining the benefit of detection and eradication of H. pylori in patients with IBD andits potential impact on the natural history of the disease.Methods: Retrospective study of 125 patients: 20 of the control group and 105 with gastrointestinal disorders. The 13Curea breath test was required as a routine procedure for all patients before receiving any dose of sulfasalazine.Results: Case group had an average of infection with H. pylori (42%), similar to the control group (40%). IBD showeda similar positivity to 13C-urea breath test (OR=0.99; 95% CI: 0.32–3.05). Higher incidence was found in microscopiccolitis (46%) and CD (52%), than in ulcerative colitis (40%), without substantial differences. Patients treated for H. pylori,reduced the number of recurrences.Conclusion: The eradication of H. pylori in patients with IBD may have a positive impact on the natural history of thedisease, although more prospective studies are needed.

Objectives: There are limited data regarding the effect of comorbidities in the intensive care unit (ICU) and 12-monthmortality rates of patients with acute respiratory failure (ARF) who are admitted to the ICU. The present investigationwas designed to determine the effect of comorbidities and identify long-term mortality predictors in this patient group.Methods: A retrospective observational cohort study was performed in a 22-bed, tertiary ICU in a teaching and research hospital. All patients who were admitted to the ICU during 2012 were included in the study. Demographics,comorbidities, ICU data at the time of admission, and the last control were recorded. ICU mortality and 12-month mortality after ICU discharge were analyzed by Cox regression and Kaplan–Meier survival analysis.Results: During the study period, 1022 patients (362 females) were admitted to the ICU, and the ICU mortality was20.8%. Older age, non-invasive mechanical ventilation failure, more invasive mechanical ventilation days, tachycardia,Acute Physiological and Chronic Health Evaluation (APACHE II) score at the time of admission, low albumin, and theratio of partial arterial oxygen pressure to inspired fractionated oxygen were associated with increased mortality. Interestingly, the presence of chronic obstructive pulmonary disease (COPD) was associated with decreased mortality.The 12-month mortality rate of the 809 patients who were discharged from the ICU was 51.9% (n = 420). Half of thesepatients died within the first 2 months after discharge. Cancer, low albumin, and higher APACHE II score at the time ofdischarge were identified as mortality risk factors.Conclusion: Patients with ARF who are admitted to the ICU have a higher rate of mortality, and only half survive >1year after discharge. COPD is a comorbid disease associated with an increased likelihood of long-term survival, whereasmalignancy is associated with poor prognosis after ICU discharge.

Objectives: The aim of this study was to examine the association between Vitamin D levels and body mass index (BMI)as an adiposity measure in the reproductive-aged women.Methods: A total of 171 women were included in this comparative cross-sectional study. The subjects were classified into three groups according their BMI’s: Group I; non-obese=80 (BMI<25.0 kg/m2), Group II; overweight=54(25.0<BMI<30 kg/m2), and Group III; obese=37 (BMI>30 kg/m2).Results: Obese women possessed the lowest mean follicle stimulating hormone levels (6.26±1.46, p=0.001), and thehighest luteinizing hormone (LH) levels were found in non-obese group (5.70±2.15, p=0.001). The comparison of antiMüllerian hormone (AMH) levels yielded that there was a significant difference between non-obese and overweightwomen (4.96±4.02 vs. 3.11±3.03, p=0.019). The mean Vitamin D level was found to be highest in the non-obese group(10.45±7.48, p=0.043). The correlation analysis demonstrated that Vitamin D level was weak correlated with AMH levelin the overweight group (r=0.285, p=0.047).Conclusion: Our study showed a negative association between Vitamin D level and obesity. Vitamin D supplementation may aid to reduce the obesity incidence. Further evaluations are needed to elucidate this issue.

Objectives: Bleeding control is crucial in preventing negative consequences by reducing blood loss in surgical operations. The aim of this study is to evaluate the hemostatic effect of a new herbal hemostatic agent called Algan Hemostatic Agent (AHA) in an uncontrolled bleeding model made by liver laceration.Methods: In these study 5–7 weeks-old 64 rats were used. Rats were randomly divided into 8 groups each consistingof eight rats (4 groups heparinize and 4 groups non-heparinize). The experimental liver laceration was performed, andphysiological serum impregnated gauze was applied to the control group for hemorrhage control, AHA liquid formimpregnated gauze, AHA gel, and AHA powder form were applied to experimental groups, respectively.Results: The shortest bleeding time was found in the AHA powder group. The AHA powder form stopped the bleedingin the heparinize group for a mean of 4 s, the non-heparinized group for 2 s. This was followed by the gel group and theliquid group. The bleeding time was significantly shorter in the all AHA group compared to the control group.Conclusion: This study showed that AHA is a highly effective hemostatic agent in controlling bleeding compared tothe control group.

Objectives: In this study, we aimed to find the answer to the question of whether intracavitary therapy administeredfor bladder tumor has any effect on the development of urethral strictures.Methods: The patients who underwent transurethral resection of the bladder with the diagnosis of bladder tumor inour clinic were divided into two as the group with urethral strictures and the group without urethral strictures. Intracavitary therapies, follow-up, and recurrence data of the patients of both groups were recorded.Results: The mean age of the patients with and without urethral stricture was 67.8 and 68.4 years, respectively. Therewas no significant difference between the T staging and grading of patients in the two groups. There was no statistically significant difference between the patients with and without urethral stricture in terms of intracavital therapyrates (p=0.943).Conclusion: Although we demonstrated that intracavitary therapy administered for bladder tumors had no effect onthe development of urethral strictures, we believe we need randomized controlled trials with larger patient series.

Objectives: Lung cancer has been the leading cause of cancer mortality, and its incidence is growing throughoutthe world. This study aims to compare the distribution of the six World Health Organization by configural frequencyanalysis (CFA).Methods: The National data (GLOBOCAN 2012) were included in the analysis. Data were analyzed by CFA which is usedfor the analysis of multiway contingency tables.Results: In Africa, East Mediterranean, Europe, and Southeast Asia, lung cancer incident cases were observed to behigher than expected. Under the years <70, in Africa, East Mediterranean, Europe, and Southeast Asia, lung cancer mortality is significantly underrepresented and therefore antitypes. Here, lung cancer mortality was observed lower thanexpected. In the more developed regions, lung cancer incident cases and mortality were significantly overrepresentedin almost all age groups in both male (years <55) and female, but in the less developed regions, it was significantlyunderrepresented in almost all age groups.Conclusion: The majority of the global lung cancer burden occurred in the more developed countries. If the currentsituation remains unchanged, incidence and mortality may continue to increase.

Objectives: We aimed to investigate the distribution of immunoreactivities of vascular endothelial growth factor(VEGF), endothelial nitric oxide synthase (eNOS), and inducible NOS (iNOS) on breast cancer cells in response to treatment with boron derivatives.Methods: We initially analyzed the cytotoxic effect and IC50 value of boron by MTT assay. For the evaluation of theangiogenesis, expression level of antibodies was detected to following boron derivatives such as boric acid, boronpenta (BP), and T-Boron (DPD) in the absence of boron treatment using the indirect immunohistochemical method. Theevaluation of these staining was done using the H-scoring system.Results: It was found that immunoreactivities of VEGF, eNOS, and iNOS increased on control compared to those of thecells of MDA-MB231 human breast cancer cell line. Following boron derivatives treatment, it was observed that theywere inhibited the VEGF/NOS labeling in MDA-MB-231 breast cancer cells.Conclusion: The present data suggest that BP, especially DPD, inhibits the angiogenesis of breast cancer cells throughVEGF pathway. From this point, these boron derivatives may provide a novel therapeutic approach for breast cancertreatment.