Melike Demir

A comparison of men and women's experiences of chemotherapy-induced alopecia

PURPOSE The effect of alopecia on men and women has not been fully documented in the literature, especially for Turkish cancer patients. The aim of this study was to determine the incidence of chemotherapy-related alopecia and how it affects the body image and quality of life of Turkish male and female cancer patients, in order to identify variables that may be important in the perception of this problem. METHODS This descriptive study was carried out between November 2010 and June 2011 at Istanbul University Institute of Oncology; 201 men and 204 women attended. A face-to-face interview was performed during chemotherapy, and the effects of alopecia on cancer patients were assessed using the Patient Information Form, Body Image Scale, and Nightingale Symptom Assessment Scale. RESULTS The study group consisted of 55.1% female and 44.9% male patients. Most of the patients experienced partial or total alopecia during chemotherapy. There were no differences between men and women with regard to body image in respect of degree of alopecia, but the body image of the male and female patients who had partial or complete alopecia was lower than that in patients who had no alopecia; psychological well-being of women was lower than that in men, because the incidence of alopecia was higher in women. CONCLUSIONS This study contributes new knowledge on the cultural characteristics of Turkish patients, which may assist other researchers working with different international populations. Alopecia is a difficult side effect for both men and women. Health professionals should assess and educate patients differently from the current standard.

Fibulin-3 as a Diagnostic Biomarker in Patients with Malignant Mesothelioma

BACKGROUND New tumour biomarkers are being intensely investigated for malignant mesothelioma (MM). Fibulin-3 is produced in MM but its role remains uncertain. The aim of this study was to evaluate the validity of measuring serum fibulin-3 in the diagnosis and prognosis of MM. MATERIALS AND METHODS This prospective study was performed on 43 patients and 40 healthy controls who were admitted to our hospital between January 2012 and January 2014. Data from MM patients, including demographic and clinical features, routine laboratory data, levels of serum fibulin-3, and treatment outcomes were defined as potential prognostic factors. The receiver operating characteristic (ROC) curve for fibulin-3 was used to detect the cut-off value with highest sensitivity and specificity. Univariate survival analysis was performed using the Kaplan-Meier method in patients with MM. Afterwards, the possible factors identified with univariate analyses were entered into the cox regression analysis. RESULTS Our results revealed that patients with MM had significantly higher serum levels of fibulin-3 than controls. The results showed that the best cut-off point was 36.6 ng/ml with an AUC (area under the curve)=0.976, sensitivity=93.0% and specificity=90.0. In our study, the initial significant poor prognostic factors were advanced stage, high white blood cell count, high platelet count, high C-reactive protein (p<0.05 for each variable). Later, according to multivariate analysis the results showed only advanced stage as significant parameter (p=0.040). CONCLUSIONS We determined that real use for serum fibulin-3 was not for prognosis but for diagnosis in MM. Also advanced stage was associated with poor MM prognosis.

Effect of Reiki on Symptom Management in Oncology

Reiki is a form of energy therapy in which the therapist, with or without light touch, is believed to access universal energy sources that can strengthen the bodys ability to heal itself, reduce inflammation, and relieve pain and stress. There is currently no licensing for Reiki nor, given its apparent low risk, is there likely to be. Reiki appears to be generally safe, and serious adverse effects have not been reported. So in this article provides coverage of how to use Reiki in oncology services.

Complementary and Alternative Therapies Used by Turkish Breast Cancer Patients Undergoing Chemotherapy

Background: Most breast cancer patients use complementary and alternative medicine (CAM), usually in parallel with their conventional treatments. This study was planned to determine the prevalence and determining factors for use of CAM by breast cancer patients undergoing chemotherapy. Patients and Methods: This descriptive study was carried out between October 2010 and May 2011, and included 96 patients at the Istanbul University Institute of Oncology. The Patient Characteristics form and Complementary and Alternative Medicine Scale were used for data collection. Descriptive and nonparametric tests were performed, and logistic regression analysis was used to predict factors affecting CAM use. Results: Praying was the most frequently used form of CAM, and most of the herbal supplements used by patients were harmless. Herbal use was higher among patients who had local disease (relative risk (RR) 4.48%, 95% confidence interval (CI) 1.12–17.95), and worship was more common among those who had not undergone surgery (RR 4.66%, 95% CI 1.64–13.20). Conclusion: The CAM approaches used by patients were found to be safe. However, sage and flax seed usage for estrogen- and progesterone-positive patients and exercise for patients with spinal metastasis can be inappropriate approaches. It is important to question and inform patients about CAM use during treatment.

Effects of Distant Reiki On Pain, Anxiety and Fatigue in Oncology Patients in Turkey: A Pilot Study

BACKGROUND Fatigue, stress and pain are common symptoms among cancer patients, affecting the quality of life. The purpose of the present study was to determine the effect of distant Reiki on pain, anxiety and fatigue in oncology patients. MATERIALS AND METHODS Participants in the control group received usual medical and nursing care during their stay. The intervention group received usual care plus five distant Reiki sessions, one each night for 30 min. A face to face interview was performed and patient personal and illness related characteristics were evaluated using the Patient Characteristics form. Pain, stress and fatigue were evaluated according to a numeric rating scale. RESULTS The experimental group was predominantly composed of women (71.4%), married individuals (40%), and primary school graduates (40%). The control group was predominantly male (72.7%), married (60%), and primary school graduates (60%). The control group demonstrated greater levels of pain (p=0.002), stress (p=0.001) and fatigue (p=0.001). The Reiki group pain score (p<0.0001), stress score (p<0.001) and fatigue score were also significantly lower. CONCLUSIONS The results of this study indicate that Reiki may decreasepain, anxiety and fatigue in oncology patients.

Bronchial atresia in an adult misdiagnosed as pulmonary mass

Bronchial atresia is a congenital anomaly where lobar or segmental bronchi end bluntly upon an interruption and which is accompanied by mucoid impaction in the periphery and hyperinflation in the obstructed lung segment (1). It is observed generally in the upper lobar bronchus and frequently in the apicoposterior segment of the left upper lobe (2). It is mostly asymptomatic and more common among males (2).

Relationship between metabolic syndrome and epicardial fat tissue thickness in patients with chronic obstructive pulmonary disease.

Objective: An increase in epicardial fat tissue (EFT) thickness was found to be associated with metabolic syndrome (MS) and ischemic heart disease. MS is a comorbidity of chronic obstructive pulmonary disease (COPD) resulting from the accompanying systemic inflammation. The aim of our study was to investigate the usefulness of EFT thickness to predict MS in COPD patients. Methods: COPD patients admitted to our clinic during January–December 2014 and healthy controls were included in this prospective case-control study. Patients with comorbidities, COPD exacerbation, and malignancies were excluded. Patients and controls were compared in terms of anthropometric measurements, MS-related examination and laboratory findings, pulmonary function tests, and EFT thickness. The correlations between EFT thickness and markers of MS in COPD were evaluated using the Students t-test and logistic regression analysis. Results: COPD patients and controls were composed of 82 and 84 individuals, respectively. MS was diagnosed in 31 (37.8%) COPD patients. The EFT thickness was significantly higher in COPD patients than in the controls and was also higher in COPD patients with MS than in those without MS (all p<0.001). Each 1-mm increment of EFT raised the risk of MS two-fold (p=0.011, OR=2.08, 95% CI: 1.18–3.68). Increase in triglyceride level (p=0.004, OR=1.02, 95% CI: 1.01–1.03) and reduction in forced vital capacity (p=0.025, OR=0.26, 95% CI: 0.08–0.84) were found to be associated with increased MS risk. The cut-off value for EFT thickness in the prediction of MS in COPD patients was 6.75 mm (sensitivity: 83%, specificity: 65%). Conclusion: EFT thickness is a non-invasive and easily available parameter, which is valuable in the prediction of increased MS risk in COPD patients. Early diagnosis of patients at risk of MS may help to prevent ischemic heart disease in these patients.

Diyarbakır ilinin 2005-2010 yılları arasındaki tüberküloz kontrol durumu

Giris: Tuberkuloz (TB) kontrol programlari, uluslararasi ve ulusal duzeyde kabul goren standardize edilmis tani, tedavi ve korunma uygulamalarini icerir. Bir bolgenin TB verilerinin ulke verileriyle kiyaslanarak analizi, o bolgenin TB kontrol programlarina uyum duzeyini belirleyecek ve ileriye donuk dogru stratejileri belirlemeye yarayacaktir. Bu calismada Diyarbakir ilinin bes yillik TB verileri ulke verileriyle kiyaslanarak irdelenmistir. Yontemler: Saglik bakanligi Verem Savas Daire Baskanliginin yillik TB raporlari esas alinarak 2006–2010 yillarina ait Diyarbakir ili TB verileri ve Ulke verileri iki grup olarak kaydedildi. TB olgularina ait, demografik, tanisal ve tedavi sonuclarini iceren veriler, iki grup arasinda karsilastirmali olarak analiz edildi. Bulgular: Diyarbakir TB verilerinden bes yillik ortalama olgu hizi (22,8/100.000) ve akciger TB icin yayma yapilma orani (%80,1) ulke ortalama olgu hizi (25,6/100.000) ve yayma yapilma oraninin (%88,3) altinda bulundu. Ayni olgularda kultur yapilma orani (40,1), kultur pozitifligi (%45,5) ve kur orani (%43,9), ulke ortalamasi olan kultur yapilma orani (%62,6), kultur pozitifligi orani(%80,4) ve kur oranindan (%58,5) daha dusuk bulundu. Tedavi basarisi (86,5), tedavi terk (%5,7) ve olum orani (%2,7) ile ulke verilerine benzer goruldu. Sonuc: Diyarbakir ilinde TB’un tanisal bakteriyolojik inceleme ve kur oraninda ulke ortalamasinin altinda elde edilen sonuclar, TB kontrolunu zorlastiran sebepler oldugunu dusundurmektedir. Muhtemel sorunlarin aydinlatilmasinda, sosyodemografik etmenlerin, saglik hizmetlerinin ve donanim alt yapisinin degerlendirildigi daha kapsamli calismalara ihtiyac oldugu dusunulmektedir. Anahtar kelimeler: Tuberkuloz, Kontrol, Diyarbakir.