Outcome and Factors Related to Isolated Liver Metastasis due to Breast Cancer.

OBJECTIVE: To determine the associated risk factors for isolated liver metastasis in breast cancer patients and to detect the prognostic factors related to survival. STUDY DESIGN: Analytical study. Place and Duration of the Study: Department of General Surgery, The University of Health Sciences, Istanbul, Turkiye, from January 2011 to November 2020. METHODOLOGY: Patients with breast cancer liver metastasis who experienced surgery were retrospectively analysed for breast cancer and metastases-related characteristics. Descriptive statistical methods were used in the evaluation of data. Survival analyses were estimated by the Kaplan-Meier method. Log-rank and univariable Cox regression tests were utilised to search for prognostic factors' impact on survival. RESULTS: Out of 12 patients, 11 had recurrent disease after a median of 36 months of disease-free survival (DFS) and one patient had de novo metastasis. Grade 3 tumours and increased expression of Ki-67 had a negative effect on DFS. The median follow-up period was 66 months. Survival analysis showed 2- and 3-year progression-free survival (PFS); overall survival rates were 82%, 69%, 92%, and 82%, respectively. Development of liver metastasis in 3 years following breast cancer treatment was linked to worse PFS (p = 0.040). CONCLUSION:  Long-term survival is possible for breast cancer survivors with liver metastasis. Disease-free interval is an important determinant. Longer progression-free survival was detected in patients who had developed metastasis after three years of breast cancer treatment. KEY WORDS: Breast cancer, Liver metastasis, Hepatic surgery.

Investigation of Clinical Histopathologic Features and Metabolic Parameters of 18F-FDG PET/CT in Invasive Breast Carcinoma with a Micropapillary Component.

Objectives: The aim of this study was to evaluate the correlation between clinical histopathologic features and micropapillary (MP) ratio with the maximum standardized uptake value (SUVmax) derived from 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in treatment naïve breast cancer. Methods: Twenty-nine patients diagnosed with breast cancer with a MP component who underwent PET/CT imaging before any local and/or systemic treatment were included in this retrospective study. All clinical histopathological features were recorded. SUVmax values were measured from 18F-FDG PET images for primary tumors and metastatic axillary lymph nodes. Results: MP component percentage did not correlate with any clinical histopathological features except age. At early ages, the MP component ratio was significantly higher. Our results showed that there is no significant correlation between the SUVmax value and MP component percentage. Conclusion: A high SUVmax value is generally expected in aggressive malignancies. However, this assumption may not be valid for the MP subgroup, which has an aggressive course compared to other subgroups in breast cancer.

The Effect of Music on Labor Pain and Duration: A Systematic Review and Meta-Analysis.

Context: The use of music in obstetrics increases every day, and it is extensively used in the control of labor pain. Objective: This study was conducted to determine the effect of music on labor pain and duration. Design and Setting: This systematic review and meta-analysis was carried out between October 15 and November 15, 2022. The search was done in the PubMed and ScienceDirect, MEDLINE, Ovid, EBSCO CINAHL Plus, and Cochrane Library databases. Outcomes meassures: According to the inclusion criteria, 12 studies included in the systematic review and meta-analysis were determined. The data were analyzed using Review Manager 5.4. The methodological quality of the studies was assessed with the RoB 2 tool. Results: Twelve articles were included in this study. According to the study results, listening to music was revealed to be statistically significantly effective in reducing pain intensity in terms of relieving labor pain (SMD:-0.98, Z=8.33, P < .001). Listening to music in the active phase was found to further decrease pain intensity compared to the latent phase (latent phase: SMD:-0.56 and active phase: SMD:-1.26), but it did not affect labor duration (MD:-0.76, Z=1.72, P = .09). Conclusion: Listening to music was determined to be effective in reducing pain intensity. The music genre selected by the researchers was found to further reduce pain intensity during labor compared to pregnant women's own choices, and it was elucidated that listening to music with headphones was effective in pain control but listening to music did not affect labor duration. PROSPERO Registration no: CRD42022367480.

Adverse Drug Reaction Reporting Pattern in Turkey: Analysis of the National Database in the Context of the First Pharmacovigilance Legislation.

INTRODUCTION: In Turkey, pharmacovigilance began in 1985. A fully structured adverse drug reaction (ADR)-reporting system was established with the publication of the first pharmacovigilance regulation in 2005. Subsequent regulation published in 2014 brought further improvements to the system. OBJECTIVE: In this study, we aimed to analyse the ADR-reporting pattern in the context of the first pharmacovigilance legislation in Turkey. METHODS: We analysed ADR reports submitted to the Turkish Pharmacovigilance Center (TUFAM) from 2005 to 2014 with respect to reporting rate (RR), patient characteristics, type of the ADRs, suspected drugs, source of the report and the profession of the reporter. RESULTS: The annual RR increased gradually over the study period. RRs for females were greater than those for males. RRs were highly correlated with age. Most commonly reported ADRs were skin and subcutaneous tissue disorders. Most commonly suspected drugs were antineoplastic and immunomodulating agents. There was no remarkable change in reporting pattern of ADRs, patient characteristics or classes of suspected drugs over the years. The most common source of reports was spontaneous reporting. Contribution of the reports from studies increased gradually. Most of the reports were reported by physicians. RRs by pharmacists increased substantially over the years. CONCLUSION: This study showed that the annual RR increased gradually over the 9-year study period. This increase was neither due to an increased reporting of a specific group of ADRs or drugs, nor to an increased reporting in a specific group of patients. There was a general increase in RR in parallel to pharmacovigilance activities.

The biomechanical and histological effects of diabetes on tendon healing: experimental study in rats.

The aim of this study was to investigate the biomechanical and histological perspectives of healing of Achilles tendon in diabetic rats and compare the results with non-diabetic subjects. Fifty four adult Wistar Albino rats weighing 300-350 g were used throughout the study. Six animals were excluded from the study and replaced. Rats were randomly assigned to either the experimental or the control group comprised of 24 rats in each. Diabetes was induced in experimental group with streptozotocin. 3 days after the induction of diabetes, both Achilles tendons were transected 5 mm proximal to their insertions to the calcaneal bone and repaired by using 6/0 polypropylene sutures with modified Kessler method. At weeks 2, 4 and 6, eight rats from each group were euthanized. Left Achilles tendons including the repair site were prepared for histological evaluation and right legs were prepared for mechanical testing. When compared to control group, diabetic animals displayed a lower peak force for failure in each of the second, fourth and sixth week. The differences between the groups in each week were found to be significant in statistical assessments (p < 0.05). Histologic assessment revealed that the diabetic animals had significantly less amount of fibroblast proliferation and lymphocyte infiltration compared to the control group. There is significant delay in tendon strength at the end of week 2, 4 and 6 postoperatively in the diabetic rats. Therefore diabetic individuals require specific postoperative follow up and rehabilitation procedures.

Use of outsized composite chondrocutaneous grafts in conjunction with dermal turnover flaps for reconstruction of full-thickness alar defects.

Chondrocutaneous (ChC) grafts have been used for nasal alar reconstruction for years. One of the consequences for using these grafts is the restriction in dimensions. In this study, we presented our results in which ChC grafts bigger than 20 mm in length have been used in conjunction with a dermal turnover flap for full-thickness alar subunit defects. Technical details and results of 8 alar subunits reconstructions in 8 patients were evaluated. Follow-up period ranged from 10 to 27 months, with a mean of 18.3 months. We achieved satisfactory results without partial or total graft failure. Finally, surgeons can safely use outsized ChC composite grafts with this type of design, for successful alar subunit reconstruction.