National study on use of artificial intelligence in breast disease and cancer.

BACKGROUND: The aim of this study was to examine the thoughts, reservations, approaches and perspectives on the future of artificial intelligence (AI) held by physicians specializing in breast healthcare in our country. METHODS: Our survey was sent to the members of the Federation of Turkish Breast Disease Associations (MHDF) by e-mail. The survey investigates the attitudes towards the use of AI in breast disease and cancer, including demographic characteristics of the participants, their daily practice and approaches, and their stance on the future. RESULTS: The questionnaire was sent to a total of 1,890 people via e-mail. 108 (40.1 %) participants believed that the use of AI in breast disease would improve their field of expertise moderately, 103 (38.3 %) expected this improvement to be considerable. 169 (70.3 %) respondents identified 'rapid diagnosis' as the most important advantage of AI. 123 (45.7 %) participants considered concerns about potential medical errors and liability issues to be the most worrying aspects of AI. CONCLUSION: According to our study, the use of AI technology in the diagnosis and treatment of breast disease and cancer seems to be beneficial for both physicians and patients. However, physicians have some concerns about possible medical errors and liability issues that AI might cause (Tab. 1, Ref. 25).

Correlation between Endoscopic and Histopathological Findings in Dogs with Chronic Gastritis.

INTRODUCTION: Chronic gastritis is a common diagnosis in dogs with signs of chronic vomiting. However, there is no data concerning endoscopic and histopathological agreement in dogs with chronic gastritis. Thus, a question should be raised whether taking gastroduodenal biopsies in dogs with chronic gastritis is necessary or not. Consequently, the purpose of the study was to compare the endoscopic and histopathological agreement in dogs with chronic gastritis. MATERIAL AND METHODS: A total of 22 non-pregnant client-owned dogs with the signs of chronic gastritis were enrolled in this prospective study. Procedures including clinical examination, blood analysis, and diagnostic imaging were performed before anaesthesia. Biopsies obtained from gastroduodenal sites were histopathologically evaluated. A total of 110 gastroduodenal samples were examined. RESULTS: Sixty-eight samples had abnormal histopathology and endoscopy while 11 showed normal histopathological and endoscopic evidence. CONCLUSION: The obtained data demonstrated that it is not necessary to take extra gastroduodenal biopsies in dogs with evidence of endoscopic gastroduodenitis. We also believe that further prospective studies, including cost and time effectiveness and more specific comparison between endoscopic appearance and histopathology, are necessary to make final recommendations regarding the need of using both procedures for definitive diagnosis.

The effect of phenol concentration on the treatment of pilonidal sinus disease: Early results of a prospective randomized study.

OBJECTIVE: Our hypothesis was that a low concentration (30%) of phenol would be more effective than a high concentration (80%) in the treatment of pilonidal disease. The purpose of our study was to compare the effects of high and low doses of liquid phenol in the treatment of pilonidal disease. SUMMARY OF BACKGROUND DATA: In the treatment of the pilonidal disease, the phenolization technique and concentration of the phenol solution is not well defined. METHODS: Consecutive patients being treated for pilonidal disease with high and low concentrations of phenol were included in this randomized prospective study. The demographic data, pilonidal disease characteristics, and results of phenol application were examined. RESULTS: Of 101 subjects, 52 were treated with 80% phenol while 49 were treated with 30% phenol. The mean observation period was approximately 1 year. The total recovery rate was higher among the 80% phenol group (P: 0.046). The recovery period, the period of leave from work, and complication rates were similar in both groups (p: 0.414, 0.328, 0.256). Also, in the Likert-type survey administered by validated methods, there was no difference in the degree of satisfaction (P: 0.494). CONCLUSION: The low concentrations of phenol did not achieve faster recovery, faster return to work, or less complications in the treatment of pilonidal disease. An 80% concentration of phenol should be used for a higher rate of recovery.

The effect of sleeve gastrectomy on serum irisin levels in patients with morbid obesity.

INTRODUCTION: Irisin, a recently identified myokine, is associated with increased energy expenditure and has a potential role in obesity. Therefore, we investigated circulating irisin levels in morbidly obese patients undergoing sleeve gastrectomy (SG). MATERIAL AND METHODS: Thirty morbidly obese patients undergoing SG and 30 healthy subjects were included. All participants were evaluated at baseline and again at three months post-SG. Body weight and height, the lipid profile, and plasma glucose, HbA1c, insulin, and irisin levels were measured at each visit. RESULTS: The two groups had similar mean age and sex distribution. Serum irisin was significantly lower in the morbidly obese subjects compared with the controls (p = 0.003) and negatively correlated with BMI, body weight, insulin levels, and HOMA-IR (p = 0.006, p = 0.011, p = 0.046, p = 0.048, respectively). When the morbidly obese patients were re-evaluated three months post-SG, their weight and BMI had significantly decreased (both p = 0.001). Similarly, the insulin, HbA1c, HDL-cholesterol, and HOMA-IR values significantly decreased (p = 0.001, p = 0.028, p = 0.006, and p = 0.001, respectively). However, irisin levels remained unchanged (p = 0,267). CONCLUSION: Although the irisin levels were significantly lower in the morbidly obese subjects, they did not change after SG-induced weight loss. (Endokrynol Pol 2016; 67 (5): 481-486).

The effectiveness of simultaneous oncoplastic breast surgery in patients with locally advanced breast cancer.

BACKGROUND: Oncological outcomes of the oncoplastic breast surgery in patients with locally advanced breast cancer (LABC) are not well defined. This study examined the effects of oncoplastic techniques for LABC in terms of localized control and survival. We also evaluated the esthetic results of patients who had undergone oncoplastic breast conservation surgery (OBCS) and their satisfaction with the outcome. METHODS: The files and Medula (Probel Co.) database records of the patients were studied retrospectively. The esthetic evaluation was conducted by a panel. A validated satisfaction study was also performed. RESULTS: In total, 42 LABC cases (median age 48 years; range 33-69 years) were included. The median observation period was 61 months (range 26-151 months). Neoadjuvant chemotherapy (NACT) was administered in 32 (76%) cases, and a pathologic complete response was observed in 7 (16.7%) cases. The median T size during the post-NACT pathological study was 27 mm (range 0-44 mm). Oncoplastic reduction surgery was performed in 13 cases, a glandular flap in 7, Grisotti flap in 5, and latissimus dorsi flap in 3 cases. The median specimen weight was 198 g (range 103-812 g), and the mean surgical margin length was 8.7 mm (range 5-17 mm). The margin was positive in 7.1% of cases, and the local repetition rate was 14.6%. The total survival rate was 86.6%, and disease-free survival was 59.6%. The rate of excellent and good ratings by the esthetic assessment panel was 79.4%. The satisfaction rate was 88.2%. The early and delayed complication rate was 16.7%. CONCLUSIONS: Oncoplastic techniques are suitable and safe for patients undergoing OBCS. These techniques do not pose a risk to oncological local control. No survival or follow-up problems were detected during the 5-year follow-up period, the esthetic results were acceptable, and the satisfaction rate was high.

Visceral organ resection during femoral hernia surgery is a predictor of morbidity.

Reports on the outcomes of emergency and elective femoral hernia surgery are scarce. Most studies do not distinguish femoral hernia from other types of groin hernia; studies of femoral hernia alone are few in number. The main objective of the present study was to identify factors affecting morbidity of femoral hernia patients. We retrospectively analyzed data on 80 patients who underwent femoral hernia surgery between June 2009 and June 2013. Patients who did and did not experience morbidity were compared in terms of age, sex, hernia location, the presence of any comorbid disease, the type of anesthesia employed, the operative technique used, the type of surgical intervention, and performance of small bowel resection. Forty-three patients (53.8%) underwent emergency surgery because of incarceration. Of these, 18 (41.9%) experienced strangulation and underwent resection. Postoperative complications developed in 11 patients (13.8%). Upon multiple logistic regression analysis, visceral organ resection (of the small bowel and/or omentum) was the only independent predictor of significant morbidity (P < 0.05; odds ratio [OR]: 14.010, 95% confidence interval [CI]: 1.001-196.143). When diagnosed, femoral hernias should be electively repaired as soon as possible. The cumulative probability of strangulation rises over time. A requirement for bowel resection seems to significantly increase morbidity.

Comparison of Clinical and Pathological Differences of Breast Cancer Patients under 35 and above 55 Years of Age.

OBJECTIVE: In this study, we aimed to evaluate the clinical, pathologic and management differences between breast cancer patients under 35 years of age and postmenopausal patients above 55 years of age. MATERIALS AND METHODS: Patients who were operated on for breast cancer between November 2003 and March 2013 in our hospital were retrospectively analyzed. Patients were separated into two Groups according their age; Group 1 (<35 years) and Group 2 (>55 years). RESULTS: 94 patients with breast cancer, 45 patients in Group 1 and 49 patients in Group 2, were included in the study. The mean follow-up was 51 (19-121) months and 50 (19-120) months in Groups 1 and 2, respectively. Stages of breast cancer at the time of diagnosis were similar between the two groups. The groups were similar in terms of rates of re-excision (p=0.42), local recurrence (p=0.34) and solid organ metastases (p=0.182). The number of oncoplastic and reconstructive procedures were higher in Group 1 (p=0.04). Regarding pathological results, the rate of grade 3 tumors, those with Ki-67>12 and triple negative breast cancer were found to be higher in Group 1. In addition, the number of patients receiving chemotherapy was significantly higher in Group 1 (p=0.03). CONCLUSION: Oncologic results were similar between young patients and postmenopausal patients. Nevertheless, tumor biology was found to be worse in young patients. In addition, oncoplastic and reconstructive approaches were significantly higher in young patients.

Effect of nifedipine on the healing of left colonic anastomoses in rats.

PURPOSE: Ca(2+) channel blockers inhibit collagenase production and have a vasodilatatory effect. They also restrict the formation of ischemia-reperfusion induced free oxygen radicals. The aim of this study was to assess the effect of nifedipine on the healing of colonic anastomoses in a rat model. METHODS: Sixty Wistar rats weighing 240-290 g were divided into four groups of 15 rats each: a 3rd day control group (group A), a 3rd day treatment group (group B), a 7th day control group (group C), and a 7th day treatment group (group D). The treatment groups were given Nifedipine 3 mg/kg per day orally as three divided doses. RESULTS: The bursting pressure values of the anastomoses in the treatment groups were significantly higher than those in the control groups ( P < 0.05). The hydroxyproline content was also significantly higher in the treatment groups than in the control groups ( P < 0.05). Histologic examination confirmed that nifedipine treatment significantly increased collagen deposition and fibroblast ingrowth compared with controls ( P < 0.05). CONCLUSIONS: These results clearly showed that nifedipine enhanced the stability of colonic anastomoses during the first postoperative week.