Emergence of a high-grade sarcoma in a recurrent meningioma: malignant progression or collision tumor?

Anaplastic meningiomas that resemble sarcomas often reveal clues to their meningothelial differentiation or develop in a plausible setting that confirms their meningothelial origin. Malignant mesenchymal neoplasms without obvious evidence of meningothelial differentiation or origin are more likely to be true primary or metastatic sarcomas. Because of their clinical and biological differences, it is important to distinguish anaplastic meningioma from a sarcoma. We present a 67-year-old woman with multiple meningiomas, who developed a high-grade spindle cell tumor 6 months after the resection of a World Health Organization grade I meningioma. It was not clear whether this tumor represented a malignant transformation of meningioma or a primary sarcoma. Malignant transformation of a meningioma is exceptional within this short period and a coexisting sarcoma and meningioma are equally uncommon. Even though these malignant neoplasms are rare in general, they appear to be more prevalent in patients with multiple meningiomas including those with neurofibromatosis type 2.     

Dental students' ability to assess gingival health status with DAAGS software

The aim of this study was to evaluate the ability of dental students at different levels of education (Basic, Preclinic, and Clinic groups) to assess the level of gingival health status by using the Development of Ability to Assess Gingival Status (DAAGS) computer software program designed according to the Oral Rating Index (ORI) criteria. Two hundred and thirteen dental students at three levels of dental education voluntarily participated in three DAAGS tests in which they judged twenty-four photos. The three groups were first- and second-year dental students (Basic), third- and fourth-year dental students who had not yet participated in the clinical periodontology course (Preclinic), and fifth-year dental students who had completed the clinical periodontology course (Clinic). A gold standard of each photo was shown after completing Test 1, and then Test 2 was conducted immediately. Two weeks later, the third test was performed. Analyses of differences among the groups and between the tests for each groups were carried out by using Kruskal-Wallis and Wilcoxon Sign Rank tests, respectively. Students were asked to evaluate the DAAGS by written survey. Most of the students had a positive opinion. There were significant differences among the groups for correct and irrelevant answers and overall ability (p<0.001). The Basic group showed a significant (p<0.01) improvement between Test 1 and Test 2. This improvement was greater than Preclinic students and almost equal to Clinic students. The findings from this study indicate that the DAAGS software can serve as a useful instructional tool for education.     

Prevalence of obesity among women in Turkey: analysis of KETEM data

Background & Purpose: Determining the prevalence of obesity is a crucial step in combating with obesity and devising national health strategies. It is particularly important to better understand prevalence of obesity among women as women in Turkey also highly impacts the dietary habits of the whole household. This article determines the prevalence of obesity among adult women in the country. Patients & Methods: Each Cancer Early Diagnosis and Screening Center were asked to submit data on BMI indices for women who visited the centers between January and June 2011. The data were collected on January 1 and July 1 first for each respective quarter. Patients ranged between 30-65 years old. World Health Organization guidelines on BMI cutoffs were used to determine the prevalence of obesity and overweight. Results: The prevalence of obesity of adult women aged 35-60 was found to be 35%. The highest prevalence was observed in Western part of Turkey in the Aegean region with 42% of women with BMI over 30. The lowest rate was observed in the Eastern Turkey with 21% obese women, followed by 28% in Southeastern Turkey. Conclusion: The prevalence of obesity among adult women in Turkey is very comparable to some of the other countries with highest rates of obesity in the world. Women specific health strategies against obesity should be devised.     

Radiation oncology facilities in Turkey: current status and future perspectives

Background and purpose: An analysis of the current radiotherapy status in Turkey was conducted to establish a comprehensive baseline. Turkey’s future demand analysis in view of international benchmarks was conducted. Moreover, the ministerial plans are shared to present an example for making a comprehensive planning in developing countries. Methods: The data from all radiotherapy centers in Turkey was collected through a survey and cross-checked with primary research and government data. Survey covered the status of radiotherapy centers in terms of major equipment and personnel. Data regarding manpower currently working is obtained from relevant academic centers and occupational associations. Results: The latest ministerial registry data demonstrated 150,000 new cancer cases each year with 400,000 patients living with cancer in Turkey. Around 100,000 patients are estimated to need radiotherapy each year - a figure expected to reach around 170,000 by 2023. The current numbers for radiotherapy centers, megavoltage equipment, radiation oncologists, medical physicists and radiotherapy technicians are 90, 186, 446, 130 and 600 respectively. By 2023, Turkey will need around 680 radiation oncologists, 624 medical physicists, 2,650 radiotherapy technicians and 379 megavoltage machines. Conclusion: Turkey faces a slight oversupply of radiation oncologists in contrast to undersupply in megavoltage machines and other personnel. Careful planning is required to allocate limited resources. The purchase of the equipment and employment policies should be structured as part of national cancer control program.     

The comorbidity of anxiety disorders in bipolar I patients: prevalence and clinical correlates

The purpose of this study was to determine the prevalence of lifetime anxiety disorders in bipolar I patients in Sanliurfa, Turkey, and to assess the association between comorbidity and several demographic and clinical variables. Seventy bipolar I patients in remission were assessed by means of the Structured Clinical Interview for DSM-IV axis I Disorders-Clinician Version (SCID-I-CV), Anxiety Disorder Module in order to detect lifetime comorbid anxiety disorders. Nineteen (27.1%) bipolar I patients were diagnosed with at least one lifetime comorbid anxiety disorder. The most common anxiety disorders in this sample were obsessive compulsive disorder (12.8%) and specific phobia (12.8%), followed by panic disorder (5.7%). Anxiety disorder comorbidity appears to be associated with greater number of hospitalizations, psychotic symptoms and suicide attempts in patients with bipolar I disorder. As comorbidity has a clear impact on the course of bipolar patients, special attention to this issue should be paid when interviewing bipolar patients.     

Repeat percutaneous tracheostomy in the neurocritically III patient

Introduction  

Percutaneous tracheostomy is a widely used and accepted method for long-term mechanical ventilation and airway protection. Neurocritically ill patients sometimes require repeat tracheostomy, which is traditionally considered a relative contraindication for percutaneous procedure. The aim of this study was to determine the safety of repeat percutaneous tracheostomy in neurocritically ill patients with a history of previous tracheostomy.     

Scalp Dermatoscopic Findings in Androgenetic Alopecia and Their Relations with Disease Severity

Background

Clinicians are searching for new methods to diagnose and predict the course of androgenetic alopecia noninvasively.

Objective

Our aim is to evaluate trichoscopic findings and their relations with disease severity in androgenetic alopecia.

Methods

The videodermatoscopic findings of 143 female and 63 male patients with androgenetic alopecia were compared with each other, with those of healthy subjects (n=100), and with those of patients with other nonscarring alopecias (n=208). Mann-Whitney U-test, χ² analyses, and logistic regression analysis were used for statistical analysis.

Results

No statistically significant relation was found between trichoscopic findings and severity in male androgenetic alopecia (MAGA) on the basis of the modified Hamilton Norwood scale (among 7 degrees); however, multihair follicular unit and perifollicular pigmentation were related to low severity whereas white dots, honeycomb pattern pigmentation, and brown dots were related to high severity. On the other hand, according to the Ludwig classification, arborizing red lines were related to low severity and brown dots were related to high severity, whereas there was no difference in stages between the Ebling and Olsen classifications in female androgenetic alopecia (FAGA). In the characteristic trichoscopic findings in this study, perifollicular pigmentation was found as a normal feature of the scalp, whereas multihair follicular unit and honeycomb pigment pattern, which were previously considered as normal features, were observed to be related to androgenetic alopecia.

Conclusion

No relation was found between MAGA severity and trichoscopic findings, as well as between FAGA severity according to different disease severity classifications and trichoscopic findings.     

Evaluation of a metal artifact reduction algorithm and an adaptive image noise optimization filter in the estimation of peri-implant fenestration defects using cone beam computed tomography: an in-vitro study

Objective

The aim of this study is to assess the effects of metal artifact reduction (MAR) and adaptive image noise enhancer (AINO) in CBCT imaging on the detection accuracy of artificially created fenestration defects in proximity to titanium and zirconium implants in sheep jaw.

Methods

Six zirconium and 10 titanium implants were planted on mandibular jaws of three sheep, and artificial defects were created. All images were obtained with a standard voxel size (0.150 mm³) and with 4 scan modes: (1) without MAR/without AINO; (2) with MAR/without AINO; (3) without MAR/with AINO; and (4) with MAR/with AINO during CBCT scanning. A total of 60 CBCT scans were produced.

Results

For all types of implants, intra- and inter-observer kappa values were the highest for MAR filter. The scan mode of with MAR filter was found to have the highest area under the curve (AUC), whereas the scan mode of without both MAR and AINO filters was found to have the lowest AUC values with statistical significance (p?≤?0.05). Titanium implants were found to have higher AUC values than zirconium (p?≤?0.05).

Conclusion

Both MAR module and AINO filters enhance the accuracy of the detection of peri-implant fenestrations; however, the use of MAR filter solely can be recommended for detection of peri-implant fenestrations.