The Association Between Somatostatin Receptor Ligand and Vitamin B12 Levels in Patients With Acromegaly

Purpose: Vitamin B12 causes hematologic and neuropsychiatric disorders, so it is important to evaluate it in risky situations. In this study, we aimed to evaluate the association between somatostatin receptor ligands and vitamin B12 levels in patients with acromegaly.Methods: Patients who were followed up with the diagnosis of acromegaly in the Endocrinology and Metabolism outpatient clinic of Istanbul University-Cerrahpaşa Medical Faculty were evaluated. Patients were divided into groups according to their somatostatin receptor ligand use status. The groups were evaluated according to their vitamin B12 levels, demographic data, and biochemical parameters.Results: One hundred fifty-two patients were evaluated. Thirteen patients had vitamin B12 deficiency. The majority (11/13) of patients with vitamin B12 deficiency were patients using somatostatin receptor ligand. In addition, the number of patients with vitamin B12 deficiency who received lanreotide autogel treatment was significantly higher compared with patients who did not use somatostatin receptor ligand (p = 0.011). Vitamin B12 levels were higher in patients who received lanreotide autogel treatment than in patients who did not use somatostatin receptor ligand treatment (p = 0.040). There was a negative correlation between vitamin B12 levels and lanreotide autogel use time, cumulative lanreotide autogel dose.Conclusion: It is important to evaluate the level of vitamin B 12 in the follow-up of patients with acromegaly using somatostatin receptor ligand treatment.

Development of Education Material for Health Literacy and Education Needs of Patients Who Receives Chemotherapy

Objecives: The aim of the study was to determine the health literacy levels of patients receiving chemotherapy, to develop written educational material considering the health literacy level and to evaluate the appropriateness. Methods 360 patients who received chemotherapy at the Istanbul University Cerrahpaşa Medical Faculty Medical Oncology Outpatient Clinic. Descriptive and methodological research method was used. The data were collected using the DISCERN, Patient Data Form, Turkish Health Literacy Scale-32, Evaluation of the Conformity of Written Materials Form. "Chemotherapy Patient Education Guide" has developed. Results 72.2% of the patients receiving chemotherapy have a poor health literacy level and 6.1% are excellent. The developed “Chemotherapy Patient Education Guide” was found to be high in reliability and information quality by experts and patients. Conclusion/Implications for Practice: Nurses should plan educational activities that will increase the health literacy levels of patients receiving chemotherapy, and develop written education materials taking into account their health literacy levels.

Selective Intra-Arterial 177Lu-PSMA Therapy for Castration Resistant Prostate Cancer: Preliminary Results of a Pilot Study

Purpose177Lu-PSMA is a promising therapy for patients with metastatic castration resistant prostate cancer patients (mCRPC). To our knowledge, no study has compared the pharmacokinetic profiles of 177Lu-PSMA therapy delivered intra-arterially. We aimed to compare the feasibility and safety of selective intra-arterial (IA) administration vs conventional intravenous (IV) administration of 177Lu-PSMA in mCRPC. MethodsIn this within-patient pilot study, four patients (median age, 62.5; range, 53-72) with mCRPC who were referred to our clinic between January 2018 and September 2019 for treatment with 177Lu-PSMA. Patients were treated in two visits; in each visit receiving half of the total empiric therapeutic dose of 200 mCi, IV at the first visit and IA at the second visit. They were followed upto 8 weeks using routine parameters such as hematological status, renal function, and serum PSA levels. For each patient, organ biodistribution in lesions, kidneys, liver, bone marrow, prostate, and whole body was calculated for both administration routes according to the Medical Internal Radiation Dose (MIRD) schema. Mean absorbed doses (MAD) across all patients were compared between both administration routes. ResultsThe MAD of all metastatic lesions was significantly higher by IA vs IV administration (1.59 vs 1.20 MGy/MBq; p=0.024). The prostate gland had a lower MAD between IA and IV administrations, but the difference was not significant (0.27 vs 0.36 MGy/MBq; p=0.22). Patients tolerated IA administration very well without unexpected side effects. ConclusionThese preliminary results of an ongoing study showed that IA 177Lu-PSMA therapy is feasible and safe to treat metastatic lesions, potentially having a higher delivery efficacy compared to IV administration.This study is approved by Cerrahpasa Medical Faculty ethics committee on March 5, 2019 and retrospectively registered with file no: 83045809-604.01.02.

Retrospective Evaluation of Helicobacter pylori Antigen Positivity in the Stool Samples of Patients with Gastroduodenal Complaints

Objective: Helicobacter pylori is an important pathogen that causes the development of important gastroduodenal pathologies such as acute and chronic gastritis, ulcer and gastric cancer. This pathogen is estimated to infect about half of the world’s population. In this study, it was aimed to evaluate the five-year data retrospectively by investigating the presence of H. pylori antigen in stool samples taken from patients who applied to Istanbul University-Cerrahpaşa Medical Faculty Medical Microbiology Department Serology/ELISA laboratory with gastroduodenal complaints between January 2015 and December 2019. Method: Stool specimens of 4696 patients admitted to the hospital with gastroduodenal complaints between January 2015 and December 2019 were analyzed using an immunochromotographic H. pylori stool antigen test containing monoclonal antibodies. Results: Among 4696 patients who were examined retrospectively in a five-year period, 1176 (25%) had positive, and 3520 (75%) of them negative H. pylori test results. H. pylori-positivity was found in 210 (21.30%) of 986 children and 966 (26.04%) of 3710 adults. H. pylori detection rate in children was found to be significantly lower than adults (p: 0.002). H. pylori positivity was found higher in the 30-39 age range compared to other age groups. Conclusion: Although current study results showed a lower prevalence compared to recent studies, it has been concluded that H. pylori is an important pathogen in all age groups with gastroduodenal complaints and should be monitored in the community.

The Investigation of Streptococcus Agalactiae Colonization in Last Trimester Pregnants by Using Standard Culture and Molecular Methods

Objective: We aimed to detect and compare group B streptococcus (GBS) colonization in pregnant women at third trimester using real-time polymerase chain reaction (real-time PCR) and culture methods. Methods: Vaginal swab specimens were taken for screening of GBS from 100 women between 35-37 weeks of gestation who were attending to antenatal outpatient unit of Obstetrics and Gynecology Department of Cerrahpasa Medical Faculty from May 2014 to September 2014. Results: Rates of GBS colonization was %5 and %7 by culture and real-time PCR methods, respectively. Using culture as the gold standard; sensitivity and specificity for real-time PCR were 100% and 97.9%, respectively. Any significant difference was not detected between GBS colonization with age groups, education levels, number of previous pregnancies, smoking habits, history of antibiotic use, and contraceptive method. Conclusion: Real-time PCR technique has proven to be as sensitive as the culture method. Also, real-time PCR may provide a rapid diagnostic tool for GBS detection potentially allowing a more effective intrapartum antibiotic prophylaxis and lower infant morbidity and mortality. However, the inability to use PCR test in every laboratory and its high cost creates a handicap.

Knowledge levels of individuals with type 2 diabetes on foot care

Purpose: In this study, is a descriptive designed to determine the level of knowledge about foot care of individuals with Type 2 diabetes mellitus. Materials and Method: Research consists 165 diabetic patient, (all of them over 40 years old) which admitted İstanbul University Cerrahpaşa Medical Faculty Endocrinology Metabolism Department. As a data collection tool, a questionnaire consisting of 44 questions which is prepared by the researcher was used. Results. The majority of the participants in the study are poorly educated, inactive and overweight participants in the 60-69 age group. Diabetic neuropathy was found in 44.8% and diabetic foot was found in 12.7% while at least one diabetic complication occurred in 65.5% of diabetic patients. 66.7% of the patient with diabetes had general diabetes education and 21.2% had diabetic foot training. 54.6% of this educations was given by the diabetes nurses. The majority of the patient with diabetic chronic complications and foot injuries had received diabetes education. As the duration of diabetes increased, the incidence of complications increased. among these complications, retinopathy and cardiovascular diseases were more common in patients with diabetes over the 11 years. The proportion of foot injuries in elderly patients participating in the study is higher than other patients. Conclusion: As a result of the study, it was determined that the patients did not apply their foot care information, did not have foot care training as they need, they applied to the hospital after the problem developed, and only then they were educated. Diabetic individuals can be recommended for the planned education, adequate time for each subject, observation of the results of the trainings and repeated periodicals to overcome these deficiencies. ​Extended English summary is in the end of Full Text PDF (TURKISH) file. Özet Amaç: Bu çalışma, tip 2 diyabet tanısı almış bireylerin ayak bakımı konusundaki bilgi düzeylerinin belirlenmesi amacıyla tanımlayıcı olarak yapılmıştır. Materyal ve Metot: Araştırma İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi Endokrinoloji Metabolizma Bilim Dalı Diyabet servisine ve polikliniğine başvuran 40 yaş ve üzeri 165 tip 2 diyabetli hastadan oluşmaktadır. Veri toplama aracı olarak 44 sorudan oluşan ve araştırmacı tarafından hazırlanan bir anket formu kullanılmıştır. Bulgular: Çalışmaya katılan bireylerin çoğunluğu 60-69 yaş arası grupta, öğrenim düzeyi düşük, çalışmayan ve kilolu katılımcılardır. Diyabetlilerin %65.5’inde diyabete bağlı en az bir komplikasyon gelişirken %44.8’inde diyabetik nöropati ve %12.7’sinde diyabetik ayak tespit edilmiştir. Diyabetlilerin %66.7’si genel diyabet eğitimi, %21.2’si diyabetik ayak eğitimi almıştır. Bu eğitimlerin %54.6’sı diyabet hemşiresi tarafından verilmiştir. Diyabete bağlı kronik komplikasyon ve ayak yarası gelişen diyabetlilerin çoğunluğu diyabet eğitimi almıştı. Diyabet süresi artıkça komplikasyon görülme oranı da artmaktaydı. Bu komplikasyonlardan retinopati ile kardiyovasküler hastalıklar 11 yıl üzeri diyabetlilerde daha yüksektir. Çalışmaya katılan yaşlı hastalardaki ayak yarası oranı, diğer hastalardan daha fazladır. Sonuç: Çalışmanın sonucunda hastaların ayak bakımı konusundaki bilgilerini uygulamaya geçirmedikleri, yeteri kadar ayak bakımı eğitimi almadıkları, sorun geliştikten sonra hastaneye başvurdukları ve ancak o zaman eğitim aldıkları belirlendi. Diyabetli bireylere verilen eğitimlerin planlı olması, her konuya yeterli zaman ayrılması, eğitimlerin sonuçlarının gözlemlenmesi ve belirli aralıklarla tekrarlanması bu eksikliklerin giderilmesi için önerilebilir.