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Background: Morphometric measurements of lumbar vertebrae are different in European and Asian populations. Transpedicular screws are candidates for the ideal method to treat instability of lumbar vertebrae and provide very strong stabilisation. Our study reflects the variation of morphometric measurements of lumbar vertebrae in the Turkish population according to sex, age, and height. The aim of our study was to measure the transverse pedicle diameter (TPD), vertical pedicle diameter (VPD), pedicle axis length (PAL), and transverse pedicle angle (TPA) of the lumbar vertebrae, using three-dimensional computed tomography (3D-CT), and assess variations according to sex, age, and height.Materials and Methods: Prospective cohort, Therapeutic Level III, Urban Level III Trauma Centre. The study design adopted a morphometric analysis using 3D-CT of the lumbar vertebrae in the Turkish population, with variation in terms of sex, age, and height and comparison with previous studies. In 240 cases, measurements of TPC, VPD, PAL, and TPA with 3D-CT were performed on a total of 1200 lumbar vertebrae. The values at each lumbar level were compared in groups based on sex, age, and height.Results: The results of our study determined the normal values of TPD, VPD, PAL, and TPA of lumbar vertebrae in the Turkish population using 3D-CT. Additionally there were variations in TPD, VPD, and PAL according to sex, age, and height. TPA varied according to age, while no difference was found in terms of sex or height.Conclusions: The morphometric measurements of lumbar vertebrae in the Turkish population are similar to western populations. Sex, age, and height are factors affecting reliable screw choice. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to evaluate long COVID patients with persistent respiratory symptoms through the application of the World Health Organization (WHO) International Classification of Functioning, Disability and Health (ICF) framework., Patients and Methods: This national, prospective, multicenter, cross-sectional study was conducted with 213 patients (118 females, 95 males; median age 56 years; range, 20 to 85 years) with long COVID between February 2022 and November 2022. The ICF data were primarily collected through patient interviews and from the acute medical management records, physical examination findings, rehabilitation outcomes, and laboratory test results. Each parameter was linked to the Component Body Functions (CBF), the Component Body Structures (CBS), the Component Activities and Participation (CAP), the Component Environmental Factors (CEF), and Personal Factors according to the ICF linking rules. Analysis was made of the frequency of the problems encountered at each level of ICF category and by what percentage of the patient sample., Results: In the ICF, 21 categories for CBF, 1 category for CBS, and 18 categories of CAP were reported as a significant problem in a Turkish population of long COVID patients with persistent respiratory symptoms. Furthermore, eight categories for CEF were described as a facilitator, and four as a barrier., Conclusion: These results can be of guidance and provide insight into the identification of health and health-related conditions of long COVID patients with persistent respiratory symptoms beyond the pathophysiological aspects, organ involvement, and damage of COVID-19. The ICF can be used in patients with long COVID to describe the types and magnitude of impairments, restrictions, special needs, and complications., Competing Interests: Conflict of Interest: The authors declared no conflicts of interest with respect to the authorship and/or publication of this article., (Copyright © 2023, Turkish Society of Physical Medicine and Rehabilitation.)

The aim of our study was to evaluate the incidence of KRAS/NRAS and BRAF mutations, analyze molecular patterns, and investigate associations with clinical parameters of these mutations in CRC KRAS/NRAS and BRAF mutations analyzed by next-generation sequencing. The detection rates of these mutations and patients' demographics were recorded and the relationship between them was evaluated using the chi-square test. KRAS mutation was detected in 332 of 694 patients, while the mutation rates in KRAS exons 2/3 and 4 were 39.6%/3.2% and 5%, respectively. The most common mutation pattern was KRAS G12D. Five atypical variants were detected: V14I in KRAS exon 2, A18D, Q22K and T50I in exon 3, and T148P in exon 4. NRAS mutation was detected in 29 (4.5%) patients. One atypical variant L80W was detected in NRAS exon 3. BRAF mutation was seen in 37 (5.3%) patients, with BRAF V600E (83.8%) being the most common mutation pattern. NRAS mutation was significantly more frequent in patients > 64 years of age, BRAF mutation in women, and NRAS/BRAF mutations in right colon tumors. Grouping BRAF mutations into BRAF V600E and BRAF non-V600E and their analysis according to specific tumor localizations showed that all four BRAF non-V600E mutations originated in the rectum. In our study, KRAS exon 2 and other RAS mutation rates were higher than in the literature, while the BRAF v.600E mutation rate was similar. NRAS and BRAF mutations were significantly more frequent in the right colon. BRAF mutation was more common in women and in the right colon.

Background: There is no standard treatment recommended at category 1 level in international guidelines for subsequent therapy after cyclin-dependent kinase 4/6 inhibitor (CDK4/6) based therapy. We aimed to evaluate which subsequent treatment oncologists prefer in patients with disease progression under CDKi. In addition, we aimed to show the effectiveness of systemic treatments after CDKi and whether there is a survival difference between hormonal treatments (monotherapy vs. mTOR-based)., Methods: A total of 609 patients from 53 centers were included in the study. Progression-free-survivals (PFS) of subsequent treatments (chemotherapy (CT, n:434) or endocrine therapy (ET, n:175)) after CDKi were calculated. Patients were evaluated in three groups as those who received CDKi in first-line (group A, n:202), second-line (group B, n: 153) and ≥ 3rd-line (group C, n: 254). PFS was compared according to the use of ET and CT. In addition, ET was compared as monotherapy versus everolimus-based combination therapy., Results: The median duration of CDKi in the ET arms of Group A, B, and C was 17.0, 11.0, and 8.5 months in respectively; it was 9.0, 7.0, and 5.0 months in the CT arm. Median PFS after CDKi was 9.5 (5.0-14.0) months in the ET arm of group A, and 5.3 (3.9-6.8) months in the CT arm (p = 0.073). It was 6.7 (5.8-7.7) months in the ET arm of group B, and 5.7 (4.6-6.7) months in the CT arm (p = 0.311). It was 5.3 (2.5-8.0) months in the ET arm of group C and 4.0 (3.5-4.6) months in the CT arm (p = 0.434). Patients who received ET after CDKi were compared as those who received everolimus-based combination therapy versus those who received monotherapy ET: the median PFS in group A, B, and C was 11.0 vs. 5.9 (p = 0.047), 6.7 vs. 5.0 (p = 0.164), 6.7 vs. 3.9 (p = 0.763) months., Conclusion: Physicians preferred CT rather than ET in patients with early progression under CDKi. It has been shown that subsequent ET after CDKi can be as effective as CT. It was also observed that better PFS could be achieved with the subsequent everolimus-based treatments after first-line CDKi compared to monotherapy ET., (© 2023. The Author(s).)

Background: In our study, we aimed to investigate the protective effects of Saccharomyces boulardii on abemaciclib-induced diarrhea model, which is a commonly used drug in breast cancer., Methods: Thirty rats were divided into 3 groups as control (Group 1), abemaciclib (Group 2), and abemaciclib + Saccharomyces boulardii (Group 3) groups. The clinical status, body weight, and defecation status were monitored daily. At the end of the 15-day experiment period, the rats were killed with high-dose anesthesia and the resected small intestine segments were evaluated histopathologically. Lesions were classified according to thickening of the villus, inflammation and edema of mucosa and intraepithelial leukocyte accumulation. Then, mean values of both crypt depths and villi thicknesses were calculated for each rat. Normal distribution assumption was controlled with the Shapiro-Wilk test. One-way analysis of variance for normally distributed variables in the comparisons of more than two independent groups and Kruskal-Wallis test for nonnormally distributed variables were used. The significance value was accepted as 0.05., Results: : There was one death in Group 3, but none in the others. There were no findings of mucositis in Group I. There was mild diarrhea and weight loss in only one rat in Group 1. For the comparison of the severity of diarrhea (72.5%/39%) and weight loss (72.5%/45%), a decrease was found in Group 3 according to Group 2 (p < 0.01). Histopathological findings such as edema, inflammation, and intraepithelial leukocyte accumulation also showed a decrease in Group 3 compared to Group 2 (p < 0.01)., Discussion: Saccharomyces boulardii should be considered as a treatment option in abaemaciclib (chemotherapy)-induced diarrhea. Further comparative studies and in vivo human randomized controlled studies can be conducted in the future.

Introduction: Osimertinib, an irreversible third-generation EGFR-TKI, is the standard of care for second-line treatment of T790M-mutant advanced NSCLC patients whose disease progressed after first-line EGFR-TKI therapy. In this multicenter study, we aimed to determine the real-life efficacy and safety of Osimertinib in pretreated advanced NSCLC patients with T790M mutation., Materials and Methods: This retrospective trial included advanced T790M-mutant pretreated NSCLC patients who received Osimertinib from 24 different centers in Turkey. Primary endpoint was time-to-treatment discontinuation (TTD). Secondary endpoints were objective response rate (ORR), overall survival (OS), and safety., Results: Of 163 patients, 68.7% had EGFR exon 19 deletion and 22.7% had exon 21 L858R mutation. Osimertinib was given as second-line treatment in 96 patients (58.9%) and third-line in 48 patients (29.4%). After median of 13-month follow-up, median TTD was 21.6 months with an 82.2% ORR. Estimated median OS was 32.1 months. Grade 3-4 adverse events were seen in 11.7% of the patients., Conclusion: Osimertinib is a highly effective option in second- or third-line treatment of NSCLC patients with T790M mutation, with a favorable safety profile., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objective: To evaluate clinical and demographic characteristics and the results of cytotoxic treatments of KRAS G12C , KRAS other , and next-generation sequencing (NGS) panel negative patients., Methods: NGS data of 1264 patients with non-small cell lung cancer were retrospectively evaluated. Among these patients, the mutation distributions of 1081 patients with metastatic lung adenocarcinoma were analyzed. A total of 150 patients with negative NGS panel or mutant KRAS followed up in our clinic were included. Clinical features, overall survival, first-line chemotherapy responses, and progression-free survival of NGS panel negative, KRAS G12C , and KRAS other groups were compared., Results: In 1081 patients who underwent NGS from tumor tissue with the diagnosis of metastatic lung adenocarcinoma, 296 (27%) NGS panel negative and 276 (26%) KRAS mutant patients were detected. Among these patients, 150 patients whose data were available were 71 (47.3%) NGS panel negative, 54 (36%) KRAS other , and 25 (16.7%) KRAS G12C . Clinical features, brain metastasis, and first-line chemotherapy response were similar among groups. Bone metastases were detected more often in the NGS panel negative group ( p = 0.03). The median follow-up was 8.4 months. Overall, 107 deaths had occurred at the time of analysis. There was no difference in overall survival ( p = 0.56) or progression-free survival ( p = 0.71) among NGS panel negative, KRAS other , and KRAS G12C patients., Conclusion: There is no difference in overall survival, first-line chemotherapy response, or progression-free survival among patients with NGS panel negative, KRAS G12C , or KRAS other metastatic lung adenocarcinoma. Bone metastases were observed more frequently in the NGS panel negative group.

Introduction: The case of a patient who developed recurrent delayed immune-related pneumonitis (checkpoint inhibitor pneumonitis [CIP]) after immune checkpoint inhibitor (ICI) therapy for advanced osteosarcoma treatment is presented. Case summary: A 25-year-old female patient with metastatic osteosarcoma was treated with atezolizumab. Grade 2 pneumonitis developed three times in the first two years. Treatment was discontinued after recovery from the last episode of pneumonitis, which was complicated with secondary spontaneous pneumothorax. 2 years after discontinuation of immunotherapy, the patient again developed CIP. Pneumonitis symptoms were regressed with oral steroid therapy during follow-up and a stable disease response continued. Conclusion: Immunotherapy can cause recurrent CIP at any time during the treatment period or after discontinuation of treatment.

Purpose: We aimed to identify the prognostic and predictive values of post-treatment prognostic nutritional index (PNI) and PNI dynamics in nasopharyngeal cancer patients (NPC) in this study., Methods: One hundred seven non-metastatic NPC patients were included. PNI was calculated by using the following formula: [10 × serum albumin value (gr/dL)] + [0.005 × total lymphocyte count (per mm3)]. ROC analysis was used for determining prognostic PNI values and univariate and multivariate statistical analyses for prognostic characterization of PNI., Results: The statistically significant cut-off values for pre- and post-treatment PNI were 50.65 and 44.75, respectively. Of the pre-treatment PNI analysis, PNI ≤ 50.65 group had shorter loco-regional recurrence-free survival (LRRFS), distant metastasis-free survival (DMFS), and overall survival (OS). Furthermore, for post-treatment PNI analysis, PNI ≤ 44.75 group had shorter LRRFS and OS. In univariate analysis, only pre-treatment PNI was associated with LRRFS and DMFS, while pre- and post-treatment PNI were both associated with OS. In multivariate analysis, both PNI were independent prognostic markers for OS. In the combined analysis, pre- and post-treatment PNI, differences between the groups were statistically significant, and the PNI dynamics was an independent prognostic indicator for OS., Conclusion: PNI is a useful, independent prognostic marker for non-metastatic NPC patients. It is used for either pre- or post-treatment patients. Furthermore, changes in pre-treatment PNI value after curative treatment is a significant indicator for OS., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Transverse colon cancer (TCC) is a rare condition that accounts for 10% of all colon cancers. TCC was accepted more likely right-sided colon cancers. We aimed to investigate whether TCC differs from other colon tumors by using clinical, pathological, and molecular prognostic factors known to be important in colon cancer and if it differs in its own anatomical structure., Patients and Methods: We evaluated local and locally advanced TCC patients between 2007 and 2020 years for demographics data, symptoms, treatment status, and histopathological and molecular features., Results: Overall, 107 TCC patients were included in this study. According to the molecular data analysis of 44, 35, and 23 patients for MSI, RAS, and BRAF status, respectively, 7 (15.9%) were MSI-H, 13 (37.1%) were RAS mutant, and 11 (47.8%) had BRAF V600E mutation. The median follow-up time was 31.5 months. Median disease-free survival (DFS) was 5.19 months, and median OS was 88.3 months for the whole study population. The tumor stage was the most significant prognostic factor for DFS and OS. Although BRAF mutation was not a significant marker for DFS, it was an independent prognostic marker for OS (HR 3.90 95% CI 1.42-10.7). There were no statistically significant differences between proximal two-thirds and distal one-third tumor location., Conclusion: TCC has molecular features and prognostic factors more likely RCC and no differences between proximal and distal sub-parts. BRAF V600E mutation status is an independent predictor of survival even in the early stages of TCC., (© 2021. Springer Science+Business Media, LLC, part of Springer Nature.)

After the Chernobyl reactor accident, Eastern Black Sea coast was one of the heavily contaminated regions of Turkey. Clouds loaded with radioactive isotopes arrived the region on May 1986 and emptied their contents with the heavy rains that are frequently seen in the region. In order to asses the current level of contamination, several different samples, moss, lichen, litter, surface soil and soil cores were collected on August 1994. Samples were brought to the laboratory and their moisture, pH and organic matter contents were determined. Gamma-ray spectra of the samples were collected with a HpGe detector. (137)Cs was the major isotope observed. Activity of most litter samples were below 1000 Bq/kg, while most of the moss samples had activities below 5000 Bq/kg, there were a few with higher (137)Cs activities. Surface soil samples generally had activities less than 2000 Bq/kg and depth profiles of cesium activities in the soil cores showed regional variations.

A simple and sensitive kinetic-catalytic method was used for the determination of iodine concentration in human milk, cows' milk and infant formula. The method, based on the catalytic effect of iodine on the redox reaction between CeIV and AsIII, was first described by Sandell and Kolthoff. The calibration curve was constructed by plotting absorbance of CeIV after a known time versus iodine concentration. The precision, accuracy and recovery of the method was determined. After the application of the method to milk and infant formula samples, the daily iodine intake of infants on their first or second day after delivery was estimated at 20.0 +/- 11.9 micrograms d-1 and 13.0 +/- 3.3 micrograms d-1 from human milk and infant formula, respectively.

A post-irradiation radiochemical separation technique was tested for the determination of selenium levels in diet samples, collected by using a duplicate portion technique, from both rural and urban population groups in Turkey. The technique involved sample irradiation, acid digestion, selective distillation, precipitation and filtration steps. During the separations it was possible to determine the yield of each sample using a stable selenium carrier. An average chemical yield of 71 +/- 3% was obtained for the radiochemical neutron activation analysis. For samples from urban and rural regions, the average selenium concentrations obtained were 0.14 +/- 0.04 and 0.07 +/- 0.02 mg kg-1, respectively. It was also possible to determine daily dietary selenium intakes, which were found to be 81 +/- 41 micrograms and 23 +/- 11 micrograms for the urban and rural groups, respectively. Although daily selenium intakes were found for a small number of subjects in this study, the separation technique developed can be used for determination of the selenium status in larger population groups.

Zinc kinetics were studied and compared after oral simultaneous administration of two tracers, radioactive (65Zn) and stable (70Zn) isotope, to four normal human volunteers. Both tracers and zinc concentration were measured in plasma, red blood cells (RBC), urine, and feces for up to 78 days. Radioactive zinc was also measured by external counting over whole body, liver, and thigh. Data from each individual were analyzed using a compartmental model for zinc metabolism. Values calculated for absorption, fractional zinc excretion in urine, exchange with RBC, and secretion into gut using 70Zn data did not differ from values calculated using 65Zn data. Results show that human zinc metabolism can be investigated using stable isotopes as tracers to determine parameters of whole body zinc metabolism, including zinc absorption, excretion, and secretion.

Enriched stable isotopes are being increasingly used for study of trace element nutrition in humans who cannot be studied by use of in vivo radioactive tracers (e.g., subjects under age 18 and pregnant women). Zinc metabolism in these subjects can be evaluated by administration of Zn enriched to 65% in the minor isotope, 70Zn (0.6% natural abundance). The enhanced 70Zn is detected later in red blood cells, plasma, urine, and feces by measuring 70Zn/64Zn or 70Zn/68Zn ratios. Stable isotope concentrations are measured by neutron activation of the samples and observation of their products: 244-day 65Zn, 14-h 69mZn, and 4-h 71mZn. Zinc-65 can be observed in these samples without chemical separations 3 weeks after irradiations, but large amounts of 24Na and other short-lived species preclude direct observation of the short-lived Zn activities. Preirradiation chemistry was developed to remove most interferences, the major steps being to place the sample on Chelex resin, elute alkali metals and alkaline earths from it, and irradiate the resin containing the Zn. gamma-Rays of 69mZn can be observed on the irradiated resin, but additional precipitation and solvent extraction steps are needed to remove 56Mn and 64Cu for clear observation of 71mZn and 65Zn within hours after irradiation. Yields for pre- and postirradiation separations are typically 85% and 70%, respectively. The stable isotope tracer method was validated by simultaneous in vivo tracing with radioactive 65Zn in four subjects.