Turkish Journal of Medical Sciences最新文献

[This corrects the article DOI: 10.55730/1300-0144.6040.].

Endocrine disruptors (EDs) are closely associated with the second brain, the microbiota-derived enteric nervous system, commonly referred to as the gut microbiota. The microbiota plays a crucial role in human health and the development of diseases. In today's industrialized world, the presence of EDs in air, water, and soil leads to primary human exposure through dermal contact and ingestion. The impact of these EDs on the microbiota remains unclear. EDs that disrupt the balance of the gut microbiota may contribute to a range of disorders, including metabolic (obesity, diabetes mellitus), cardiovascular (vascular stenosis, cerebrovascular disease), reproductive (infertility, ovarian and testicular tumors), neurological (dysfunction of the amygdala, cortex, and cerebellum), and behavioral disorders (dementia, depression, anxiety, and schizophrenia). This review examines the effects of commonly encountered environmental EDs on the gut microbiota and summarizes the most recent findings on this topic. The concept of the microbiota-derived enteric nervous system and the modulation of the hormonal system through interactions between microorganisms and environmental chemicals have prompted specialists in endocrinology and metabolism to reconsider patient management and treatment strategies. This necessitates a comprehensive evaluation of treatment options that incorporate microbiome data. The information presented in this review will help illuminate future research directions and serve as a valuable resource for subsequent studies.

Endocrine disrupting chemicals (EDCs) are exogenous compounds that have hormone-like effects inside the body. Endocrine disruptors can affect adrenal glands in humans and animals. Adrenocortical dysfunction related to chemical exposure has been reported in the literature. The human adrenal gland is crucial for the synthesis of steroid hormones (glucocorticoids, mineralocorticoids, and androgens) and amino acid-derived hormones (epinephrine and norepinephrine). All steps in the adrenocortical steroidogenesis pathway are potential targets for chemical inhibition, including the adrenocorticotropic hormone receptor, steroidogenic acute regulatory protein, mitochondrial cytochrome P450 (CYP) enzymes (CYP11A1, CYP17, CYP21, CYP11B1, and CYP11B2), and 3-hydroxysteroid dehydrogenase D4,5 isomerase. EDCs either inhibit the enzymes in steroid biosynthesis or, occasionally, activate them further. Several studies have reported evidence linking EDC exposure to different cancers, early puberty, and reproductive dysfunction. The risk of these harmful effects is higher during development. Pregnant women, babies, children, and adolescents are especially vulnerable, and should therefore be kept away from these chemicals.

Background/aim: Radiofrequency ablation of solitary parathyroid adenoma has been used to treat primary hyperparathyroidism (pHPT) in high-risk patients for parathyroidectomy. This study aimed to evaluate the clinical efficacy of radiofrequency ablation for treating pHPT in patients with parathyroid adenomas.

Materials and methods: The sample for this retrospective study comprised all consecutive patients with solitary parathyroid adenoma treated with radiofrequency ablation between 2013 and 2021. Patients' baseline serum calcium and parathyroid hormone (PTH) values were obtained. The patients were followed up with serial biochemical measurements after the intervention, then at the first-week, first-month, third-month, sixth-month, and twelfth-month follow-ups. The study's primary outcome was a biochemical cure, defined as the reestablishment of normal serum calcium and PTH levels, persisting for at least 6 months after the ablation.

Results: The changes in the serum calcium and PTH levels were significant (p < 0.05). The biochemical cure rate was 30.2% at 1 year. At the end of 1 year, the rate of patients with normal serum calcium levels was 86.6%, whereas the rate of patients with normal serum calcium and higher PTH levels was 55.8%.

Conclusion: Radiofrequency ablation of a solitary parathyroid adenoma may be considered an alternative treatment for pHPT, given that more than half of the cases investigated in this study had normocalcemic hyperparathyroidism at 1 year.

Endocrine-disrupting chemicals (EDCs) are a diverse, comprehensive group of mostly synthetic chemicals that disrupt many physiological functions in humans and animals. EDCs are particularly disruptive to the female reproductive system. Reproductive function in women is a dynamic process regulated by the hypothalamic-pituitary-ovarian axis. EDCs show their effects on the reproductive system through estrogenic, antiestrogenic, androgenic, and antiandrogenic effects or by directly affecting gonadotropin-releasing hormone secretion. Disruption in the menstrual cycle, decrease in fertility, infertility, increased risk of miscarriage, polycystic ovary syndrome, endometriosis, early or delayed puberty, and hormone-sensitive cancers can be listed as the main negative effects of endocrine disruptors on the female reproductive system. In this review, findings on the effects of the most studied EDCs, bisphenol A, phthalates, methoxychlor ethane, tetrachlorodibenzo-p-dioxin, atrazine, per- and polyfluoroalkyl substances, and micro- and nanoplastics on the female reproductive system are summarized.

Background/aim: This study investigates the relationship between fear of COVID-19, measured using the Fear of COVID-19 Scale (FCV-19S), and the hygiene behaviors of secondary school students, assessed with the Hygiene Behavior Scale (HBS).

Materials and methods: Included in this cross-sectional study were 206 secondary school students. The study data were analyzed using multivariate linear regression.

Results: No relationship was found between the fear of COVID-19 scale (FCV-19S) score of the student sample and the mean total HBS and subdimension values (p > 0.05). It was noted that positive hygiene behaviors decreased as the scale score increased. Students with retired mothers scored 4.463 units higher in the personal hygiene subdimension than those whose mothers were housewives, while the students whose mothers were in blue-collar roles scored 4.868 units higher on the personal hygiene subdimension than those whose mothers were housewives (p < 0.05). The students whose mothers were retired scored 3.845 units higher on the hand-washing subdimension than those whose mothers were housewives (p < 0.05), while those with retired mothers scored 4.052 units higher on the food hygiene subdimension than those whose mothers were housewives (p < 0.05). Students whose mothers were retired scored 12.361 units higher on the HBS than those whose mothers were housewives, while those whose mothers were blue-collar workers scored 7.884 units higher on the HBS than those whose mothers were housewives (p < 0.05). The total mean HBS score of the sample was 48.25 ± 14.41, while the total mean FCV-19S score was 15.18 ± 7.69.

Conclusion: No significant relationship was noted between the Fear of COVID-19 Scale (FCV-19S) scores and hygiene behaviors of secondary school students. Significantly higher total and subdimension HBS scores were noted in students whose mothers were retired or employed than in those whose mothers were housewives. These findings suggest that maternal employment status may play an influential role in the hygiene behaviors of students.

Background/aim: Biliary tract cancers (BTC) are relatively rare and have a poor prognosis in both localized and metastatic settings. Clinical trials tend to include patients who can tolerate treatments; however, chemotherapy eligibility, patterns, and survival may differ in the real world. The present study provides a 5-year overview of chemotherapy eligibility, patterns, tolerance, and survival in patients with resected and advanced BTCs.

Materials and methods: Included in the study were patients with resectable or advanced BTC (excluding ampullary cancers) diagnosed between 2019 and 2024. The demographic/clinical characteristics, chemotherapy eligibility, patterns, and survival outcomes of the patients were evaluated.

Results: Of the 151 patients included in the study, 61 (40.7%) had resected BTC and 90 (59.3%) had advanced BTC. Among the patients with resected BTC, only 52.5% received adjuvant chemotherapy, 38.7% needed dose reductions, and 29% could not complete the planned cycles. Median recurrence-free survival and overall survival (OS) were 24.1 months (95% confidence interval (CI): 11.4-58.0) and 59 months (95% CI: 38.4-59) in patients with resected BTC, respectively, for all patients. In a multivariable analysis, only the number of adjuvant chemotherapy cycles was associated with OS [Hazard ratio (HR):0.63 (95% CI: 0.39-1.00), p=0.050]. Among the patients with advanced disease, 16.7% were not eligible for first-line chemotherapy, and 70.7% needed dose reduction. The median number of cycles was three (0-18); grade 3-4 adverse events were observed in 52% of the patients; and median progression-free survival and OS were 4.3 months (95% CI: 3.3-5.0) and 9.4 months (95% CI: 5.9-13.7) for all patients, respectively. Only 36.7% were able to receive second-line treatment. The number of first-line chemotherapy cycles [HR: 0.58 (95% CI: 0.45-0.76), p < 0.001]/discontinuation due to toxicity [HR: 3.26 (95% CI: 1.34-7.93), p = 0.009], cisplatin-gemcitabine regimen [HR: 0.10 (95% CI: 0.01-0.58), p<0.001], and receiving second-line chemotherapy [HR: 0.28 (95% CI: 0.11-0.68), p < 0.001] were significantly associated with OS in multivariable analyses.

Conclusion: This study shows that a significant proportion of patients with BTC are not eligible or intolerant to chemotherapy in the real world. Maintaining the planned treatment, even with dose reduction, is associated with better OS.

Background/aim: To assess the potential of the ratio between PI-RADS 3 lesion volume and total prostate volume as a predictive parameter for guiding the decision to perform a biopsy in patients presenting with PI-RADS 3 lesions on multiparametric prostate magnetic resonance imaging (mpMRI).

Materials and methods: A total of 749 patients who underwent mpMRI due to suspected prostate cancer between January 2014 and August 2023 were scanned. Based on predefined inclusion and exclusion criteria, 308 patients were included. Age, total prostate-specific antigen (PSA) value, prostate volume measured in mpMRI, mpMRI result, PI-RADS 3 lesion volume, and biopsy results were collected. The PI-RADS 3 ratio was calculated as PI-RADS 3 lesion volume/total prostate volume. PSA density (dPSA) was calculated. The patients were categorized according to their biopsy results as benign or malignant (subclassified by Gleason group grade), and the two groups were compared.

Results: The average PI-RADS 3 ratio was 0.032 ± 0.002. There were 230 (74.7%) patients in the benign group and 78 (25.3%) patients in the malignant group. There was a statistically significant difference detected in average prostate volumes (p < 0.001), dPSA values (p = 0.001), and PI-RADS 3 ratios (p < 0.001). The receiver operating curve analysis of PI-RADS 3 ratio indicated an area under the curve of 0.643 ± 0.037. The optimal cut-off point was 0.026 with a sensitivity of 58.97% and a specificity of 66.96%. A positive, albeit weak, statistically significant relationship was found between PIRADS-3 ratios and dPSA values (rs ρ = 0.261 and p < 0.001).

Conclusion: PI-RADS 3 ratio may serve as an auxiliary clinical parameter alongside age, dPSA, and lesion volume alone in identifying more refined candidates for biopsy in the goal of patient care individualization.

Background/aim: No reliable, easily measurable biomarker currently exists for the screening or prognosis of lung cancer. The present study evaluates the potential utility of vascular endothelial growth factor (VEGF) and endocan, which can be readily measured in blood samples, as biomarkers for screening and prognostic assessment in lung cancer.

Materials and methods: Included in the study were 38 patients with early-stage non-small cell lung cancer (NSCLC) and 29 controls. All patients underwent surgical intervention and were monitored for 1 month postoperatively. Serum VEGF and endocan levels were measured preoperatively and postoperatively. Clinical characteristics, laboratory data, and histopathological findings were recorded for all participants.

Results: The preoperative VEGF levels of the patients were significantly higher than those of the controls (p = 0.001), while postoperative VEGF levels decreased significantly following surgery (p < 0.001). The endocan levels of the patients and controls were similar preoperatively. Additionally, endocan levels were significantly increased after the surgery in the patient group (p < 0.001). A comparison of VEGF and endocan levels according to TNM staging and tumor histopathology revealed no significant differences.

Conclusion: VEGF can serve as a potential biomarker for screening and prognostic assessment in early-stage NSCLC. In contrast, endocan did not demonstrate utility for such clinical purposes. VEGF may also be considered for the evaluation of treatment efficacy following surgical intervention.