Exercise in patients coping with breast cancer: An overview

Breast cancer is the most common type of cancer in women, but fortunately has high survival rates. Many studies have been performed to investigate the effects of exercise in patients diagnosed with breast cancer. There is evidence that exercise after the diagnosis of breast cancer improves mortality, morbidity, health related quality of life, fatigue, physical functioning, muscle strength, and emotional wellbeing. Based on scientific data, breast cancer patients should be recommended to participate in rehabilitation programs including aerobic and strength training. The aim of this article is to review the recently published data on the effect of exercise in patients with breast cancer in order to present the current perspective on the topic.

Allogeneic stem cell transplantation in chronic myeloid leukemia patients: Single center experience

Chronic myeloid leukemia(CML) is a myeloproliferative disease which leads the unregulated growth of myeloid cells in the bone marrow. It is characterized by the presence of Philadelphia chromosome. Reciprocal translocation of the ABL gene from chromosome 9 to 22 t(9; 22)(q34; q11.2) generate a fusion gene(BCRABL). BCR-ABL protein had constitutive tyrosine kinase activity that is a primary cause of chronic phase of CML. Tyrosine kinase inhibitors(TKIs) are now considered standard therapy for patients with CML. Even though, successful treatment with the TKIs, allogeneic stem cell transplantation(ASCT) is still an important option for the treatment of CML, especially for patients who are resistant or intolerant to at least one second generation TKI or for patients with blastic phase. Today, we know that there is no evidence for increased transplantrelated toxicity and negative impact of survival with pretransplant TKIs. However, there are some controversies about timing of ASCT, the optimal conditioning regimens and donor source. Another important issue is that BCRABL signaling is not necessary for survival of CML stem cell and TKIs were not effective on these cells. So, ASCT may play a role to eliminate CML stem cells. In this article, we review the diagnosis, management and treatment of CML. Later, we present our center's outcomes of ASCT for patients with CML and then, we discuss the place of ASCT in CML treatment in the TKIs era.

Synapsin Polymorphisms Could Be Correlated with Stroop Simple Reaction Time Scores

Objective: The aim of this study was to research the relationship between Attention Deficit Hyperactivity Disorder (ADHD) and the synapsin III -196G>A and -631C>G polymorphisms and study their impact on neurocognition and behavior in Turkish children and adolescents. Methods: A total of 201 ADHD-diagnosed children and 100 control subjects aged between 8 and 15 years were recruited, and genetic material was obtained from saliva. In the diagnostic assessments, the KSADS- PL semi-structured interview was applied. Children with any comorbid psychiatric diagnosis (with the exclusion of oppositional defiant disorder (ODD)), medical conditions, prior psychotropic drug use history or IQ score below 80 were excluded. For the behavioral and ADHD symptom assessments, the Turgay DSM-IV Disruptive Behaviors Rating Scale, Teacher Report Form (TRF) and Child Behavior Checklist (CBCL) were completed by the parents and teachers. Neurocognitive profiles were evaluated with the CNS-Vital Signs computerized neurocognitive test battery. Results: No significant difference in ADHD prevalence was observed between subjects with the synapsin III gene -196G>A polymorphism and -631C>G polymorphisms. These polymorphisms were also not associated with subtypes of ADHD. We found a relationship between both polymorphisms and Stroop simple reaction time. Conclusion: Synapsin’s effect could be limited during childhood, but synapsin polymorphisms could be associated with Stroop simple reaction time.

局部外用皮质类固醇引起Mibelli型汗孔角化症

Background:Porokeratosis of Mibelli is a chronic disorder characterised by slightly atrophic plaques surrounded by keratotic border.Methods and Results:A 45-year-old man treated with clobetazole propionate ointment for psoriasis over 15 years developed characteristic lesions of porokeratosis Mibelli on the elbows.Histopathological examination revealed the cornoid lamellae located on the edges of the specimen and psoriasiform acanthosis and a spongiotic pustule formation in the center of the specimen;thus,it was suggested as ’psoriasis encircled by porokeratosis’.Conclusions:Development of porokeratosis may be explained by the local immunosuppressive effect of the prolonged application of the topical steroid.

皮肤纤维瘤中均质性蓝色色素沉着似蓝痣

A case with a pigmented skin lesion that was diagnosed as a blue naevus on clinical and dermoscopic grounds and histopathologically confirmed as a dermatofibroma is presented.By means of this case,we define dermatofibroma as a new exception for ’homogeneous blue pigmentation’on dermoscopy.

血管性勃起功能障碍患者的内皮功能

Objectives: Erectile dysfunction(ED) commonly coexists with coronary artery disease(CAD) and/or risk factors for atherosclerosis. Because the silent or documented atherosclerosis or vascular risk factors are very frequent, the possibility of endothelial dysfunction in ED patients is expected to be increased. Our aim was to evaluate the endothelial functions in patients with vasculogenic ED with vascular risk factors and compare them with age-matched non-ED patients or healthy controls. Design: We studied 36 patients with presumed vasculogenic ED, 39 age-matched patients with similar risk factors without ED and 25 age-matched healthy controls without ED, known cardiovascular disease or risk factors. Erectile function was evaluated by the International Index of Erectile Dysfunction(IIEF) scores. Brachial artery flow-mediated dilatation(FMD) and nitroglycerine-mediated dilatation(NMD) were measured. Results: Baseline demographics were similar except the IIEF score and duration of diabetes in patients with ED. Brachial artery FMD and NMD were significantly reduced in patients with ED(3.2±3. vs. 6±4, p< 0.0001 for FMD, 12.2±6 vs. 15.4±6 p=0.032 for NMD). In patients with similar risk factors but without ED, FMD was significantly lower but NMD were not different compared with healthy controls(6±4 vs. 10.2±3, p< 0.0001 for FMD and 15.4±8 vs. 16.4±6, p=0.81). IIEF scores were weakly correlated with FMD(r=0.25, p=0.028) in patients with ED. There were significant correlations between FMD and NMD in patients with ED(r=0.46, p=0.05) and with risk factors(r=0.72, p< 0.0001) but not in healthy controls(r=0.54, p=0.792). Vasculogenic ED patients have more markedly impaired endothelial and smooth muscle functions compared with patients with similar risk factors but no ED.

Perioperative anesthetic management in pediatric hereditary angioedema;case report

Hereditary angioedema is a rare but life-threatening disease, usually resulting from upper respiratory tract traumas and stress. In this case report, we present the management of a 14-year-old female patient who was diagnosed with hereditary angioedema and scheduled to undergo transurethral resection of bladder (TURB) procedure for bladder tumor. She was on prophylactic danazol treatment and prior to the operation the dose of danazol was increased. On the day of the operation, patient was given C1-IHN concentrate and was sedated. In conclusion, hereditary angioedema is a rare disease in which multidisciplinary and aggressive approach during anesthesia would yield successful results.

Effect of dyspnea and clinical variables on the quality of life and functional capacity in patients with chronic obstructive pulmonary disease and congestive heart failure

Background Chronic obstructive pulmonary disease （COPD） and congestive heart failure （CHF） are two chronic diseases that affect negatively the functional condition and quality of life of patients. We assessed the effect of symptoms and clinical variables on the functional capacity and quality of life in COPD and CHF patients. Methods The study included 42 COPD and 39 CHF patients. In both patient groups, dyspnea was assessed using Borg scale; functional capacity by shuttle-walk and cardiopulmonary exercise test and quality of life by short form-36 （SF36）. Results No statistically significant difference was found in neither of the two disease groups regarding the dyspnea score, shuttle-walk test and the majority of subgroup scores of SF36 （P〉0.05）. A statistically significant difference was observed in peak VO2 in favor of COPD group （P〈0.05）. No significant relationship was established between dyspnea score and forced expiratory volume in one second （FEV1） in COPD patients, and left ventricular ejection fraction （LVEF） in CHF patients （P〉0.05）. A significant negative correlation was observed between dyspnea score and functional capacity tests in both disease groups （P〈0.05）. On the other hand, no relationship was found between LVEF and FEV1 and quality of life and functional capacity （P〉0.05）. Conclusions It was revealed that symptoms have an impact on functional capacity and quality of life in both disease groups, however, objective indicators of disease severity do not show a similar relationship. Therefore, in addition to the objective data related to the disease, we recommend that symptoms should also be taken into consideration to assess cardiopulmonary rehabilitation program and during following-up.