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SUMMARY OBJECTIVE: Uterine carcinosarcomas are aggressive, rare biphasic tumors with malignant epithelial and malignant sarcomatous components. The prognostic significance of the presence of extrauterine sarcoma (heterologous component) is controversial. Therefore, the aim of this study was to investigate the effect of heterologous components in uterine carcinosarcomas on disease-free survival, overall survival, and other prognostic factors. METHODS: Clinical and histopathological data from patients treated for uterine carcinosarcoma in a tertiary cancer center in Turkey between July 2000 and January 2020 were collected. Independent risk factors affecting overall survival and disease-free survival were analyzed by univariate and multivariate Cox regression analyses. RESULTS: A total of 98 patients were identified. The median follow-up was 21.8 (1.2-233.1) months. In the multivariate analysis, the median overall survival and disease-free survival were 23.8 and 20.7 months in those with homologous mesenchymal components and 17.6 and 9.7 months in those with heterologous mesenchymal components, respectively. It was found that the presence of heterologous mesenchymal components significantly reduced both overall survival and disease-free survival (odds ratio [OR], 2.861; 95% confidence interval [CI] 1.196-6.841; p=0.018 and OR, 3.697; 95%CI 1.572-8.695; p=0.003, respectively). In addition, both lymphadenectomy and adjuvant radiotherapy were found to significantly increase overall survival and disease-free survival. Age was found to increase only disease-free survival. CONCLUSION: The results obtained in this study showed that the presence of heterologous components in uterine carcinosarcoma is a prognostic factor that adversely affects both overall survival and disease-free survival. Lymphadenectomy and adjuvant radiotherapy have beneficial effects on both overall survival and disease-free survival.
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Abstract Introduction Tinnitus is a perception of sound in the absence of an external source and it is a distressing issue. Yoga is a system of mind-body practices with the goal of uniting the body,mind and soul. It has been shown to reduce anxiety and stress, as well as improving the quality of life. Objective The aim of this study is to investigate the effects of yoga in patients suffering from chronic subjective tinnitus. Methods Twelve subjects previously diagnosed with chronic subjective tinnitus were selected for the study. The patients were asked to attend to yoga classes once a week and to practice yoga at home using a worksheet for 3 months. Each yoga class consisted of body exercises (asana), breathing (pranayama) and meditation (shavasana and yoga nidra). Tinnitus scores before and after the yoga classes were compared using the Wilcoxon test. Results Among the 12 patients, there were 4 men and 8 women and their mean age was 52.5 years. The median duration of tinnitus among the group was 5.4 years. There were statistically significant differences in the stress (p = 0.01), handicap (p = 0.004) and severity (p = 0.007) questionnaires scores. Conclusion This study indicated that yoga practices may reduce life stress and symptoms of subjective tinnitus.
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AbstractBackground:The relationship between psychiatric illness and heart disease has been frequently discussed in the literature. The aim of the present study was to investigate the relationship between anxiety, depression and overall psychological distress, and coronary slow flow (CSF).Methods:In total, 44 patients with CSF and a control group of 50 patients with normal coronary arteries (NCA) were prospectively recruited. Clinical data, admission laboratory parameters, and echocardiographic and angiographic characteristics were recorded. Symptom Checklist 90 Revised (SCL-90-R), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) scales were administered to each patient.Results:The groups were comparable with respect to age, sex, and atherosclerotic risk factors. In the CSF group, BAI score, BDI score, and general symptom index were significantly higher than controls (13 [18.7] vs. 7.5 [7], p = 0.01; 11 [14.7] vs. 6.5 [7], p = 0.01; 1.76 [0.81] vs. 1.1[0.24], p = 0.01; respectively). Patients with CSF in more than one vessel had the highest test scores. In univariate correlation analysis, mean thrombolysis in myocardial infarction (TIMI) frame counts were positively correlated with BAI (r = 0.56, p = 0.01), BDI (r = 0.47, p = 0.01), and general symptom index (r = 0.65, p = 0.01). The psychiatric tests were not correlated with risk factors for atherosclerosis.Conclusion:Our study revealed higher rates of depression, anxiety, and overall psychological distress in patients with CSF. This conclusion warrants further studies.
ResumoFundamento:A investigação da relação entre doença psiquiátrica e doença cardíaca sempre foi um tema de interesse na literatura médica.Objetivo:Investigar a relação entre ansiedade, depressão e distúrbios psicológicos gerais e fluxo coronariano lento (FCL).Métodos:Quarenta e quatro pacientes com FCL e 50 pacientes com fluxo coronariano normal (FCN) foram recrutados prospectivamente. Foram registrados: dados clínicos, parâmetros laboratoriais à admissão e características ecocardiográficas e angiográficas. Escalas de avaliação da Lista de Verificação de Sintomas-90 Revisada (SCL-90-R), do Inventário Beck de Depressão (IBD) e do Inventário Beck de Ansiedade (IBA) foram determinadas para cada paciente.Resultados:O grupo FCL incluiu 44 indivíduos e o grupo controle 50 indivíduos. Os grupos foram comparados quanto à idade, sexo e fatores de risco para aterosclerose. No grupo FCL, os escores do IBA, do IBD e do índice geral de sintomas foram significativamente mais altos que no grupo controle (13 [18,7] vs. 7,5 [7], p = 0,01; 11 [14,7] vs. 6,5 [7], p = 0,01; 1,76 [0,81] vs. 1,1[0,24], p = 0,01; respectivamente). Pacientes com FCL em mais de um vaso apresentaram os escores mais elevados. Na análise de correlação univariada, a média das contagens de quadros TIMI foi correlacionada positivamente com o IBA (r = 0,56, p = 0,01), com o IBD (r = 0,47, p = 0,01) e com o Índice Geral de Sintomas (r = 0,65, p = 0,01). Os testes psiquiátricos não tiveram correlação com fatores de risco para aterosclerose.Conclusão:Nosso estudo revelou taxas de depressão, ansiedade e distúrbios psicológicos gerais mais elevadas em pacientes com FCL. Esta conclusão justifica novos estudos.
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Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos de Ansiedade/fisiopatologia , Doença da Artéria Coronariana/fisiopatologia , Doença da Artéria Coronariana/psicologia , Circulação Coronária/fisiologia , Transtorno Depressivo/fisiopatologia , Estresse Psicológico/fisiopatologia , Velocidade do Fluxo Sanguíneo/fisiologia , Pressão Sanguínea/fisiologia , Angiografia Coronária , Métodos Epidemiológicos , Testes PsicológicosRESUMO
OBJECTIVE: To investigate the prevalence of obstructive sleep apnea in patients with ischemic stroke and to evaluate the effectiveness of nasal continuous positive airway pressure treatment. METHODS: Overnight polysomnography was performed by a computerized system in 19 subjects with ischemic stroke. Patients with an apnea-hypopnea index > or = 5 were considered to have obstructive sleep apnea. The appropriate level of continuous positive airway pressure for each patient was determined during an all-night continuous positive airway pressure determination study. Attended continuous positive airway pressure titration was performed with a continuous positive airway pressure auto-titrating device. RESULTS: Obstructive sleep apnea prevalence among patients with ischemic stroke was 73.7%. The minimum SaO(2) was significantly lower, and the percent of total sleep time in the wake stage and stage 1 sleep was significantly longer in patients with obstructive sleep apnea. In two patients with severe obstructive sleep apnea, we observed a decrease in the apnea-hypopnea index, an increase in mean wake time, mean SaO(2), and minimum SaO(2), and alterations in sleep structures with continuous positive airway pressure treatment. CONCLUSION: As the diagnosis and treatment of obstructive sleep apnea is of particular importance in secondary stroke prevention, we suggest that the clinical assessment of obstructive sleep apnea be part of the evaluation of stroke patients in rehabilitation units, and early treatment should be started.
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Isquemia Encefálica/etiologia , Pressão Positiva Contínua nas Vias Aéreas/métodos , Apneia Obstrutiva do Sono/complicações , Acidente Vascular Cerebral/etiologia , Idoso , Idoso de 80 Anos ou mais , Isquemia Encefálica/epidemiologia , Brasil/epidemiologia , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polissonografia , Prevalência , Índice de Gravidade de Doença , Apneia Obstrutiva do Sono/epidemiologia , Apneia Obstrutiva do Sono/reabilitação , Fases do Sono/fisiologia , Acidente Vascular Cerebral/epidemiologiaRESUMO
OBJECTIVE: To investigate the prevalence of obstructive sleep apnea in patients with ischemic stroke and to evaluate the effectiveness of nasal continuous positive airway pressure treatment. METHODS: Overnight polysomnography was performed by a computerized system in 19 subjects with ischemic stroke. Patients with an apnea-hypopnea index > 5 were considered to have obstructive sleep apnea. The appropriate level of continuous positive airway pressure for each patient was determined during an all-night continuous positive airway pressure determination study. Attended continuous positive airway pressure titration was performed with a continuous positive airway pressure auto-titrating device. RESULTS: Obstructive sleep apnea prevalence among patients with ischemic stroke was 73.7 percent. The minimum SaO2 was significantly lower, and the percent of total sleep time in the wake stage and stage 1 sleep was significantly longer in patients with obstructive sleep apnea. In two patients with severe obstructive sleep apnea, we observed a decrease in the apnea-hypopnea index, an increase in mean wake time, mean SaO2, and minimum SaO2, and alterations in sleep structures with continuous positive airway pressure treatment. CONCLUSION: As the diagnosis and treatment of obstructive sleep apnea is of particular importance in secondary stroke prevention, we suggest that the clinical assessment of obstructive sleep apnea be part of the evaluation of stroke patients in rehabilitation units, and early treatment should be started.