Prevalence and costs of defensive medicine: a national survey of Italian physicians.

Objective To identify the prevalence of the practice of defensive medicine among Italian hospital physicians, its costs and the reasons for practising defensive medicine and possible solutions to reduce the practice of defensive medicine. Methods Cross-sectional web survey. Main outcome measures Number of physicians reporting having engaged in any defensive medicine behaviour in the previous year.

Coronary flow reserve is reduced in sarcoidosis.

Background And Aims: Sarcoidosis is a multisystem disease with frequent cardiac involvement, albeit manifest cardiac disease is rare. Though epicardial coronary arteries are not frequently involved, microvascular disease is rather common in both symptomatic and asymptomatic patients. The mechanism of microvascular involvement has not been elaborated yet.

Can Parathormon Levels after Ipsilateral Lobectomy Predict Postoperative Hypocalcemia in Patients Undergoing Total Thyroidectomy?

The purpose of this study was to investigate the relationship between the serum parathormone (PTH) levels measured after completion of hemithyroidectomy on the first side during total thyroidectomy and the postoperative hypocalcemia. The patients were divided into two groups, as those who demonstrated a decrease in PTH levels measured after completion of hemithyroidectomy of the first side (Group 1, n = 43) and those who did not demonstrate a decrease in PTH levels (Group 2, n = 24). The serum PTH levels were measured just before the incision (PTHi), when the hemithyroidectomy stage had been completed (PTHht), at the end of the operation (PTHtt), and at the postoperative 24th hour (PTH24hr).

Paraoxonase and Arylesterase Levels in Behcet's Disease and Their Relations with the Disease Activity.

The aim of this study was to determine the paraoxonase (PON) and arylesterase (ARE) enzyme activity levels in Behcet's disease (BD) and to investigate whether they are associated with the disease activity. Twenty-six patients (study group) with active BD and 28 healthy controls (control group) were included in this study. While the patients who had at least one of the symptoms related to genital ulcer, skin lesions, active uveitis, arthritis, thrombophlebitis, or central nervous system involvement in addition to oral ulcers were considered as the active group, the patients who did not show clinical symptoms in the last one month due to the medical treatment were considered as the inactive group in the clinical evaluation of patients with BD.

Selective rescue of heightened anxiety but not gait ataxia in a premutation 90CGG mouse model of Fragile X-associated tremor/ataxia syndrome.

A CGG-repeat expansion in the premutation range in the Fragile X mental retardation 1 gene (FMR1) has been identified as the genetic cause of Fragile X-associated tremor/ataxia syndrome (FXTAS), a late-onset neurodegenerative disorder that manifests with action tremor, gait ataxia and cognitive impairments. In this study, we used a bigenic mouse model, in which expression of a 90CGG premutation tract is activated in neural cells upon doxycycline administration-P90CGG mouse model. We, here, demonstrate the behavioural manifestation of clinically relevant features of FXTAS patients and premutation carrier individuals in this inducible mouse model.

Sorafenib with TACE improves the survival of hepatocellular carcinoma patients with more than 10 cm tumor: a single-center retrospective study.

Purpose: Sorafenib, a multikinase inhibitor, is effective in patients with advanced hepatocellular carcinoma (HCC). Transarterial chemoembolization (TACE) is an important palliative treatment for unresectable HCC, but TACE-induced ischemic injury can upregulate angiogenic factors and it might be associated with poor prognosis. The purpose of this study was to evaluate the efficacy of conventional TACE with or without sorafenib in patients with Barcelona Clinic Liver Cancer (BCLC) stage A-B HCC.

Endocan Measurement for Active Behçet Disease.

Objectives: This study aims to investigate the relationships between serum endocan, vascular endothelial growth factor (VEGF), and tumor necrosis factor-alpha (TNF-α) levels in active Behçet disease.

Patients And Methods: Forty patients with active Behçet disease (24 males, 16 females; mean age 37.6±8.

Outcomes after lobectomy and pneumonectomy in lungcancer patients aged 70 years or older.

Background/aim: For the early stage of nonsmall-cell lung cancer, surgical resection provides the best survival, but the surgical risk generally increases with age because of the increased prevalence of comorbidities, especially cardiovascular disorders. The aim of this study was to compare survival and mortality rates of two groups with different ages, younger and older than 70 years, who went curative resection for nonsmall-cell lung cancer.

Materials And Methods: We analyzed the patients who underwent curative lung cancer surgery in the Department of Thoracic Surgery of Gaziantep University Research Hospital between January 1997 and November 2014.

Association between the plasma levels of IMA and coronary atherosclerotic plaque burden and ischemic burden in early phase of non-ST-segment-elevation acute coronary syndromes.

Objective: Ischemia-modified albumin (IMA), a novel biochemical marker, is known to reflect ischemia in early phases of acute coronary syndrome (ACS). In the present study, we evaluated the role of IMA on the prediction of coronary atherosclerotic plaque burden and ischemic burden in patients with non-ST-segment-elevation acute coronary syndromes (NSTEACS).

Patients And Methods: Ninety-six consecutive NSTEACS patients presented within the first three hours of symptom onset were prospectively enrolled in this study.

Diagnostic value of Gd-EOB-DTPA-enhanced MR cholangiography in non-invasive detection of postoperative bile leakage.

Objective: To assess the diagnostic value of dynamic T weighted (T1w) gadolinium ethoxybenzyl diethylenetriamine penta-acetic acid (Gd-EOB-DTPA)-enhanced MR cholangiography (MRC) for the detection of active bile leaks.

Methods: A total of 28 patients with suspected biliary leakage who underwent routine T weighted (T2w) MRC and T1w GD-EOB-DTPA-enhanced MRC at our institution from February 2013 to June 2016 were included in this study. The image sets were retrospectively analyzed in consensus by three radiologists.

Somatic SNPs of the BRCA2 gene at the fragments encoding RAD51 binding sites of canine mammary tumors.

Mammary tumors are the most common tumor type both in women and in female dogs. In women, heritable breast cancers have been linked mutations in the breast cancer susceptibility gene BRCA2 and it contains eight BRC repeats in exon 11 that bind to RAD51. In this study, we investigated the sequence variations of BRC1-BRC8 and C-terminus of canine BRCA2 gene.

Meningoencephalitis caused by pathogenic Sarcocystis species in a naturally infected sheep in Turkey.

A 3-year-old sheep was examined after an acute onset of hind limb paralysis and ataxia. At necropsy, central nervous system, pulmonary and intestinal hyperaemia and ecchymoses in the aortic arch were observed. Main microscopic lesions were confined to the heart, cerebrum and cerebellum.

The management of adnexal masses in premenopausal patients: a ten-year retrospective study at a single center.

Purpose Of Investigation: To distinguish adnexal masses as benign and malignant, and to thereby identity the suitable surgical method for these masses, in premenopausal women, by retrospectively evaluating over a ten-year period, the diagnostic parameters, such as serum CA 125 and transvaginal ultrasonography (TVS), in combination with the presence of ascites in the abdomen.

Materials And Methods: The study was conducted with 255 premenopausal patients diagnosed with adnexal masses who had been admitted to the Gaziantep University Faculty of Medicine, Clinic of Gynecology and Obstetrics, between January 2003 and January 2013. Data collected from these patients included age, menopausal state, information regarding the presence of ascites, ultrasound findings, and serum CA 125 levels.

Impact of a care pathway for COPD on adherence to guidelines and hospital readmission: a cluster randomized trial.

Purpose: Current in-hospital management of exacerbations of COPD is suboptimal, and patient outcomes are poor. The primary aim of this study was to evaluate whether implementation of a care pathway (CP) for COPD improves the 6 months readmission rate. Secondary outcomes were the 30 days readmission rate, mortality, length of stay and adherence to guidelines.

Effect of Different Surface Treatments on Bond Strength of Resin Cement to a CAD/CAM Restorative Material.

Purpose: To investigate the effects of various surface treatment methods on the shear bond strength of self-adhesive resin cement to a novel CAD/CAM hybrid ceramic material.

Materials And Methods: A novel hybrid ceramic restorative material (Vita Enamic) was used in this study. Sixty resin block specimens were prepared and separated into six groups for each surface treatment method (n = 10); group 1: control group, no treatment applied; group 2: sandblasted by 30 μm silicate-coated alumina particles (CoJet Sandblasting); group 3: 50 μm Al O sandblasting; group 4: 10% hydrofluoric acid; group 5: no surface treatment + universal adhesive (3M Single Bond Universal); group 6: 200 mJ, 10 Hz 2W Er,Cr:YSGG laser treatment.

Effect of Platelet-Rich Fibrin on Peripheral Nerve Regeneration.

Purpose: This study aimed to evaluate the effect of platelet-rich fibrin (PRF) on peripheral nerve regeneration on the sciatic nerve of rats by using functional, histopathologic, and electrophysiologic analyses.

Materials And Methods: Thirty female Wistar rats were divided randomly into 3 experimental groups. In group 1 (G1), which was the control group, the sciatic nerve was transected and sutured (n = 10).

Delayed diagnosis: An important prognostic factor for oesophageal atresia in developing countries.

Aim: The aim of this study is to analyse the effect of delayed diagnosis on mortality rates, and evaluate the role of delayed diagnosis as a new prognostic factor in patients with oesophageal atresia (OA), especially in developing countries.

Methods: The records of 80 consecutive patients with OA (2008-2013) were reviewed. Patients were divided into two groups according to the time of diagnosis.

Polymorphisms in the MTHFR gene are associated with recurrence risk in lymph node-positive breast cancer patients.

Purpose: The aim of this study is to clarify the relationship between recurrence risk of breast cancer and methylenetetrahydrofolate reductase (MTHFR) C677T polymorphisms.

Patients And Methods: Breast cancer patients who had undergone surgery in Gaziantep University Oncology Hospital between June 2005 and June 2012 were followed-up and retrospectively enrolled in this study. Blood samples were collected from all patients to assess MTHFR C677T polymorphisms.

Determination of skin wound age by using cytokines as potential markers.

Interleukin-1 beta (IL-1β), IL-6, tumour necrosis factor-alpha (TNF-α) and epidermal growth factor (EGF) play important roles in the wound healing process. In the present study, human wound specimens (n = 50) were collected from cases of death due to injuries from firearms, penetrating trauma by sharp objects and blunt trauma with a known time of injury and death identified by forensic autopsy. Full-thickness tissue specimens were obtained from injured skin sites, and equally sized intact tissues obtained from the same person were used as controls.

Association between radionuclides (Po and Pb) and antioxidant enzymes in oak (Quercus coccifera) and mastic tree (Pistacia lentiscus).

The activity levels of naturally occurring radionuclides Polonium-210 and lead-210 in different subjects including plant species have direct or indirect impact on human beings. High levels of ionising radiation cause oxidative stress and the interaction between antioxidative defense and radionuclides is not well established in plant systems. In this study, we aimed to understand the impact of oxidative stress caused by Po and Pb in two Mediterranean plants; Quercus coccifera and Pistacia lentiscus.

Polymorphism of CYP3A4 and ABCB1 genes increase the risk of neuropathy in breast cancer patients treated with paclitaxel and docetaxel.

Background: Interindividual variability of pharmacogenetics may account for unpredictable neurotoxicities of taxanes.

Methods: From March 2011 to June 2015, female patients with operable breast cancer who had received docetaxel- or paclitaxel-containing adjuvant chemotherapy were included in this study. All patients were treated with single-agent paclitaxel intravenously (IV) 175 mg/m(2) every 3 weeks for four cycles, or IV 80 mg/m(2) weekly for 12 cycles, and IV 100 mg/m(2) docetaxel for four cycles as adjuvant treatment.

Misdiagnosed epigastric mass: Ectopic liver.

Unlabelled: We discuss an ectopic liver misdiagnosed as an abdominal mass and the importance of magnetic resonance imaging (MRI) in liver positional anomalies. A solid midline mass midline adjacent to the liver was found in a 45-year-old female at an external center during an ultrasound investigation conducted for occasional abdominal pain of many years. The patient was referred to us for MRI.

Imparied retrobulbar blood flow and increased carotid IMT in patients with Crohn's disease.

Crohn's Disease [CD] is one of the Inflammatory Bowel Diseases that are chronic relapsing inflammatory diseases. Despite the major affected organ is intestine in CD, extra intestinal organs and tissues including cardiovascular system are also affected. Several studies have demonstrated that CD patients may have a higher risk of advancing atherosclerosis.

The Biochemical, Histopathological and Clinical Comparison of the Neuroprotective Effects of Subcutaneous Adalimumab and Intravenous Methylprednisolone in an Experimental Compressive Spinal Cord Trauma Model.

Aim: To evaluate the neuroprotective effects of adalimumab in an experimental spinal cord injury model and compare them with those of the widely-used methylprednisolone.

Material And Methods: Forty male Wistar rats were divided into 5 as the sham, trauma, adalimumab, methylprednisolone, and adalimumab+methylprednisolone groups. Only laminectomy was performed in the sham group.

The determinants of defensive medicine in Italian hospitals: The impact of being a second victim.

Background: Defensive medicine affects healthcare systems worldwide. The concerns and perception about medical liability could lead practitioners to practise defensive medicine. Second victim is a healthcare worker involved in an unanticipated adverse patient event.