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This study investigates the relationship between chronotype and schizophrenia, focusing on the mediating role of vitamin D. A cross-sectional design was used, involving 51 schizophrenia patients and 53 healthy controls. Participants completed the Morningness-Eveningness Questionnaire (MEQ), and their vitamin D levels were measured. Schizophrenia patients exhibited significantly lower MEQ scores and vitamin D levels than controls. A mediation analysis revealed that vitamin D levels partially mediated the relationship between MEQ scores and the presence of schizophrenia. Lower MEQ scores, indicating an evening chronotype, were associated with reduced vitamin D levels, which, in turn, correlated with an increased likelihood of schizophrenia. However, no significant associations were found between vitamin D levels and symptom severity (measured by PANSS scores). These findings highlight the potential interplay between chronotype and vitamin D in schizophrenia, suggesting that addressing circadian disruptions and vitamin D deficiency could enhance therapeutic strategies for schizophrenia.. [ABSTRACT FROM AUTHOR]

Objective: Gastric cancer, with notable regional variations in incidence rates, ranks as the third most prevalent cause of cancer-related deaths globally and the fifth most common cancer overall. The objective of this study is to examine the pathological, clinical, and demographic characteristics of patients diagnosed with undifferentiated gastric cancer (UGC) and to determine the major prognostic markers that impact survival and recurrence. Materials and Methods: This retrospective analysis included patients who underwent surgery for gastric cancer at our center between March 2010 and February 2019. The inclusion criteria required a confirmed diagnosis of UGC and availability of pathological data. Data collected included demographic information, clinical parameters, pathological findings, surgical details, and survival outcomes. The primary outcomes were overall survival and local recurrence. Results: Twenty-four patients were included, 66.7% of whom were male, with a mean age of 58.5 years. Local recurrence occurred in 50% of patients and was significantly associated with perineural and vascular invasion. Receiver operating characteristic (ROC) analysis identified a metastatic lymph node cutoff of 8.5, with an area under the curve (AUC) of 0.826, specificity of 100%, and sensitivity of 63.2%. Patients with fewer than 8.5 metastatic lymph nodes had a median survival of 16.0 months, compared to 7.0 months for those with more than 8.5 nodes (p=0.003). Conclusion: Perineural and vascular invasion significantly affect local recurrence in UGC patients. A metastatic lymph node cutoff of 8.5 is a critical predictor of mortality. These findings underscore the importance of thorough pathological assessments and lymph node evaluations in guiding treatment decisions and improving outcomes. Further research is necessary to validate these results and explore additional prognostic markers. [ABSTRACT FROM AUTHOR]

Aim: This article aims to assess Mental Health Literacy (MHL) in dialysis patients and examine their impact on anxiety, depression and physical health. Material and Method: The study was conducted in the Hemodialysis Unit of Karaman Training and Research Hospital between March and June 2024. A total of 87 patients who met the inclusion criteria and agreed to participate were included in the study. Data were collected using a semi-structured sociodemographic form, Mental Health Literacy Scale, Hamilton Depression Scale and Hamilton Anxiety Scale. Biochemical parameters were obtained from electronic patient records. Results: The frequency of depression was 45%. There was no significant difference in MHL points among individuals with and without depression. Furthermore, no correlation was found between MHL and duration of disease or dialysis. A significant relationship was found between Total and Resource subscale scores of MHL and estimated glomerular filtration rate (eGFR). Conclusion: The frequency of depression was higher in dialysis patients than in the general population. Albeit no significant difference in MHL was observed between patients diagnosed with depression and those without, the significant relationship between MHL and eGFR suggests that interventions to increase MHL may have positive effects on disease progression. [ABSTRACT FROM AUTHOR]

Background and Objectives: In ampullary cancer, 5-year survival rates are 30–50%, even with optimal resection and perioperative systemic therapies. We sought to determine the important clinicopathological features and adjuvant treatments in terms of the prognosis of patients with operable-stage ampullary carcinomas. Materials and Methods: We included 197 patients who underwent pancreaticoduodenectomy to treat ampullary carcinomas between December 2003 and May 2019. Demographics, clinical features, treatments, and outcomes/survival were analyzed. Results: The median disease-free survival (mDFS) and median overall survival (mOS) were 40.9 vs. 63.4 months, respectively. The mDFS was significantly lower in patients with lymphovascular invasion (p < 0.001) and lymph node involvement (p = 0.027). Potential predictors of decreased OS on univariate analysis included age ≥ 50 years (p = 0.045), poor performance status (p = 0.048), weight loss (p = 0.045), T3–T4 tumors (p = 0.018), surgical margin positivity (p = 0.01), lymph node involvement (p = 0.001), lymphovascular invasion (p < 0.001), perineural invasion (p = 0.007), and poor histological grade (p = 0.042). For the multivariate analysis, only nodal status (hazard ratio [HR]1.98; 95% confidence interval [CI], 1.08–3.65; p = 0.027) and surgical margin status (HR 2.61; 95% CI, 1.09–6.24; p = 0.03) were associated with OS. Conclusions: Nodal status and a positive surgical margin were independent predictors of a poor mOS for patients with ampullary carcinomas. Additional studies are required to explore the role of adjuvant therapy in patients with ampullary carcinomas. [ABSTRACT FROM AUTHOR]

Objective: Peritoneal dialysis is a widely used renal replacement therapy for end-stage renal disease (ESRD). This study aims to evaluate the duration of use and complications associated with peritoneal dialysis catheters (PDC) placed using an open surgical method in a singlecenter experience. Materials and Methods: This study included 127 ESRD patients who underwent PDC placement between 2018 and 2023. We analyzed the patients' clinical and demographic data, the reasons for transitioning to hemodialysis, and the complications leading to this transition. Patients with a body mass index (BMI) of 30 or higher were considered obese, and the impact of this condition on complications was specifically investigated. The PDC placement using the open surgical method was performed by the same surgical team. Results: Of the 127 patients who had PDCs placed in the last five years, approximately 55.1% experienced various complications, leading to a transition to hemodialysis in 31 patients. Reasons for switching included catheter-related problems (35.4%), peritonitis (25.8%), ultrafiltration failure (19.3%), dialysis inadequacy (6.4%), and hernia (3.2%). No significant change in the overall risk of complications was observed in patients with a BMI of 30 or higher; however, a significant increase in the risk of peritonitis was noted in these patients. Conclusion: The open surgical method is a preferred technique for PDC placement due to its ease of application and low complication rates. Notably, in patients with a BMI of 30 or higher, an increase in infection-related complications, such as peritonitis, was observed. Therefore, greater attention should be devoted to managing infection-related complications in the use of PDCs among obese patients. [ABSTRACT FROM AUTHOR]

The article discusses a study on erlotinib response in a smoker Turkish male with metastatic lung adenocarcinoma characterized by a rare exon 20 mutation. Topics include the confirmation that epidermal growth factor receptor (EGFR)-activating mutations represents the main predictor of clinical outcome with tyrosine kinase inhibitor (TKI) therapy, a case report showing a good clinical response to erlotinib after platinum-based chemotherapies, and conclusion on EGFR exon 20 mutations.

Aim: To identify factors that can help us to avoid a preoperative incorrect diagnosis of vascular occlusion by evaluating patients who underwent laparotomy with a probable preoperative diagnosis of acute mesenteric ischemia (AMI), but later at laparotomy, were diagnosed to have a different pathology than AMI., Material and Methods: A total of 213 patients who were operated with the diagnosis of AMI were enrolled in this study. Based on their operational, clinical, and pathological findings, they were divided into two groups. Patient demographic data, along with the American Society of Anesthesiology (ASA) score, Charlson comorbidity index, history of previous abdominal surgery, and computed tomography (CT) findings were compared between groups., Results: There were 37 patients in Group 1 (non-mesenterovascular pathology) and 176 patients in Group 2 (mesenterovascular pathology). The percentage of ASA 4 patients was higher in Group 2, with 48.3%, compared to 35.1% in Group 1 (p-value: 0.028). Upon admission, Group 2 had a higher rate of pathologic findings on CT examinations. 21.8% of the patients with non-mesenterovascular pathology had normal intra-abdominal findings. In univariate and multivariate analysis for no-nmesenterovascular pathology, patient age less than 65, Charlson comorbidity index 1-2, INR level >1.2, history of previous abdominal operation, and pneumatosis intestinalis were identified as independent risk factors., Discussion: The possibility of non-mesenterovascular pathology in presumed AMI patients should be kept in mind, especially if the patients have a history of abdominal surgery, a low comorbidity index, an elevated international normalised ratio (INR), and are younger than 65 years of age., Conclusion: Evaluating the significant parameters identified in this study among patients with a preliminary diagnosis of AMI may prove useful in avoiding misdiagnosis and unnecessary surgeries.

Purpose: After failure of the first-line sorafenib treatment in advanced or metastatic stage hepatocellular carcinoma (HCC), regorafenib is one of the newly-approved targeted agents. We aimed to evaluate the efficacy of regorafenib in patients with advanced HCC treated in the second- or third-line setting., Methods: In this retrospective and multicenter study, advanced HCC patients not eligible for local therapies, who received a second- or third-line regorafenib therapy after progression on the first-line sorafenib or sequential therapy with chemotherapy (CT) followed by sorafenib, were included., Results: In the first-line setting, 28 (28.9%) patients received CT and 69 (71.1%) patients received sorafenib. There were 24 (24.7%) patients who were intolerant to sorafenib. Disease control rate (DCR) was 53.6% for all patients treated with regorafenib, 62.3% in patients who received regorafenib in the second-line, and 32.1% for those receiving regorafenib in the third-line (p=0.007). Median progression-free survival (PFS) and overall survival (OS) were 5.6 (range; 4.3-6.9) and 8.8 (range, 6.3-11.3) months for all patients treated with regorafenib vs. 7.1 months and 10.3 months for patients who received regorafenib in the second-line vs. 5.1 and 8.7 months for patients who received regorafenib in the third-line, respectively; however, there was no statistically significant difference (pPFS=0.22 and pOS=0.85)., Conclusion: Although receiving CT as a first-line therapy in advanced HCC patients did not affect the survival rates of subsequent regorafenib therapy, it might diminish the DCR of regorafenib.

Purpose: To evaluate the efficacy and adverse events with cetuximab plus FOLFOX administered as second- and third-line therapy in metastatic colorectal cancer (mCRC) patients., Methods: IPatients were administered cetuximab plus FOLFOX as second- and third-line therapy from January 2010 through October 2015. mCRC patients with wild type KRAS were alsï given irinïtecan and/ïr ïxaliplatin cïmbined with fluorïpyrimidine±bevacizumab. Tumor respïnse and survival were evaluated using RECIST and Kaplan-Meier methïd respectively., Results: Sixty patients were included this study. Cetuximab plus FOLFOX was administered to 40 (66.7%) patients as second-line and to 20 (33.3%) as third-line therapy. The majority of the patients had a good ECOG performance status (PS) (0 or 1). Clinical benefit was partial plus stable disease and it was 75.0% for both of these two lines. The median progression free survival (PFS) was 7.1 months (95% CI=3.2-10.9) and 6.0 months (95% CI=2.4-9.6), in the second-and third-line (p=0.484). The median ïverall survival (ÏS) was 14.3 and 9.2 mïnths in secïnd-and third-line therapy respectively (p=0.071). The common toxicities were haematologic and gastrointestinal, mostly grade 1 and 2., Conclusion: The addition of cetuximab to FOLFOX was well-tolerated and had antitumor activity both in second- and third-line therapy in patients with mCRC.