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Permanent URI for this collectionhttps://hdl.handle.net/20.500.14288/3

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Sponsors: search.filters.sponsors.TÜBİTAKSubject: search.filters.subject.Oncology

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    The effect of a biofeedback-based virtual reality game on pain, fear and anxiety levels during port catheter needle insertion in pediatric oncology patients: a randomized controlled study
    (ELSEVIER SCI LTD, 2024) Bayram, Cengiz; Umaç, Eyşan Hanzade; Semerci, Remziye; Graduate School of Health Sciences; School of Nursing
    Purpose: It is essential to control pain, fear, and anxiety related to medical procedures to improve the well-being of the child and family trying to cope with the disease process. This study investigated the impact of the biofeedback-based virtual reality game (BioVirtualPed) on pain, fear, and anxiety levels during port needle insertion in pediatric oncology patients (POPs). Methods: This randomized controlled study was conducted at a hospital between August and December 2023 involving 62 POPs aged 6-12 and their mothers. The intervention group wore a virtual reality headset and a respiratory sensor during the procedure. Data were collected using the Descriptive Information Form, Wong-Baker Pain Assessment Scale, Child Fear Scale, Children's State Anxiety, Satisfaction Scoring-Visual Analog Scale, and ADXL354 Sensor. Statistical analysis was performed using IBM SPSS for Windows Version 24.0. Results: The intervention group showed lower mean pain scores than the control group (p < 0.001). There was no difference in pre-procedure fear and anxiety scores between groups (p > 0.05 and p > 0.05, respectively). Post-procedure fear and anxiety scores were lower in the intervention group (p < 0.001 and p < 0.001, respectively). The intervention group's mean respiratory rates were lower (p < 0.001), and their satisfaction scores were higher (p < 0.001). Agreements between POPs and mothers on pain, fear, and anxiety scores were good and excellent across groups (p < 0.001). Conclusions: The BioVirtualPed reduced procedure-related pain, anxiety, and fear, increased care satisfaction, and had a positive effect on the mean respiratory rate, hence it shows promising results, but these findings need further comfirmation.
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    Subgrading of G2 pancreatic neuroendocrine tumors as 2A (Ki67 3% to < 10%) versus 2B (10% to ≤ 20%) identifies behaviorally distinct subsets in keeping with the evolving management protocols
    (Springer, 2024) Bağcı, Pelin; Balcı, Serdar; Ohike, Nobuyuki; Sökmensüer, Cenk; Leblebici, Can Berk; Xue, Yue; Reid, Michelle D.; Krasinskas, Alyssa M.; Kooby, David; Maithel, Shishir K.; Sarmiento, Juan; Cheng, Jeanette D.; Tarcan, Zeynep Çağla; Luchini, Claudio; Scarpa, Aldo; Baştürk, Olca; Eren, Özgür Can; Saka, Burcu; Taşkın, Orhun Çığ; Kapran, Yersu; Adsay, Nazmi Volkan; School of Medicine
    Background Grade 1/2 PanNETs are mostly managed similarly, typically without any adjunct treatment with the belief that their overall metastasis rate is low. In oncology literature, Ki67-index of 10% is increasingly being used as the cutoff in stratifying patients to different protocols, although there are no systematic pathology-based studies supporting this approach. Methods Ki67-index was correlated with clinicopathologic parameters in 190 resected PanNETs. A validation cohort (n = 145) was separately analyzed. Results In initial cohort, maximally selected rank statistics method revealed 12% to be the discriminatory cutoff (close to 10% rule of thumb). G2b cases had liver/distant metastasis rate of almost threefold higher than that of G2a and showed significantly higher frequency of all histopathologic signs of aggressiveness (tumor size, perineural/vascular invasion, infiltrative growth pattern, lymph node metastasis). In validation cohort, these figures were as striking. When all cases were analyzed together, compared with G1, the G2b category had nine times higher liver/distant metastasis rate (6.1 vs. 58.5%; p < 0.001) and three times higher lymph node metastasis rate (20.5 vs. 65.1%; p < 0.001). Conclusions G2b PanNETs act very similar to G3, supporting management protocols that regard them as potential therapy candidates. Concerning local management, metastatic behavior in G2b cases indicate they may not be as amenable for conservative approaches, such as watchful waiting or enucleation. This substaging should be considered into diagnostic guidelines, and clinical trials need to be devised to determine the more appropriate management protocols for G2b (10% to <= 20%) group, which shows liver/distant metastasis in more than half of the cases, which at minimum warrants closer follow-up.