Background: Palliative therapies have an important role in increasing the quality of healthcare and in dealing with physical and psychosocial problems due to cancer. We here aimed to evaluate the managerial perspectives and opinions of the hospital managers and clinical directors about specialized palliative care centers. Materials and Methods: This study was conducted in two large-scale hospitals in which oncology care is given with medical directors (n:70). A questionnaire developed by the researchers asking about demographic characteristics and professional experience, opinions and suggestions of medical directors about providing and integrating palliative care into healthcare was used and responses were analyzed. Results: Potential barriers in providing palliative care (PC) and integrating PC into health systems were perceived as institutional by most of the doctors (97%) and nurses (96%). Social barriers were reported by 54% of doctors and 82% of nurses. Barriers due to interest and knowledge of health professionals about PC were reported by 76% of doctors and 75% of nurses. Among encouragement ideas to provide PC were dealing with staff educational needs (72%), improved working conditions (77%) and establishing a special PC unit (49)%. An independent PC unit was suggested by 27.7% of participants and there was no difference between the hospitals. To overcome the barriers for integration of PC into health systems, providing education for health professionals and patient relatives, raising awareness in society, financial arrangements and providing infrastructure were suggested. The necessity for planning and programming were emphasized. Conclusions: In our study, the opinions and perspectives of hospital managers and clinical directors were similar to current approaches. Managerial needs for treating cancer in efficient cancer centers, increasing the capacity of health professionals to provide care in every stage of cancer, effective education planning and patient care management were emphasized.

Background: Hypertrophic cardiomyopathy (HCM) is a common genetic heart disease characterized by ventricular hypertrophy, myocardial fibrosis, and impaired ventricular relaxation. The exact mechanisms by which fibrosis is caused remain unknown. Hypothesis: Circulating TGF-β is related to poor prognosis in HCM. Methods: We compared TGF-β levels of 49 HCM patients with those of 40 non-HCM patients. We followed the patients with HCM for 18 months and divided them into 2 groups: low TGF-β (≤4877 pg/mL) and high TGF-β (>4877 pg/mL). We compared the 2 groups in terms of brain natriuretic peptide (BNP), echocardiographic parameters, and clinical outcomes including myocardial infarction, arrhythmias, implantable cardioverterdefibrillator implantation, hospitalization, New York Heart Association (NYHA) class, acute heart failure, and mortality. Results: The HCM patients had higher TGF-β levels than those in the control group (P = 0.005). In the follow-up, those in the high TGF-β group had higher BNP levels, larger left-atrial size, thicker interventricular septum, NYHA class, more hospitalizations, and a greater number of clinical adverse events (P < 0.001, P = 0.01, P < 0.001, P = 0.002, P < 0.001 and P = 0.003, respectively). TGF-β level of >4877 pg/mL can predict adverse events with a specificity of 75% and a sensitivity of 72% (P = 0.014). In multivariate regression analysis, TGF-β, BNP, and interventricular septum thickness were significantly associated with adverse events (P = 0.028, P = 0.030, and P = 0.034, respectively). Conclusions: The TGF-β level is higher in HCM patients and associated with a poor prognosis in HCM.

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Background/Aim: The single nucleotide polymorphism -31C/G identified in the survivin gene promoter seems to be associated with over-expression of survivin, an anti-apoptotic protein. In gliomas, increased survivin expression correlated with decreased survival. The aim of the study was to investigate whether survivin gene polymorphism associates with benign and malignant brain tumors and whether it affects survivin serum levels. Patients and Methods: Survivin polymorphism -31C>G was genotyped in 82 patients with brain tumors and 65 healthy controls by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and survivin levels were evaluated by enzyme-linked immuno sorbent assay (ELISA) in patients and controls. Results: Serum survivin levels in patients with malignant tumors were higher than patients with benign tumors (p<0.001). Survivin levels in patients with malignant glial tumors and the frequency of the GG genotype were higher than in patients with benign tumors (p=0.04) and controls (p=0.05). The prevelance of the survivin gene promoter polymorphism -31C>G did not differ between patients and controls. Conclusion: Survivin promoter -31C>G gene polymorphism seems to be associated with serum survivin levels in brain tumors of different grades and histologies.

Background Smoking cessation practices enable health professionals to identify lifestyle of their patients as an initial step to achieve predictive, preventive, and personalized medicine (PPPM). In this study, we aimed to investigate the relationship between the smoking habit and health-promoting behavior of patients who planned to quit smoking. Methods In this descriptive study, Health-Promoting Lifestyle Profile II (HPLP-II) was implemented to current smokers admitted to smoking cessation outpatient clinics of two tertiary hospitals. Patients without any comorbidities were included. Sociodemographic variables, Fagerström dependency test, and smoking habit were recorded. Descriptive and analytical statistical evaluations were performed. Results A total of 200 patients, 134 men (67%) and 66 women (33%) with a mean age of 34.49 ± 8.82, were included to the study. Among them, 90 (45%) were white collar, and 110 (55%) were blue-collar workers. Patients with BMI ≥ 25 were 126 (63%); Fagerström test score median was 7. Packages per year, dependency scores, the age the patients started smoking, and cigarettes smoked per day inversely correlated with health-promoting behavior. Our patients had high scores in spiritual growth and interpersonal relationships and had low scores in physical activity and stress management. Health-promoting behavior, health responsibility, self-actualization, and interpersonal relationships were less favorable in blue-collar workers than white-collar workers. Conclusions Smoking behavior affects especially physical activity and stress management in the study population preparing for smoking cessation. Health-promoting activities in smokers are influenced by occupation as well as dependency levels and smoking habits. Differences exist among white and blue-collar workers in health-promoting behavior. Defining and screening multiple health risk behavior in smokers empower predictive measures and targeted preventive medicine, such as maintaining healthy nutrition and leaving sedentary lifestyle along with efforts to quit smoking. Awareness about health-promoting behavior and thus identifying smokers who need lifestyle interventions can provide and attenuate a holistic and personalized approach in preventive medicine.