Yazar "Kaplan, Mehmet Ali" seçeneğine göre listele
Listeleniyor 1 - 20 / 28
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe THE ACCESS RATE TO DIAGNOSIS AND TREATMENT MODALITIES IN BREAST CANCER PATIENTS IN TURKEY; MULTICENTER OBSERVATIONAL STUDY(Aves, 2011) Saip, Pinar; Keskin, Serkan; Ozkan, Metin; Kaplan, Mehmet Ali; Aydogan, Fatma; Demirag, Guzin Gonullu; Uzunoglu, SernazPurpose: We aimed to determine the elapsed time between the first notification of the disease and the accession to the diagnosis and treatment modalities and its associated factors in female patients with breast cancer in Turkey. Patients and Methods: The data was acquired by a questionnaire completed by 535 patients who applied to the 14 various oncology clinics between 1st and 28th of February 2010 in Turkey. The centers located in metrople - Istanbul, Izmir, and Ankara- were named Group 1 (n= 161), the centers located in Marmara and Central Anatolia region - Kocaeli, Bursa, Edirne and Kayseri- were named Group 2 (n= 189), and the centers located in Karadeniz and East-Southeast Anatolia region - Zonguldak, Samsun, Trabzon, Elazig and Diyarbakir- were named Group 3 (n= 185). The grouping for the centers were configured according to their socio- economic development of provinces. Results: Median age was 48 +/- 11.2 (24- 89) years, the number of patients of age less than 50 years were 282 (% 56.1). 85% of the patients detected a mass in their breast by themselves. % 27 of the patients over age 50 never had a breast ultrasound and/ or mammography done until the definite diagnosis was established. The median elapsed time between the disease noticed by the patient and the application to a health care center was 10 days, between the application and the biopsy was 19 days, between the biopsy and the surgery was 31 days. The elapsed time between recognition of the disease by the patient and the patient applying to a health care center in Group 1, Group 2, and Group 3 was 15, 10 and 14 days, respectively, and the elapsed time between the biopsy and surgery was 14, 1.5 and 12 days, respectively. The elasped time between the first recognition of the disease and applying of the patient to the health care center and the elapsed time between the biopsy and surgery in Group 2 centers was statistically significantly shorter compared to group 1 and 3 centers (p< 0.05). Conclusions: A high level of awareness of breast cancer in our country has examined through the time that is defined as 10 days between recognition of the disease and medical application. Compared with the developed countries the elapsed time between the application and biopsy, surgery and systemic therapy is longer than the expected and it has been marked differences between regions.Öğe Bevacizumab every 4 weeks is as effective as every 2 weeks in combination with biweekly FOLFIRI in metastatic colorectal cancer(Springer, 2012) Yildiz, Ramazan; Benekli, Mustafa; Ozkan, Metin; Alkis, Necati; Berk, Veli; Kaplan, Mehmet Ali; Ciltas, AydinThe efficacy and tolerability of bevacizumab every 2 or 4 weeks using the same dosage in combination with biweekly FOLFIRI were retrospectively evaluated in metastatic colorectal cancer (mCRC) patients in the first-line and second-line therapy. A total of 332 patients from six centers were evaluated. The patients had received biweekly FOLFIRI in combination with bevacizumab 5 mg/kg every 2 weeks or every 4 weeks schedule for various reasons in individual patients. Approximately 70 % of all patients had 2-week treatment schedule. In the first-line therapy (n = 240), the overall response rate (ORR) was 34.1 % in 2-week and 36.3 % in 4-week groups. Median progression-free survival (PFS) was 8 months (95 %CI, 6.8-9.2) and 9 months (95 %CI, 6.6-11.4) (p = 0.074), and median overall survival (OS) was 22 months (95 %CI, 15.8-28.2) and 20 months (95 %CI, 8.1-31.9) (p = 0.612) in 2- and 4-week groups, respectively. One-year survival rate was 76.2 % for 2-week group and 73.2 % for 4-week group. In the second-line therapy (n = 92), the ORR was similar between the groups (24.5 vs 25.9 % in 2- and 4-week groups, respectively). Median PFS was 6 months (95 %CI, 4.7-7.3) and 11 months (95 %CI, 6.3-15.7) (p = 0.074), and median OS was 15 months (95 %CI, 9.6-20.4) and 17 months (95 %CI, 13.7-20.3) (p = 0.456) for 2-week and for 4-week groups, respectively. One-year survival rate was 61.3 % for 2-week and 71.3 % for 4-week groups. Toxicity profile was similar in 2- and 4-week groups and included neutropenia, febrile neutropenia, nausea and vomiting, diarrhea, mucositis, bleeding, hypertension, thromboembolism and fistulization. Bevacizumab 5 mg/kg every 2 weeks or every 4 weeks in combination with biweekly FOLFIRI had similar efficacy and tolerability in mCRC. Because of the retrospective nature of our study, the data should be examined cautiously. However, our study clearly points out the need for determination of optimum biological dosing interval of bevacizumab in well-designed, prospective, randomized trials.Öğe Bevacizumab-containing Chemotherapy is Safe in Patients with Unresectable Metastatic Colorectal Cancer and a Synchronous Asymptomatic Primary Tumor(Oxford Univ Press, 2013) Cetin, Bulent; Kaplan, Mehmet Ali; Berk, Veli; Tufan, Gulnihal; Benekli, Mustafa; Isikdogan, Abdurrahman; Ozkan, MetinSurgical resection of asymptomatic primary colorectal cancer in patients presenting with synchronous unresectable metastatic disease is controversial. Concerns and controversies remain over combining cytotoxic chemotherapy with bevacizumab in this patient population. We identified medical records of 99 patients with synchronous metastatic primary colorectal cancer who received chemotherapy with bevacizumab as their initial treatment. The incidence of subsequent use of surgery and surgical outcomes were recorded. Patients were also assessed for overall survival. Patients who received bevacizumab-containing chemotherapy for synchronous metastatic primary colorectal cancer were divided into the non-surgery and surgery groups according to the resection status of their asymptomatic primary tumor. In the non-surgery group, two patients (4.4) underwent additional surgery, while three patients (5.7) required surgery for rectovesical fistula in the surgery group. The median overall survival was 17 months for the non-surgery group (95 CI: 10.623.3 months) and 23 months for the surgery group (95 CI: 21.324.6 months; P 0.322). This study utilizing chemotherapy with bevacizumab did not result in an increased rate of morbidity related to the unresected primary tumor. Survival is not compromised by leaving the primary colon tumor intact.Öğe The case of gastric adenocarcinoma applying with malign Acanthosis Nigricans(Kare Publ, 2015) Oruc, Zeynep; Kaplan, Mehmet Ali; Urakci, Zuhat; Kucukoner, Mehmet; Avci, Yahya; Isikdogan, AbdurrahmanAchantosis Nigricans (AN) is a skin disorder characterised with hyperpigmented hyperkeratotic lesions. It occurs mostly in association with insulin resistance while it may also arise as a symptom of visceral malignancies. In the occurrence of AN considered as associated with malignancy, a detailed examination may be necessary to identify underlying malignancy. 85% of malign AN cases abdominal adenocarcinomas, and especially 60% of those are gastric adenocarcinomas. A 44-year-old male patient applied to our clinic with hyperpigmentation and hyperkeratosis, widespread body pain and weight loss within 3-4 months. Skin symptoms were reviewed as acanthosis nigricans. He had no endocrinological diseases such as DM or obesity. Due to ocurrence of many skin symptoms in accordance with acanthosis nigricans in a rapid growth on our patient, no findings of other AN causes, systemic symptoms such as the age of patient and weight loss, it is considered as malign AN.Öğe Classic Kaposi's sarcoma: A review of 156 cases(Elsevier Ltd, 2018) Çetin, Bülent; Aktaş, Bilge; Bal, Oznur; Algin, Efnan; Akman, Tülay; Koral, Lokman; Kaplan, Mehmet Ali; Uncu, Doğan; Özet, AhmetBackground: Kaposi's sarcoma (KS) is a reactive, multifocal, multicentric, angiogenic neoplastic proliferation that is thought to originate from endothelial cells that are infected with human herpesvirus-8 (HHV-8). This report examines a cohort of patients with classic Kaposi's sarcoma (KS) evaluated at the national institute of oncology over the 13-year period. Methods: A retrospective analysis of 156 patients with classic KS, between January 2000 and November 2013, was performed. This study focused on the clinical presentation, staging, diagnosis, and treatment of classic KS. Results: One hundred fifty-six patients (median age 69 and 115 male) were enrolled into the study. Median age at diagnosis was 69 (range: 32–95 years). Male/female ratio was 2.80. The most common location was the lower limbs. There were 75 stage I patients (48.1%), 8 stage II patients (22.4%), 31 stage III patients (19.9%) and 15 stage IV patients (9.6%). Surgery was the most common local treatment method (43%). 44 patients (28.2%) received radiotherapy (RT) at diagnosis. Cytotoxic treatment with chemotherapy or interferon-α was administered in 57 patients. Visceral involvement was observed in 10 patients (lung: nine patients, liver: one patient) and bone metastasis occurred in two patients at relapse. Conclusion: This study is one of the largest reported series. Further studies are required and it will be important to standardize the assessment of disease activity and clinical response.Öğe The clinical and pathologic characteristics of 400 gastrointestinal stroinal tumor patients from Turkey: The final results of the Turkish Anatolian Society of Medical Oncology Multicenter Registery(Lippincott Williams & Wilkins, 2014) Sevinc, Alper; Seker, Mesut; Yildiz, Ramazan; Cihan, Sener; Kaplan, Mehmet Ali; Dane, Faysal; Karaca, Halit[Abstract Not Available]Öğe Clinical characteristics, treatment and survival outcomes in malignant pleural mesothelioma: An institutional experience in Turkey(Imprimatur Publications, 2014) Kucukoner, Mehmet; Kaplan, Mehmet Ali; Inal, Ali; Urakci, Zuhat; Abakay, Ozlem; Tanrikulu, Abdullah Cetin; Abakay, AbdurrahmanPurpose: To compare treatment modalities and investigate potential prognostic factors for survival in patients with malignant pleural mesothelioma (MPM). Methods: The present study has investigated the data of 150 patients with MPM who were examined and treated in our center from 2005 to 2012. Results: The study included 87 male (58%) and 63 female (42%) patients. Surgical resection (pleurectomy/decortications (P/D), and extrapleural pneumonectomy (EPP)) was performed in 32 (36.7%) patients; 87 patients (58%) received chemotherapy alone and 16 (10.7%) had surgery, chemotherapy and radiotherapy (trimodal treatment). The median progression free and overall survival (PFS and OS) for all patients were 10.6 and 14.8 months, respectively. No statistically significant difference was observed between the patients who received pemetrexed/cisplatin (N=54) and gemcitabine/cisplatin (N=28) in terms of PFS and OS (p=0.145, p=0.244, respectively). Also, no statistically significant difference was registered between operated and non operated patients (PFS and OS, p=0.416, p=0.095, respectively). There was no difference in both PFS and OS rates between patients who had P/D or EPP (p=0.87, p=0.652, respectively). Log rank analysis: Eastern Cooperative Oncology Group performance status (ECOG PS)(p=0.018), histology (p < 0.001), stage (p < 0.001) and leukocytosis (p=0.005) were found to be significant prognostic factors of OS. At multivariate analysis, ECOG PS (p=0.016) and stage (p < 0.001) were independent prognostic factors for OS. Conclusion: Median OS was approximately 1 year. ECOG PS, histological type, stage and presence of leukocytosis were prognostic factors that affected both PFS and OS. EPP or P/D surgical options did not provide difference in terms of survival. Survival rates in patients who received a combination of platinum analogues with pemetrexed or gemcitabine as front-line chemotherapy were similar.Öğe A Clinical, Radiographic and Laboratory Evaluation of Prognostic Factors in 363 Patients with Malignant Pleural Mesothelioma(Karger, 2010) Tanrikulu, Abdullah Cetin; Abakay, Abdurrahman; Kaplan, Mehmet Ali; Kucukoner, Mehmet; Palanci, Yilmaz; Evliyaoglu, Osman; Sezgi, CengizhanBackground: Malignant pleural mesothelioma (MPM) has a poor prognosis. Objectives: Only few studies in literature investigated the presence of pleural fluid and radiographic findings for the prognosis of MPM. Methods: We retrospectively investigated the hospital charts of 363 MPM patients who were diagnosed from January 1989 to March 2010. Survival time was calculated by the Kaplan-Meier method. Pretreatment clinical, laboratory and radiographic features of each patient at the time of diagnosis were obtained from patients' charts. Results: The mean age of 363 patients (217 men, 146 women) was 50.6 +/- 11.2 years (range 19-85) and the mean survival time was 11.7 +/- 8.6 months (range 1-53). Histological types of MPM were epithelial (71.2%), mixed (15.9%) and sarcomatous type (4.9%). The frequency of disease stages were 31.4% for stage 1, 24.2% for stage 2, 28.6% for stage 3 and 15.8% for stage 4. The most frequent symptoms were dyspnea (82.1%), chest pain (68.3%) and weight loss (58.9%). Results of univariate and multivariate analyses revealed that a Karnofsky performance score <= 60, a pleural fluid glucose level <= 40 mg/dl, a C-reactive protein level > 50 mg/l, a serum lactate dehydrogenase level > 500 U/l, the presence of pleural fluid, pleural thickening > 1 cm and a platelet count of > 420 x 10(3)/mu l were found to be associated with poor prognosis in MPM. Conclusions: Our data suggest that low pleural fluid glucose and high C-reactive protein, the presence of pleural fluid and pleural thickening were associated with poor MPM prognosis. Further prospective studies are needed to highlight prognostic factors more clearly. Copyright (C) 2010 S. Karger AG, BaselÖğe Disturbances of hematologic malignancies between 1995-2005: A single center experience from southeastern region of Turkey(Elsevier, 2006) Altintas, Abdullah; Kaplan, Mehmet Ali; Cil, Timucin; Atay, Ahmet Engin; Isikdogan, Abdurrahman; Ayyildiz, Orhan; Muftuoglu, Ekrem[Abstract Not Available]Öğe Efficacy and safety of raltitrexed combinations with uracil-tegafur or Mitomycin C as salvage treatment in advanced colorectal cancer patients.(Amer Soc Clinical Oncology, 2014) Ozkan, Metin; Bozkurt, Oktay; Karaca, Halit; Ozaslan, Ersin; Daloglu, Osman Onur; Ciltas, Aydin; Kaplan, Mehmet Ali[Abstract Not Available]Öğe Efficacy of palbociclib and endocrine treatment in heavily pretreated hormone receptor-positive/HER2-negative advanced breast cancer: Retrospective multicenter trial(Aves, 2020) Demir, Atakan; Mandel, Nil Molinas; Paydas, Semra; Demir, Gökhan; Er, Özlem; Turhal, Nazım Serdal; Bavbek, Sevil; Eralp, Yeşim; Saip, Pınar Mualla; Güler, Emine Nilüfer; Aydıner, Adnan; Uluç, Başak Oyan; Kılıçkap, Sadettin; Üskent, Necdet; Karadurmuş, Nuri; Kaplan, Mehmet Ali; Yanmaz, Mustafa Teoman; Demir, Hacer; Alan, Özkan; Korkmaz, Taner; Olgun, Polat; Uysal, Özlem Sönmez; Altundağ, Kadri; Gündüz, Seyda; Günaldı, Meral; Sarı, Murat; Beypınar, İsmail; Başaran, GülBackground: The synthesis of CDK4/6 inhibitors with endocrine treatment in two series of treatment has been widely accepted as the standard for patients with estrogen receptor-positive metastatic breast cancer. In spite of this, the activity of CDK4/6 inhibitors in patients with metastatic breast cancer who have progressed despite receiving multiple lines of treatment is not well understood. Aims: To report the activity and safety of a CDK4/6 inhibitor (palbociclib) in patients in whom at least three lines of treatment for ER+ metastatic breast cancer had failed. Study Design: Multicenter retrospective observational cohort study. Methods: In this retrospective observational cohort study, we included 43 patients who received palbociclib after at least three lines of systemic treatment for ER+/HER2- metastatic breast cancer. Results: The median progression-free survival in our population was 7 months (25th-75th percentile, 4-10), and the median overall survival was 11 months (25th-75th percentile, 6-19). Although there were some adverse events, palbociclib was generally well tolerated, so dose reduction was needed for only six patients (14%). Conclusion: The efficacy of palbociclib among heavily treated hormone receptor-positive/HER2- patients with advanced breast cancer was acceptable in terms of clinical benefit, and it was generally well tolerated among this population.Öğe Efficiency and Side Effects of Sorafenib Therapy for Advanced Hepatocellular Carcinoma: A Retrospective Study by the Anatolian Society of Medical Oncology(Asian Pacific Organization Cancer Prevention, 2013) Berk, Veli; Kaplan, Mehmet Ali; Tonyali, Onder; Buyukberber, Suleyman; Balakan, Ozan; Ozkan, Metin; Demirci, UmutBackground: Inoperable and metastatic hepatocellular carcinoma (HCC) is associated with a poor prognosis and low chemotherapeutic efficiency. Sorafenib is an oral multi-kinase inhibitor exerting its effects via the RAF/MEK/ERK pathway, vascular endothelial growth factor receptor (VEGFR) and platelet derived growth factor receptor beta (PDGFR-beta) tyrosine kinases. Randomized studies have shown a significant contribution of sorafenib to life expectancy and quality of life of cancer patients. The aim of the present study is to evaluate the efficacy and side effects of sorafenib therapy in Turkey. Materials and Methods: Data for 103 patients (82 males, 21 females) receiving sorafenib therapy in 13 centers from February 2008 to December 2012 were evaluated. Median age was 61 years and median ECOG performance status was 1 (range: 0-2). 60 patients (58%) had hepatitis B, 15 patients (15%) had hepatitis C infection and 12 patients (12%) had a history of alcohol consumption. All of the patients had Child scores meeting the utilization permit of the drug in our country (Child A). Results: A total of 571 cycles of sorafenib therapy were administered with a median of four per patient. Among the evaluable cases, there was partial response in 15 (15%), stable disease in 52 (50%), and progressive disease in 36 (35%). Median progression-free survival was 18 weeks and median overall survival was 48 weeks. The dose was reduced only in 6 patients and discontinued in 2 patients due to grade 3-4 toxicity, 18 patients (17%) suffering hand-foot syndrome, 7 (7%) diarrhea, and 2 (2%) vomiting. Conclusions: This retrospective study demonstrated better efficacy of sorafenib therapy in patients with advanced HCC compared to the literature while progression-free survival and overall survival findings were comparable. The side effect rates indicate that the drug was tolerated well. In conclusion, among the available treatment options, sorafenib is an efficient and tolerable agent in patients with inoperable or metastatic HCC.Öğe Epidemiological and clinical characteristics of malignant melanoma in Southeast Anatolia in Turkey(African Field Epidemiology Network-Afenet, 2016) Sula, Bilal; Ucmak, Feyzullah; Kaplan, Mehmet Ali; Urakci, Zuhat; Arica, Mustafa; Isikdogan, AbdurrahmanIntroduction: The present study aimed to establish the epidemiological and clinical characteristics of patients who were histopathologically diagnosed with malignant melanoma (MM). Methods: The present study retrospectively analyzed the data of 78 patients who were histopathologically diagnosed with MM in Dicle University Medical Faculty, Dermatology and Medical Oncology departments between 2005 and 2014. Results: The study included 78 patients in total with 44 (56.4%) male and 34 (43.6%) female. Median age of the patients was 62.50 years (range: 27 - 84 years). Of the patients, 78.2% (n=61) had cutaneous melanoma, 8.9% had solid organ melanoma, and 2.5% had ocular and mucosal melanoma. The most common tumor localization among the patients was the lower extremities with 29.4% (n=23). The most common histopathological type was nodular malignant melanoma with 35.8% (n=28). Based on TNM, Clark and Breslow classifications, 26.9% (n=21) of the patients were stage 4, 26.9% (n=21) were Clark stage 4, and 37.1% (n=29) were Breslow stage 4. Median overall survival in all patients was 14.9 months (95% CI 10.9 - 18.8 months). In the multivariate Cox analysis, only stage statistically significantly affecting survival [ odds ratio (OR): 0.54; (95% CI 0.16-1.82, p=0.02)]. Conclusion: Malignant melanoma data are also important for the optimal utilization of effective methods and healthcare resources to prevent the disease. In order to minimize MM mortality and morbidity, not only the society but also physicians from primary and secondary care hospitals should become familiar with melanoma.Öğe Hodgkin's disease in southeast region of Turkey: Clinicopathologic features of 138 cases(Oxford Univ Press, 2006) Altintas, Abdullah; Isikdogan, Abdurrahman; Ayyildiz, Orhan; Kaplan, Mehmet Ali; Cil, Timucin; Atay, Ahmet Engin; Buyukbayram, Huseyin[Abstract Not Available]Öğe The importance of acoustic radiation force impulse (ARFI) elastography in the diagnosis and clinical course of acute pancreatitis(Aves Yayıncılık, 2018) Kaya, Muhsin; Değirmenci, Mehmet Serdar; Göya, Cemil; Tuncel, Elif Tuğba; Uçmak, Feyzullah; Kaplan, Mehmet AliBackground/Aims: Acute pancreatitis (AP) is characterized by acute inflammation of the pancreas and it has a highly variable clinical course. The aim of our study was to evaluate the value of acoustic radiation force impulse (ARFI) elastography in the diagnosis and clinical course of AP. Materials and Methods: Consecutive patients with a diagnosis of AP (patients group) and healthy subject (control group) were prospectively enrolled to the study. Demographic features and clinical, laboratory, and radiological data were recorded. Virtual Touch Tissue Quantification (VTQ) was used to implement ARFI elastography. The tissue elasticity is proportional to the square of the wave velocity (SWV). Results: A total of 108 patients (age, 57±1.8 y) and 79 healthy subjects (age, 53.6±1.81 y) were included in the study. There were 100 (92.5%) edematous and 8 (7.4%) necrotizing AP. The mean SWV was significantly higher in the patient group than in the control group (2.43±0.08 vs. 1.27±0.025 m/s, p<0.001). There was not significant difference between patient and control group regarding age and gender. SWV cutoff value of 1.63 m/s was associated with 100% sensitivity and 98% specificity for the diagnosis of AP. There was not significant difference between patients with and without complications and patients with edematous and necrotizing AP regarding mean SWV value. There was also not significant correlation between mean SWV value and age, mean length of hospital stay, and mean amylase level. Conclusion: ARFI elastography may be a feasible method for the diagnosis of AP, but it has no value for the prediction of clinical course of AP.Öğe Increased anti-Echinococcus granulosus antibody positivity in Fasciola hepatica infection(Aves, 2012) Kaya, Muhsin; Bestas, Remzi; Girgin, Sadullah; Cicek, Muttalip; Kaplan, Mehmet AliBackground/aims: Parasitic helminths express some antigen, which often accounts for serological cross-reactions. The aim of this study was to determine the prevalence of anti- Echinococcus granulosus antibody in patients with Fasciola hepatica infection using indirect immunofluorescence assay. Materials and Methods: The study population consisted of the following groups: Fasciola hepatica group (n=22), hydatid disease group (n=22) and healthy control group (n=24). Indirect immunofluorescence assay for Echinococcus granulosus was performed in all groups. Results: Indirect immunofluorescence assay was positive in all patients with hydatid disease, in 13 of 22 (59%) patients with fascioliasis and in 2 of 24 (8%) healthy subjects. The positivity rate of indirect immunofluorescence assay was significantly higher in the hydatid disease group compared to the fascioliasis group (p<0.001) and compared to the control group (p<0.001), and it was significantly higher in the fascioliasis group compared to the control group (p=0.001). Antibody titer was 11100 in 7 patients, 11320 in 12 patients and 111000 in 3 patients with hydatid disease. Indirect immunofluorescence assay was positive in 10 of 15 patients with hepatic phase and in 3 of 7 patients with biliary phase of fascioliasis. The antibody titer was 11100 in 6 and 11320 in 7 patients with fascioliasis. The antibody titer was 11100 in both healthy subjects. Conclusions: Indirect immunofluorescence assay for Echinococcus granulosus may be positive in a majority of patients with Fasciola hepatica infection and in some healthy subjects.Öğe Increased bone mineral density in patients with non-alcoholic steatohepatitis(Baishideng Publishing Group Inc, 2013) Kaya, Muhsin; Isik, Devran; Bestas, Remzi; Evliyaoglu, Osman; Akpolat, Veysi; Buyukbayram, Huseyin; Kaplan, Mehmet AliAIM: To determine the relationship between non-alcoholic steatohepatitis (NASH) and bone mineral density (BMD). METHODS: A total of 38 patients (25 males) with a diagnosis of histologically proven NASH and 42 healthy controls (24 males) were enrolled in the study. Demographic features, clinical findings, complete blood count and routine biochemical analysis, as well as adrenal, thyroid and gonadal functions, were recorded. Additionally, intact parathormone, 25-OH-vitamin-D3, tumor necrosis factor-alpha, interleukin-6, interleukin-1, in-sulin-like growth factor-1 and insulin-like growth factor binding protein-3 levels were measured in both groups. Furthermore, lumbar spine and femoral neck BMD of both groups were measured by the dual-energy X-ray absorptiometry (DXA) method. RESULTS: The mean age was 41 +/- 12 years in the NASH group and 43 +/- 11 years in the control group. Among demographic features, waist circumference was significantly larger in the NASH group compared to the control group (P < 0.019). Among laboratory parameters, serum triglyceride (P < 0.008), alanine transaminase (P < 0.0001), aspartate transaminase (P < 0.001), alkaline phosphatase (P < 0.016), gamma glutamyl transferase (P < 0.0001), ferritin (P < 0.001) and 25-OH-vitamin-D3 levels (P < 0.0001) were significantly higher in the NASH group compared to the control group. Lumbar BMD was significantly higher in the NASH group compared to the control group (1.057 +/- 0.119 g/cm(2) vs 0.941 +/- 0.133 g/cm(2); P < 0.001, respectively). In the NASH group, there was no significant relationship between BMD and fibrosis stage in liver biopsy. CONCLUSION: NASH increases BMD and may be related to an elevated serum 25-OH-vitamin D3 level. (C) 2013 Baishideng Publishing Group Co., Limited. All rights reserved.Öğe Is the Pretreatment Neutrophil to Lymphocyte Ratio an Important Prognostic Parameter in Patients with Metastatic Renal Cell Carcinoma?(Cig Media Group, Lp, 2013) Cetin, Bulent; Berk, Veli; Kaplan, Mehmet Ali; Afsar, Baris; Tufan, Gulnihal; Ozkan, Metin; Isikdogan, AbdurahmanIn this study, we have undertaken a retrospective review of 100 patient charts to investigate whether neutrophil to lymphocyte ratio (NLR) is associated with progression-free survival (PFS) in metastatic renal cell carcinoma (mRCC) patients treated with second-line vascular endothelial growth factor (VEGF) targeted tyrosine kinase inhibitors (TKIs) after failure of interferon-alpha. We have shown that NLR at diagnosis is an independent predictor of survival in mRCC patients. Investigation of therapies which harness the immune response are warranted in this disease. Background: Tyrosine kinase inhibitor is a standard treatment for mRCC. The NLR, an index of systemic inflammation, is associated with outcome in several cancer types. To study the association of pretreatment NLR with PFS and overall survival (OS) of patients treated with VEGF-targeted therapy. Patients and Methods: We retrospectively studied an unselected cohort of patients with mRCC, who were treated with TKIs. Kaplan-Meier and log-rank analyses were employed on PFS and OS and multivariate Cox proportional hazard model analyzed clinical parameters for their prognostic relevance. Results: A total of 100 patients with mRCC who had early progressed after first-line therapy with interferon-alpha were included in this retrospective multicenter study conducted at 4 centers between February 2008 and December 2011. The median of the NLR was 3.04 and patients were divided into 2 higher and lower NLR groups according to median of NLR. Median PFS was 9 versus 11 months in patients with baseline NLR > 3.04 versus <= 3.04 (P = .009). The median OS was 16 months versus 29 months, in patients with NLR > 3.04 versus <= 3.04, respectively (P = .004). In the whole group OS was independently associated with higher NLR (hazard ratio [HR], 2.406; P = .004), PFS more than 6 months (HR, 4.081; P = .0001), and sex (HR, 2.342; P = .040). On the other hand in the higher NLR group (HR, 1.107; P = .009) Memorial Sloan-Kettering Cancer Center score (HR, 3.398; P = .0001) was associated with PFS. Conclusion: In patients with mRCC treated with VEGF-targeted therapy, pretreatment NLR, the duration of PFS might be associated with OS. This should be investigated prospectively. (C) 2013 Elsevier Inc. All rights reserved.Öğe Massive Metformin Overdose in Two Subjects with Suicidal Behavior: Brief Communication(Ortadogu Ad Pres & Publ Co, 2012) Arikan, Senay; Tuzcu, Alpaslan; Bahceci, Mithat; Kaplan, Mehmet Ali; Gokalp, DenizLactic acidosis is a well-recognized side effect of metformin, especially in patients with renal failure. Only a few cases of deliberate self-poisoning with metformin have been described in the literature. The mechanism of metformin-associated lactic acidosis is complex. In the absence of acute overdose, metformin-associated lactic acidosis rarely develops in patients without comorbidities such as renal or hepatic insufficiency or acute infection. We report two patients who had a large dose of metformin in an attempt to harm themselves and presented with lactic acidosis. In our experience, metformin intoxication may lead a high anion gap metabolic acidosis after a suicide attempt. Sodium bicarbonate infusion is able to correct the acid-base metabolism sufficiently in subjects with normal renal functions.Öğe Multicentric study on malignant pleural mesothelioma in Turkey: clinicopathologic and survival characteristics of 282 patients(Humana Press Inc, 2012) Elkiran, Emin Tamer; Kaplan, Mehmet Ali; Sevinc, Alper; Aksoy, Sercan; Demirci, Umut; Seker, Mesut; Harputluoglu, HakanMalignant pleural mesothelioma (MPM) is a relatively rare, but aggressive tumor that causes high mortality. The major risk factor involved in the etiology is environmental and occupational exposure to asbestos. The optimal modality of therapy is controversial. The present study retrospectively evaluated the data pertinent to 282 patients who were examined and treated in 11 different medical oncology centers in Turkey. There were 161 males (57.1 %) and 121 females (42.9 %), with a mean age of 56.38 +/- A 12.07 years. Surgery was used in 74 patients, 21 patients (28.4 %) received only chemotherapy and 28 patients (37.8 %) received chemoradiotherapy after surgery. The median survival in patients who were administered adjuvant therapy after surgery was 24 months, while the median survival in patients who had only surgery was 6 months (p = 0.029). 106 patients were administered pemetrexed-platinum combination and 35 patients were administered gemcitabine-platinum combination as front-line chemotherapy. Median survival, 1- and 2-year survival rates in patients who received platinum analogues and pemetrexed or gemcitabine combinations were found statistically similar (p = 0.15). The median survival for all patients with MPM in our study was 18 months. The main factors influencing the overall survival were stage of the disease (p = 0.020), performance status (p < 0.001), asbestos exposure (p = 0.030) and mesothelioma histological subtypes (p < 0.001). Results of our study suggest that multi-modality treatment regimens consisting of surgery, radiotherapy and chemotherapy prolong overall survival. Survival rates in patients who received combining platinum analogues with pemetrexed or gemcitabine as front-line chemotherapy were found similar.
