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Öğe Effects of treatment regimens on survival in patients with malignant pleural mesothelioma.(2013) Abakay A.; Abakay O.; Tanrikulu A.C.; Sezgi C.; Sen H.; Kaya H.; Kucukoner M.In this study, we aimed to investigate the factors affecting the survival of patients with malignant pleural mesothelioma (MPM) according to their treatment regimens, including best supportive care (BSC), chemotherapy, surgical group and multimodality (MM) therapy. A retrospective analysis was performed on clinical data and treatment outcomes of 400 patients registered in our hospital with MPM between January 1989 and April 2010. Mean age (p < 0.001), presence of asbestos exposure (p = 0.0014), presence of smoking history (p < 0.001), Karnofsky performance status (p < 0.001), histological subtype (p = 0.034) and stage (p < 0.001) variables were found to be significantly different among the four treatment regimens. Mean survival time of all patients was 12.32 months. Mean survival time 10.5 months for the BSC group, 15.7 for the surgical group, 16.02 for the chemotherapy group, and 26.55 for the MM group. There were significant differences in mean survival time among the four treatment regimens. In addition, a significant difference was found in survival time between the two chemotherapy groups (p = 0.032). Mean survival time for cisplatin + gemcitabine was found to be 14.49 months and for cisplatin + pemetrexed, 18.34 months. The MM group had better survival rates than the other groups. The new chemotherapy combination, cisplatin + pemetrexed, can be helpful in improving survival time.Öğe Environmental malignant pleural mesothelloma in Southeast Turkey(2006) Tanrikulu A.C.; Senyigit A.; Dagli C.E.; Babayigit C.; Abakay A.[No abstract available]Öğe Fibulin-3 as a diagnostic biomarker in patients with malignant mesothelioma(Asian Pacific Organization for Cancer Prevention, 2015) Kaya H.; Demir M.; Taylan M.; Sezgi C.; Tanrikulu A.C.; Yilmaz S.; Bayram M.Background: New tumour biomarkers are being intensely investigated for malignant mesothelioma (MM). Fibulin-3 is produced in MM but its role remains uncertain. The aim of this study was to evaluate the validity of measuring serum fibulin-3 in the diagnosis and prognosis of MM. Materials and Methods: This prospective study was performed on 43 patients and 40 healthy controls who were admitted to our hospital between January 2012 and January 2014. Data from MM patients, including demographic and clinical features, routine laboratory data, levels of serum fibulin-3, and treatment outcomes were defined as potential prognostic factors. The receiver operating characteristic (ROC) curve for fibulin-3 was used to detect the cut-off value with highest sensitivity and specificity. Univariate survival analysis was performed using the Kaplan-Meier method in patients with MM. Afterwards, the possible factors identified with univariate analyses were entered into the cox regression analysis. Results: Our results revealed that patients with MM had significantly higher serum levels of fibulin-3 than controls. The results showed that the best cut-off point was 36.6 ng/ml with an AUC (area under the curve)=0.976, sensitivity=93.0% and specificity=90.0. In our study, the initial significant poor prognostic factors were advanced stage, high white blood cell count, high platelet count, high C-reactive protein (p<0.05 for each variable). Later, according to multivariate analysis the results showed only advanced stage as significant parameter (p=0.040). Conclusions: We determined that real use for serum fibulin-3 was not for prognosis but for diagnosis in MM. Also advanced stage was associated with poor MM prognosis.Öğe An overview of thrombolytic treatment for pulmonary embolism: A single Centre experience(Acta Medica Mediterranea, 2014) Şen H.S.; Abakay Ö.; Sezgi C.; Yilmaz S.; Taylan M.; Kaya H.; Tanrikulu A.C.Introduction: A massive pulmonary embolism (MPE) has a poor prognosis and high mortality. Thrombolytic therapy is preferred in patients with life-threatening symptoms such as hypotension, cardiogenic shock, and right ventricular failure due to the risk of severe bleeding. Materials and methods: This is a retrospective analysis of patients who were hospitalized with the diagnosis of pulmonary embolism (PE) and given thrombolytic therapy in the chest diseases clinic of a tertiary university hospital between January 2008 and November 2013. Results: The subjects' mean age was 59.54 ± 13.76 years. Fourteen of 39 patients who were treated with thrombolytic therapy were male (35.89%) and 25 (64.10%) were female. The symptoms experienced by the patients included dyspnea in 39 patients, chest pain in 35 patients, hemoptysis in 6 patients, syncope in 13 patients and cough in 10 patients. Risk factors were advanced age (> 60 years) in 19, immobilization in 19, malignancy in 3, major surgery in 11 patients. The in-hospital mortality analysis showed that 32 patients were discharged and 7 patients died. Four patients died from their pulmonary embolism and 3 patients died because of a major bleeding complication. Conclusions: Pulmonary embolism is a disease that may lead to death within hours secondary to acute right heart failure. Early diagnosis and treatment can be life saving. Thrombolytic therapy has been shown to improve hemodynamic parameters in the early period post-PE. An increased risk of bleeding is one of the most important drawbacks of thrombolytic therapy. Nonetheless, it can be a life-saving therapy in properly selected patients.Öğe Pericardial involvement of malignant pleural mesothelioma: Comparison of two imaging methods(2005) Tanrikulu A.C.; Özdemir L.; Eren Da?li C.; Şenyi?it A.; Aritürk Z.Malignant pleural mesothelioma (MPM) tends to progress locally. Data relating pericardial involvement is limited. In this study, the relationship between pericardial involvement and the severity of the disease was investigated. Total of 27 MPM patients; 9 (33%) female, 18 (67%) male who were followed-up between January 2001-December 2003 in Chest Diseases and Thoracal Surgery departments of Dicle University Hospital were included to the study. The mean age was found as 51.8+- 12.3 (22-82). Of patients 23 (85%) had asbestos exposure and it was environmental. Of patients, 22 ( 82%) was diagnosed by pleural biopsy, 5 (18%) by operative methods. Epithelial type was detected in 11 cases, mixed type in 3 cases and sarcomatous type in 1 case. Type detection could not be done in 12 patients. Stage 1 included 18 (67%) patients, stage 2 included 8 (29%) patients and stage 3 included 1 (4%) patient. Pericardial involvement was investigated by echocardiographic method. Totally 19 (70%) patients were found to have pericardial involvement. Of these cases; 9 patients had pericardial thickening, 8 had increasement of pericardial echogenity, 2 had pericardial mass and 2 had pericardial effusion. No relationship was detected between the stage of the disease and echocardiographic pericardial involvement. Torax CT of 4 patients showed pericardial involvement. Pericardial involvement in MPM patients occurs frequently. This involvement can be detected by echocardiography easily. In these cases, routine echocardiographic investigation is a non-invasive, cheap and usefull method.Öğe Primary giant hydatid cyst of the diaphragm.(2004) Eren S.; Ulku R.; Tanrikulu A.C.; Eren M.N.We report a case of an hydatid cyst of diaphragma in a 34-year-old female who was admitted to our clinic for right basithoracic pain. Magnetic resonance imaging (MRI) reported a giant hydatid cyst including multiple vesicles at the right lower thoracic cavity. Surgical exploration revealed an independent giant diaphragmatic hydatid cyst. We performed cystotomy and more than 200 daughter vesicles were removed from the cyst. The rest of the giant cyst cavity was excised.Öğe A Rare Hydatid Cyst Involvement: Bilateral Pulmonary Artery (Case Report)(2010) Abakay A.; Gümüş H.; Tanrikulu A.C.; Atilgan Z.A.; Avci A.Hydatid cyst is a parasitic disease that may involve many organs. Hydatid cyst with pulmonary artery involvement is a very rarely encountered form. It was aimed to present a rare bilateral pulmonary artery involvement determined in a 61-year-old male case with hydatid cyst. In our case, the lesions were determined in many segments of bilateral lungs, right atrium lateral wall of the heart and in many branches of bilateral pulmonary artery. Pathological evaluation of the patient underwent surgery for the cardiac mass revealed hyda-tid cyst. The patient, who refused the proposal of surgery for the lesions in lungs and pulmonary artery, was given medical drug therapy. We think that it may be helpful to include hyda-tid cyst in prediagnosis list for the patient applied to a doctor with multiple cystic or nodular images.Öğe Rifampycine induced trombositopenia: A case report(2010) Tanrikulu A.C.; Abakay A.; Turan H.Tuberculosis (TB) is still remained serious public health problem. Anti-TB treatment is given twice weekly caused by immun thrombocytopenia. This complication is rare when the medication is given in small daily doses (10 mg/kg). 16 years old man case with anti-TB is given daily doses (10 mg/kg) but to develop this complication is reported. This patient had applied to emergency service with epistaksis and is administered symptomatic therapy. Patients who had taken anti-TB treatment this complication to retain and should be follow.Öğe The value of new inflammatory parameters in Malignant mesothelioma prognosis(Acta Medica Mediterranea, 2015) Tanrikulu A.C.; Hocanli I.; Yilmaz A.; Meteroglu F.; Taylan M.; Demir M.; Kaya H.Aim: Malignant mesothelioma (MM) has a poor prognosis. Inflammation is associated with MM prognosis and symptoms. Several inflammatory markers were investigated to estimate MM prognosis. We investigated the role of available inflammatory index and markers for MM prognosis. We developed the advanced mesothelioma index (AMI) to assess the degree of inflammation in MM. Materials and methods: We performed a retrospective study of 202 MM patients (116, male, 86 female) evaluated at Dicle University. Demographic parameters and laboratory data were collected. The AMI was calculated as Body Mass Index*serum albumin value (g/dl)/platelet-to-lymphocyte ratio. Results: The mean age of patients was 59.04 years. A total of 135 (66.8%) patients showed epithelial-type histopathological subtypes and 177 patients had pleural MM. The mean survival time was 13.1±11.5 months in the all MM patients. Twenty-four potential prognostic factors were associated with a poor outcome and then analyzed in the univariate analysis. Eighteen of them were definitely associated with a poor prognosis. These 18 potential prognostic factors were analyzed in the multivariate analysis. Based on the results of the multivariate analysis, only patients with an AMI<0.5 had an associated poor prognosis. An AMI<0.5 increased the mortality rate by 10.47. Furthermore, low AMI was associated with other bad inflammatory markers (such as high platelet count, high C reactive protein level, low Body Mass Index, low albumin and low hemoglobin). Conclusion: Our findings indicate that the AMI can be used to assess the degree of systemic inflammation.
